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New fathers’ depression is not narcissism

What is your response to learning that there is a treatable but often undiagnosed medical condition that could mean that a baby is significantly more likely to require medical intervention for speech and language development? What if research had found the same condition led to the child being vastly more likely to develop behavioural problems and peer relationship problems? What if it could be affecting one in 30 newborn babies, or about 25,000 children every year in the UK alone, while minimal efforts are made to intervene?

If you’re a compassionate, empathic human being you probably feel a twinge of concern, maybe think more should be done to investigate, identify and treat the problem at the earliest stage. If you’re a national newspaper columnist, you might feel differently.

Harsh? Not if the condition we are discussing is paternal depression. It was the Daily Mail’s resident GP Robert Lefever who set the tone last week, reporting on a small study by Oxford University scientists that compared the communications of depressed and non-depressed fathers with their newborns. Lefever misreported the study’s findings as being that 5% of fathers develop post-natal depression. He went on to sarcastically ask whether men would get pre-menstrual tension next, and revealed his true colours by worrying that “politicians, of the bleeding heart tendency, will say that these men should be treated sympathetically – at the expense of their employers”.

Not to be outdone, Barbara Ellen of the Observer chipped in with a piece of almost breathtaking heartlessness. “I would have been more concerned that the mothers in question were having to put up with such exhausting narcissists as partners,” she opined, “men incapable of hiding their sulky self-absorption, even while being watched by researchers for a period of, wait for it, three minutes. Even serial killer Ted Bundy managed to look ‘normal’ for longer than that.”

Let’s clear up a few misconceptions. Postpartum or postnatal depression (PND), as clinically understood, is a complex and extremely serious mental health condition affecting somewhere between 10% and 30% of new mothers. Although it has some social factors, the primary causes are widely believed to be physiological, notably hormonal fluctuations triggered by pregnancy, childbirth and lactation. Men do not get PND by that definition, and that is why the scientists working in the field rarely, if ever, use the term. Instead they talk about “depression in the postnatal period” “paternal depression” or in the case of the latest study, “background depression in men”. The assertion that these men are suffering from PND, directly equivalent to maternal PND, seems to be the invention of journalists, not scientists, and certainly not the men themselves.

Can fathers of new children be depressed? Of course they can. Some may have been living with the illness long before the birth or pregnancy, others may slip into depression as a consequence of the stress and lifestyle changes brought about by the new arrival. Nobody with the faintest awareness of mental health should be surprised by this, and nobody with understanding of depressive illness should be glibly dismissive of the possible consequences.

Both Lefever and Ellen strongly imply that paternal depression is little more than whiny men wishing to jump aboard the PND bandwagon. Their prescription would appear to be: man up and suck it up. The reality emerging from medical and psychological research is precisely the opposite. Again and again, researchers point out that the biggest problem is that many men will not admit to depression and will not seek help when needed. The results are not only huge developmental risks to children, but also unnecessary suffering to the individual and raised risks of physical illness, self-destructive behaviour, loss of employment and in severe cases suicide or even murder-suicide. Researchers like SethnaRamchandani and Nazareth are pressing for greater diligence and awareness of these issues among health workers, precisely because of the tendency of fathers, and men more generally, to simply “man up”, often with disastrous consequences for everyone.

With a heavy heart, I’ve come to accept that there is a significant minority of both women and men who simply do not care about men’s health and welfare beyond its impacts on the female partners who might have to “put up with such exhausting narcissists” or the poor employers who might have to fork out sick pay for seriously ill employees. Those who genuinely feel like that can wrestle it out with their own consciences. But when such people use national newspaper columns to disparage and undermine medical research that strives to address tragic impacts upon tens of thousands of children, the rest of us should surely unite in revulsion.