'I just felt empty': Understanding perinatal anxiety and depression in fathers

Trent Gallucci knew quite quickly after the birth of his first son in June 2021 that something felt wrong.

"I just felt empty," he says.

"The miracle of childbirth had happened, and the miracle of modern medicine had allowed him to be here … but it was a really weird feeling," the 31-year-old who lives on Gadigal land in Sydney says.

At the 30-week mark of the pregnancy, he came home from work and his wife Stella said she wanted to go the hospital.

"The baby hadn't been kicking all that much and she just wanted to go to the hospital and get it checked out."

She spent the night there and Trent came back the next day expecting to drive her home, but Stella had an emergency caesarean hours later.

"We had a number of specialists, the paediatrician, the anaesthetist and some social workers come to speak to us about the risk factors of having a premature birth, risk factors regarding an emergency caesarean and just all those risk factors … it hits you."

After the first few days, Trent felt hollow instead of the elation he'd expected. He says feelings of guilt and then fear followed.

How common is perinatal anxiety and depression in fathers?

Danya McStein, a psychologist and clinical team manager for Gidget Foundation Australia, says while perinatal depression and anxiety is less common in men it is still "relatively common".

She says fathers or non-birthing parents can experience perinatal depression and anxiety during pregnancy or after the baby's arrival.

There has been a recent call for fathers to receive mental health screening alongside their partners, part of a submission set to be canvassed by a parliamentary inquiry into postpartum health care in Australia.

An associate professor in the School of Psychology at Deakin University in Naarm/Melbourne, Jacqui Macdonald, says in large-scale studies about one in 10 fathers present with depression, anxiety or psychological distress, but these experiences could be more prevalent.

"We think that's potentially an underestimate and one of the main reasons for that is the measures that we use are less likely to pick up typical presentations of men's mental health problems," the convener of the Australian Fatherhood Research Consortium says.

"Often men have been socialised to externalise their mental health concerns," she says, and externalising symptoms can look like anger, aggression or risk-taking.

What are the symptoms for men?

"If you have postnatal depression, your mood is usually affected, while if you have postnatal anxiety, you will experience feelings of worry or fear that are difficult to control," according to the Pregnancy, Birth and Baby website, operated by Healthdirect.

Ms McStein says some symptoms — such as a change in mood over a period, low mood and feeling less motivated — can unfortunately be common when you're sleep deprived with a newborn.

But someone losing interest in something they usually enjoy, withdrawing socially from colleagues or friends, worrying excessively about the pregnancy, the baby or their own health and intense self-criticism can be signals to look for, she says.

Trent's son Xavier spent about 10 weeks in a neonatal intensive care unit (NICU) and special care across two hospitals, and Trent says while he felt "unconditional love" for his son, he also felt sad and angry.

"I'm quite a level-headed person and … little things upset me more than what they usually would," he says.

The "massive red flag", Trent says, is that he wasn't experiencing joy, and none of his usual go-to activities — sport, water or music — helped.

"I'd just sit behind the drum kit and look at my sticks."

Trent says it's obvious that he was experiencing perinatal depression, "but at the time it wasn't obvious at all".

How to find help for prenatal depression and anxiety?

Trent had never interacted with a mental health service before, but about six weeks after Xavier was born, he called the number on a Gidget Foundation flyer.

The foundation is a not-for-profit that provides clinical services to potential, expectant and new families.

The process for accessing counselling was outlined clearly, but the idea of going to the GP and asking for a mental health assessment was still "daunting", Trent says.

"I felt like I was being selfish and a bit of a failure as a father to reach out."

But two weeks after making that call, he spoke with a therapist.

If someone feels like they're struggling to cope with the transition to fatherhood, Ms McStein says ideally, they recognise that and speak with their doctor.

"Early intervention is going to be the most effective mechanism for recovering from perinatal anxiety and depression."

Dr Macdonald also suggests filling out an online screening questionnaire as a potential starting point. Lots of mental health services — such as Beyond Blue — have them, she says.

Connecting with fathers' groups in your area can also be helpful as "social connection is critical".

"If you can regenerate and rejuvenate your mental health through the connections that you have with someone, you're going to be able to give back more to your partner and to your children," Dr Macdonald says.

'Very treatable'

Dr Macdonald says the early parenting period is set up to support mothers and infants, and fathers are typically "considered the support person".

But she says the transition to fatherhood involves a "massive psychological change" and "our system isn't asking men at this stage, 'Are you doing OK?'".

Ms McStein adds that sometimes men don't know what help is available."

"Depression and anxiety are very treatable," she stresses.

Trent says he did feel like acknowledging and accessing help as a father was still a bit taboo.

"I don't know if it's an instinctual thing. I don't know if it's a hardwired thing. I will say I think it is changing," he says.

"I think it is getting better and it will continue to get better as more and more generations go on."

This is general information only. For detailed personal advice, you should see a qualified medical practitioner who knows your medical history.