Mark Williams is shocked Canada doesn't provide screening for perinatal mental illness for women or men.
The dad of one, who lives in Wales, had his first panic attack during the birth of his son, Ethan. His wife, Michelle, had been in labour for 22 hours before being told she needed an emergency C-section.
"No one told me what was going on," Williams told HuffPost Canada. "I thought both my wife and baby were going to die."
Michelle was diagnosed with severe postpartum depression in the months following and Mark's symptoms worsened. He started to feel depressed and suicidal.
"I saw a woman I love go to hell and back but felt I couldn't tell anyone how I was feeling due to stigma," Williams said. "My personality totally changed. I was avoiding situations, drinking more than ever and starting fights. I didn't know dads could suffer from postpartum depression."
WATCH: Dads get postpartum depression, too. Story continues below video.
When Williams finally got the help he needed, he began advocating for perinatal mental illness screening for men in the U.K. where screening for women already exists. He wrote a book called Daddy Blues, founded Fathers Reaching Out, and started an online petition.
His efforts paid off just this past December, when NHS England announced it would begin providing perinatal depression screening to new and expectant fathers, a development they themselves call "landmark" and "radical." Now that the U.K. is on board, Williams is targeting Canada, as well as other countries that don't screen for perinatal mental illness.
"I'm shocked that no one is screening moms or dads for their mental health in Canada," Williams said. "It causes relationships to end, substance abuse, the poor development of children and sadly, suicide."
Canadian dads are at risk for depression
While perinatal mental illness affects up to 20 per cent of women, the latest research pegs men's prevalence at 8.4 per cent with previous studies putting it in a range of anywhere from four to 25 per cent. In Canada, one study revealed that more than 13 per cent of expectant fathers experience elevated levels of depressive symptoms.
Another study points out that 80 per cent of men in Canada won't get help unless their partner convinces them to.
"The new U.K. guideline is an excellent start to identifying and addressing the mental health needs in men," Dr. Andrew Howlett, a psychiatrist at St. Joseph's Health Centre in Toronto, told HuffPost Canada.
"It would be great if Canada or the provinces and territories implemented screening for both women and men for common conditions such as depression during the transition to parenthood in order to initiate appropriate support and minimize the impact of mental illness on their relationship with their children and their child's development."
Howlett co-founded the Fathers Mental Health Network along with fellow Mount Sinai Hospital psychiatrist, Dr. Benjamin Rosen. For the past five years, Howlett and Rosen have been providing psychiatric services to soon-to-be dads, or new fathers who are struggling with mental health issues such as depression.
"Many men feel too ashamed and embarrassed to acknowledge that they are struggling during and after the pregnancy and may be reluctant to ask for help," Rosen told HuffPost Canada. "As a result, many men we see don't know how common their experience is and tend to feel isolated in their suffering."
The greatest risk factor for the development of postpartum depression in men is having a partner with postpartum depression. Men may be at greater risk of employment-related stress and loss of social supports during the postpartum period, which may also contribute to the development of their depression. There is also evidence that a drop in the hormone testosterone in men following their partner's labour may lead to postpartum depression.
Postpartum depression in men can look more angry than sad
While men and women can present with similar symptoms such as low mood, loss of interest, negative thoughts, and changes in sleep, energy and appetite, there are often differences in the way men and women express and acknowledge their depression.
"Men are more likely to present with symptoms such as anger, irritability and avoidance rather than sadness and negative self-talk," Rosen said. "Men are more likely to cope by using substances or working to the point of burnout."
While the specific treatments are often the same, the approach to delivering treatment may be different. There may be greater focus on reducing stigma, and providing education about the important role that fathers plan in child development.
"Fathers are sometimes more motivated to make changes for the wellbeing of their children and families, rather than themselves," Rosen said. "I would love to see screening for perinatal depression be incorporated into routine care for both parents."
Are you in a crisis? If you need help, contact Crisis Services Canada at their website or by calling 1-833-456-4566. If you know someone who may be having thoughts of suicide, visit CAMH's resource to learn how to talk about suicide with the person you're worried about.
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