New Dad Anxiety

If you are struggling right now

If you feel unable to keep yourself or anyone else safe, call 999 or go to A&E. If you need to talk to someone tonight, Samaritans is free to call on 116 123, at any time, from any phone. Tommy's directs partners to that same number, and adds that getting help for yourself also means you are better able to support your partner and baby.

Anxiety after a baby is not only a maternal condition

The perinatal literature has been slow to look at fathers and partners at all. The Scottish Government's evidence review on paternal perinatal mental health opens by acknowledging "a relative lack of attention in research, policy and service provision around the mental health implications of the transition to parenthood for fathers", and concludes that evidence shows there may be an elevated risk of depression and anxiety among fathers in the perinatal period, affecting their own wellbeing and their relationships with partners and children.

Mind's information for partners makes the same point from the clinical side: partners can develop mental health problems around this time, and whether or not a professional calls it "postnatal" is a labelling argument that does not change what you need.

What it actually looks like

PANDAS, which supports parents through perinatal mental illness, lists the psychological signs of anxiety as feeling anxious all or most of the time and being unable to control it, restlessness, excessive worry, a sense of dread, being unable to concentrate or feeling that your mind goes blank, irritability, feeling constantly on edge, difficulty falling or staying asleep, and catastrophising with unwanted negative thoughts.

It lists the physical signs as a racing heartbeat, a feeling of dread or fear of dying, chest pain, shortness of breath or hyperventilation, dizziness, excessive sweating, feeling faint, shakiness, tingling in the hands or feet, a churning stomach, and aches and pains.

In new fathers and partners this often presents in a specific shape: checking the baby is breathing repeatedly through the night, an inability to leave the house without running through disaster scenarios, a rigid need to control the routine, and a permanent low-grade dread that something is about to go wrong. It can also present as irritability and short temper, which is why it is so often mistaken for a character problem.

The difference between worry and an anxiety disorder

PANDAS puts it usefully: anxiety is a normal response to a situation perceived as difficult or threatening, and it normally stops when you get used to the situation, when the situation changes, or when you leave it. With an anxiety disorder the sense of dread does not go away, and if left untreated it can lead to depression and a paralysing fear of ordinary activities.

The NHS describes generalised anxiety disorder as anxiety about a wide range of situations rather than one specific thing, where the feeling is difficult to control and affects daily life. That is the threshold worth using: not how frightening it feels, but whether it is running your day.

Why it goes unnoticed

Nobody asks. Every antenatal and postnatal contact is built around the birthing parent, so the routine mood questions are directed at them. The Scottish Government's review found that current perinatal mental health services overlook the mental health needs of men, with low levels of practical accessibility such as appointments outside working hours, and a lack of awareness and training in the workforce.

It also found that fathers are more likely to conceal or not disclose their mental health concerns, partly out of concern that doing so would detract from the needs of their partner or children, and that GPs are a preferred route but that many men only contact a GP once symptoms are severe or unmanageable.

That is the trap. The instinct to protect your partner by saying nothing is exactly what delays treatment until it is harder to treat.

What actually helps

Tell one person out loud

Tommy's advice to partners is to talk to someone if you feel you are not coping or often feel angry or stressed: friends, family, your GP or your health visitor. It notes explicitly that your health visitor is there for you as well as your partner, which is the single most under-used route to help that partners have.

Use the treatment routes that exist

The NHS offers talking therapies for anxiety and depression, and in England adults can be referred by a GP or refer themselves directly, provided they are registered with a GP. Cognitive behavioural therapy, counselling and guided self-help are among the options. This is a normal, unglamorous route and it works for a large proportion of people who use it.

Mind adds that a GP can refer you to local support services or talking therapies, and can also prescribe medication for mental health problems. Which medicine, if any, and at what dose, is a decision for your own doctor and not something to read off the internet.

Fix the sleep and the alcohol before you conclude it is character

PANDAS lists sleep deprivation and alcohol or drug misuse among the common risk factors for fathers' mental health difficulties. Both are treatable inputs. If your household has no arrangement that gives you one unbroken block of sleep, that is worth changing before you decide the problem is you.

Peer support, not just professionals

The Scottish Government's review found that many men prefer informal support, that partners are an important source of support but risk being the only one, and that a lack of peer support, particularly for first-time fathers, can have a negative impact on mental health. Tommy's points partners towards UK-wide talking groups for men run by Andy's Man Club, and PANDAS runs a free bookable call service and WhatsApp support for anyone affected, including partners.

When to go sooner rather than later

Go now if the anxiety is stopping you sleeping when the baby sleeps, if you are avoiding being alone with your baby, if you are having intrusive thoughts that frighten you, or if you have started drinking to take the edge off. PANDAS notes that symptoms lasting two to four weeks or more are worth taking to a GP or midwife, and that early recognition, support and treatment benefits the whole family.