Dads and Perinatal Mood and Anxiety Disorders

“We’re pregnant!” As a Dad of now four kiddos, I remember the mix of excitement and terror that came with our first positive pregnancy test. I also remember feeling for the first time (and truthfully still live with) a unique brand of anxiety that goes along with being a parent.

It is very normal to experience symptoms of anxiety and depression while expecting and after the arrival of a newborn. Symptoms of anxiety can include restlessness, feeling keyed up or on edge, being easily fatigued, difficulty concentrating, muscle tension, and sleep disturbances such as troubling falling or staying asleep. Symptoms of depression can include depressed mood, loss of interest in previously pleasurable activities, sleep disturbance, fatigue, feelings of worthlessness, indecisiveness, and thoughts of death or suicide. If you are noticing that these symptoms are persisting or increasing in yourself or your partner, you may be experiencing what is known as a perinatal mood and anxiety disorder (PMAD). Did you know that 1 in 7 women and 1 in 10 men experience a PMAD? To put that in context, that’s a minimum of 3 to 5 parents of students in a class size of 30.

What to know and expect about a PMAD? To begin, it is not the fault of the Mom or Dad and no one did anything wrong to bring the symptoms on. In my work as a clinical therapist, I know that people can under-report the intensity, frequency and duration of their depressive and anxious symptoms. There are a variety of reasons for this, including not wanting to feel like a burden in general or to their spouse in specific, not knowing how to talk about feelings that are persistent and even scary at times, feeling guilt or shame, as well as just being overwhelmed and too exhausted to take note of what is being experienced. The reason for sharing this is that if you are noticing that you or your partner are exhibiting symptoms of anxiety and/or depression, those symptoms could be more intense than you are observing and are likely going to be under-reported by your partner.

What can you do? As a Dad, you are going to feel tired and overwhelmed at times too. Have you felt as a Dad that more is being expected of you? That’s probably because it is! In his book, The New Rules of Marriage, Terry Real talks about 21st century expectations for marriage and how they have shifted. He extends this to indicating that expectations for us as Dads have increased and rightfully so. Taking a hard look at ourselves and how we can share in the hard work of managing the household (e.g., cooking, laundry and cleaning) and talking about this with your partner would be helpful.  

You can be empathetic and show understanding by asking open-ended questions. For example, two great questions are: “What can I do to help?” and “What do you need from me?” Additionally, be prepared for your partner have different answers to those questions depending on the day or that your partner may not be able to speak what they need in the moment. That is totally okay.  On this note, another way to be helpful is to take initiative without being asked. A key point here is communicating with your partner to see if they want to be asked, prefer you take initiative, or a combination of both.

You can encourage self-care for your partner and for you. You can encourage rest, exercise, socializing with friends and prepare healthy meals. You can go with your partner to see the doctor and/or to see a therapist. One avenue to consider when seeking therapy is that many companies and plans have what is called an Employee Assistance Program (EAP). EAPs typically authorize a certain number of sessions (often 3 to 4) that are no cost to the employee or spouse.

Finally, you can get informed and seek out support from people who have been there or who are currently going through what you are…you are not alone! You can communicate with your partner and loved ones in a caring yet direct way that you are concerned about them. The links below are two great places for Dads to start…

http://postpartumdads.org/

You got this and will get through it! There is hope!


-Written by Joe Halaiko, LPC-IT, SAC-IT

Joe Halaiko, LPC-IT, SAC-IT specializes in relationship concerns, trauma, grief/loss, managing chronic illness, depression, substance abuse and anxiety. He has prior experience in human resources and can help people strategize on work issues or navigate career transitions. He works with adolescents, adults, couples and families to develop goals tailored to each of their individual needs. He uses an integrated approach, drawing on Person-centered, Existential/Humanistic and Narrative models, as well as using Cognitive Behavioral and Motivational Interviewing strategies. He plays guitar, and believes in the power of creativity, possibility and compassion.

Therapy from the Therapist’s Perspective

In this post, Stacy Stefaniak Luther, PsyD, LPC, answers some questions about therapy and what a new mom can expect should she decide to seek help from a trained therapist.

What are some opening thoughts you’d like to share about therapy?

Visiting a therapist can be very intimidating. It takes courage not only to schedule that first appointment but also to attend that appointment. It can be weird, or awkward, to share your personal story with a stranger. Despite these facts, therapy is an effective way to tackle a variety of mental health concerns including those experienced with a perinatal mood or anxiety disorder. Furthermore. therapy can also serve as a means of self-care, which can be difficult to schedule with an infant but is also critically important to mom’s overall well-being.

As a therapist, I recognize the strength it takes to walk into the office each session and bare your soul; sharing intimate details of yourself and your life. But there is something so special about each individual’s story and the details of this story are worked into the therapeutic approach. Therapy is grounded in research, but treatment isn’t one-size-fits-all.

What can I expect at my first session?

Typically, the first session is a “get-to-know-you” session where the provider will ask a lot of questions and you will be encouraged to ask questions as well. Information about follow-up sessions is discussed at this time in addition to diagnosis, treatment, informed consent, confidentiality, and other more technical aspects of therapy. The first impression during this session is critically important. If you are not comfortable, (say so!) and ask about different providers. A client needs to feel comfortable sharing details that may be private and sensitive; therefore, finding a provider who is a good-fit is essential. Professionals will never be offended if the relationship spark just isn’t there. The relationship is the catalyst for healing so don’t be discouraged if finding the right partnership takes time.

How long is a typical session?

Therapy sessions are anywhere from 30-60 minutes, with 45 minutes being average. During these sessions, you are invited to sit back, relax, and share. The therapist will listen and help you reflect. You will also have the opportunity to learn and practice different skills outside of session. Most importantly, there will be validation that the emotions you are experiencing and the thoughts you are having are real and okay.

How often do I need to come to session?

There are many factors that contribute to scheduling future sessions. Typically, although each situation is unique, you will be asked to schedule 1 session a week (or every other week). During these sessions, your willingness and ability to be open and vulnerable is instrumental in determining the effectiveness of therapy.

Can I bring my baby (and/or my older children) to therapy?

If it serves as a barrier to treatment, a good therapist will encourage women to bring infants (and other children) to session if they want to (or have to). Other times, a mom who is able, might choose to find childcare so that she can enjoy her session independently. It is up the mother to determine what she is most comfortable with and what her lifestyle allows.

What is a therapy office like?

Offices are set up in a variety of different ways, yet all are designed to promote comfort and ease. These are not like your primary care provider’s office. Therapy offices are set up with a home-like atmosphere and often reflect the therapist’s personality.

What is a final message you’d like to leave our readers with?

One theme that is extremely common for the women I work with is how alone they feel. The truth is, there are others out there who have had similar experiences or who are currently experiencing the same difficulties. The women I work with have struggled with infertility, experienced the heartbreak of miscarriage, stillbirth, and infant loss. I’ve seen women who did not want to be pregnant or have children who become pregnant, women who struggle to bond with their infant, women who experience intense, frightening intrusive thoughts, women who are sad, women who are scared, women who don’t feel like themselves…the list goes on. It is so important to know that you are not alone. Perinatal mood and anxiety disorders exist but so does treatment. There is no shame in asking for or receiving help!

We would like to thank Stacy Stefaniak Luther, PsyD, LPC, for sharing her perspective with us. If you would like to learn more about Stacy and/or are local to central Wisconsin and would like to schedule an appointment with her, you may find more information on her website: http://www.bhcwausau.com/learn-stacy-luther-ms/ .