This week marks Perinatal Mental Health Week, with health experts in Australia calling for more awareness of how it affects both men and women. Here, a father and a mother share their stories.
Content warning: this article contains references to suicide
"It wasn’t a joyous time," Craig Anderson says of the birth of his now two-year-old son Clarke.
"People say 'those first couple of weeks, you just try and soak it up because it’s the most amazing time in the world', but for us, it was a continued source of frustration. No sleep and not a lot of eating, and a lot of feeling like we’re really inadequate parents," he told SBS News.
Those feelings, he would later learn, were symptoms of perinatal depression (meaning before and after birth), a mental illness that impacts 100,000 Australian families each year. And they got worse.
"The anxiety for me was very specific. It was [in] public places with my son. Anywhere there were crowds, anywhere that I didn’t have an escape plan, I suffered pretty severely. It was quite physical, my guts would go, I would have pain and butterflies in my stomach," Craig, 35, said.
"And then that would start manifesting itself in other ways; grinding my teeth in my sleep. I would wake up in the middle of the night with a sore jaw."
While perinatal depression and anxiety, or PNDA, is more commonly experienced by women - affecting one in five mothers - men are by no means immune. One in 10 new fathers are impacted by the condition but data released earlier this year revealed almost 50 per cent of fathers in Australia are not aware they can experience it.
Craig says his diagnosis caught him completely off-guard.
"My initial reaction when I found out that I had a postnatal anxiety disorder was, number one, I didn’t give birth, how did this happen? The idea that a bloke could suffer from postnatal depression or anxiety was really foreign to me, I couldn’t believe it."
"[But] I'm guilty of it, when a new parent comes back to work [you ask] 'how's the family, how’s the bub?' but we never really ask how they are ... How are you coping?'"
Calls for more awareness
This week marks Perinatal Mental Health Week, with health experts and support groups using the event to increase awareness and education around the issue.
"It's really important that we, as a country, realise that adjustment disorders are experienced by over 50 per cent of all new parents," CEO of support group the Gidget Foundation Arabella Gibson said.
"Our recommendations are that we raise awareness and education around the issue, but also look at universal screenings, and of course, having in place treatment services available."
Obstetrician-gynecologist Katheryn Austin says while progress has been made in recent years, there are still limitations.
"We're fortunate in this country that we are starting to have huge inroads into awareness of mental ill-health around the perinatal space, but we have a huge way to go in terms of recognition, education and training," Ms Austin said.
"There’s a huge amount of under-reporting that goes on in mental health recognition and that impacts hugely on our daily work," she says.
There has also been limited research into how one parent's experience of PNDA can affect the potential onset in the other parent as a result.
Craig's diagnosis came months after his wife was told she was also suffering from the condition.
"Trying to be super dad doing everything you possibly can, my wife got the breaks she needed, the time to focus on things she enjoyed. Overtime that got particularly overwhelming ... it was eating away at me little by little."
Data released this month reveals the financial toll of PNDA, with the impacts of the illness in the first year alone totalling $877 million, according to a PwC Australia analysis prepared for the Gidget Foundation.
"That's made up of things like productivity losses, and of course, care responsibilities and requirements as well. You've also got the health cost, and that's made up of both primary care through hospital, and the more acute situations, but also community and basic health costs as well," Ms Gibson said.
Craig agreed: "You're talking about seeing psychologists and seeing psychiatrists, time off work, time off for additional care. We’re really lucky we had really supportive families but if you don’t have that and the parents need time away, you’ve got care associate costs with that."
Research by Perinatal Anxiety & Depression Australia, or PANDA, also reveals the social and emotional costs of PNDA.
It says data taken from callers using its national helpline has revealed three-quarters found it difficult to adjust to becoming a parent, with just one in three saying they opened up to their partner about their emotional wellbeing.
It also found one in five callers suffered for at least six months before seeking help.
Suffering in silence
Just after her son Dimitri turned two, Yvette Mystakas thought about suicide. She had been suffering severe perinatal depression since she was pregnant without seeking help.
"I finally, after all these years, just snapped. I was just mindlessly calculating [how to do it] and I'm just going to drown in my sorrows, and if I don't wake up, I don't wake up," she said, fighting back tears.
The now 34-year-old says her symptoms began almost immediately after she found out she was pregnant.
"I was crying because I wasn't ready. I didn't think that I was going to become a mum so young [at 26]. I thought we'd wait for a few more years, travel a little bit more, maybe buy a bigger house later on down the track," she said.
"I had just completed four-and-half years of university, so I had all these aspirations and big career ideas, but that didn't happen straight away. My new role was becoming a mum."
Things got worse when Dimitri was born, she said.
"When my son was asleep I'd be just sobbing in the lounge room going, 'I'm not even fit to be a mum, this was not how it was supposed to be,' because I had this idea of being a perfect mother where I would have it together and everything would be OK and I could do it all."
Yvette says she took the advice of her husband and GP, and sought professional help, yet remained in denial about her illness.
"I didn't think I had a problem, even when I got diagnosed with severe post-natal depression and anxiety. I was seeing a psychologist and a psychiatrist and I [would] walk out going 'there is nothing wrong with me'."
It wasn't until she contemplated suicide, that she understood the extent of her struggles.
"My husband kept calling me and messaging me as I was on the way to do it, and something inside of me said 'Yvette, you have gone through worse than this and you have never thought about taking your life, you need help.'
"And that's when I answered the call from my husband and I said 'you need to take me to the emergency department. I'm not well ... I'm ready to give up'."
The Cost of Perinatal Depression and Anxiety in Australia report also lists a number of communities vulnerable to perinatal depression.
Culturally and linguistically diverse Australians, it says, can be less comfortable seeking mental health care because of language barriers, as well as having a limited understanding of how to navigate the health system.
Aboriginal and Torres Strait Islander communities are also at risk.
"Lower economic status can also lead to reduced access to health care which is related to poorer perinatal health experienced by Aboriginal and Torres Strait Islander women compared to other Australian women," the report states.
Reduced healthcare in some Indigenous communities can lead to complicated pregnancies and births, and can increase the likelihood of PNDA, it says.
With maternal suicide still the number one cause of death among new mothers, breaking down the stigma that gets in the way of people seeking help is a key priority for health experts and support groups.
Yvette ended up being admitted to a psychiatric unit.
"It was really heartbreaking, but my time in there allowed me to reflect on everything that happened, and it was probably the best thing for me to go there and just take a time out," she said.
Both her and Craig want to encourage those with symptoms to speak out.
"I’ve had a lot of conversations with my mates about what our family has been through. I’m very lucky we’ve got the help I needed and it’s allowed me to be the father I need to be," he said.
"Hopefully, word gets out there that this is a serious thing that can be treated."
PANDA provides anxiety and depression support at panda.org.au and via the helpline on 1300 726 306.
Gidget Foundation Australia supports expectant and new parents experiencing perinatal depression and anxiety with a range of treatment services. Contact 1300 851 758 or gidgetfoundation.org.au