As a therapist working with men and couples, I have seen how paternal mental health remains an overlooked aspect of family wellbeing. Research from the Avon Longitudinal Study of Parents and Children has shed new light on this with findings that should change how we approach mental health support for expectant and new fathers.
Paternal Anxiety in the Perinatal Period
The transition to fatherhood is often portrayed as a time of joy and celebration. However, the reality is more complex. Research shows that between 7% and 14% of new fathers experience anxiety during the perinatal period – a rate significantly higher than anxiety in men generally (2 – 4%). This suggests that becoming a father may be a risk factor for developing anxiety.
What makes these findings concerning is that paternal perinatal anxiety does not just affect fathers – it has consequences for their children’s mental health and development. Children whose fathers experienced anxiety during pregnancy or early parenthood showed increased rates of emotional and behavioural difficulties at ages 3 and 7, even when accounting for maternal mental health and other family factors.
The Barriers: Why Men Do Not Seek Support
Despite the clear evidence of paternal mental health’s importance, men remain significantly less likely to seek professional help. Through my work, I have observed several key barriers:
Traditional Masculinity and Stigma
Many men feel pressure to be the “strong provider” and protector of their family. Admitting to anxiety or emotional struggles can feel like a failure of their masculine identity. The cultural narrative that men should “tough it out” creates shame around seeking help.
Lack of Recognition and Awareness
Paternal mental health receives far less attention than maternal postnatal mental health. Men may not recognise their symptoms as anxiety, dismissing them as normal stress about new responsibilities. Both parents should be honest about changes in how they are feeling, and be supported to seek help.
Different Symptom Expression
Men often express anxiety differently than women. Instead of reporting worry and emotional symptoms, they may present with:
- Irritability and anger
- Withdrawal and isolation
- Physical symptoms (headaches, sleep problems)
- Increased work focus or other avoidant behaviour
- Substance use
Limited Peer Connection
Men are less likely to have strong social networks where they can openly discuss emotional struggles. The isolation of new parenthood can exacerbate this, leaving fathers feeling alone with their concerns.
What Fathers Can Do: Steps for Better Mental Health
If you are an expectant or new father experiencing anxiety, here are evidence-based strategies that can help:
Practice Daily Stress Management:
- Physical Activity: Just 20 minutes of walking can reduce anxiety symptoms. Exercise releases endorphins and provides a healthy outlet for stress. In my experience of working with men, developing strength significantly reduces feelings of stress and anxiety.
- Breathing Exercises: Try the 4-7-8 technique – breathe in for 4 seconds, hold for 7 seconds, exhale for 8 seconds. Practice this several times daily
- Sleep Hygiene: Where possible, maintain consistent sleep and wake times. Avoid screens before bed and create a calming bedtime routine. Do not add to the problem by going to sleep late. Often, men use that moment late at night to unwind, focusing on their time; however, this interferes with a good night’s sleep, and results in always trying to catch up with sleep
- Mindfulness: Use apps like Headspace or Calm for guided meditations. Even 5 minutes daily can help manage anxious thoughts
- Limit Triggers: Reduce news consumption, social media, or other anxiety-provoking content
- Structure: Maintain routines where possible – they provide stability during times of change
Challenge Anxious Thinking:
- Notice catastrophic thoughts and ask: “What evidence do I have for this worry?”
- Practice the 5-4-3-2-1 grounding technique: name 5 things you see, 4 you can touch, 3 you hear, 2 you smell, 1 you taste
- Write down worries and schedule specific “worry time” rather than ruminating all day
- Use positive self-talk: “I am learning to be a good father” rather than “I do not know what I am doing”
Getting Professional Help: A Step-by-Step Guide
Consider therapy if you experience:
- Persistent worry that interferes with daily activities
- Sleep problems lasting more than two weeks
- Irritability affecting your relationships
- Physical symptoms without medical cause
- Thoughts of avoiding your baby or partner
- Feeling hopeless about your ability to parent
- Using alcohol or other substances to cope
Therapeutic Approaches That I Most Often Use With Men:
Cognitive Behavioural Therapy (CBT):
- Practical, problem-solving focused approach
- Helps identify and challenge anxious thought patterns
- Provides concrete tools for managing symptoms
- Usually involves homework assignments and skill practice
Solution-Focused Brief Therapy:
- Builds on existing strengths and past successes
- Goal-oriented and time-limited
- Focuses on what is working rather than what is wrong
- Appeals to men who prefer practical, results-oriented approaches
I also use Acceptance and Commitment Therapy (ACT) and Dialectical Behaviour Therapy (DBT) Skills.
Other bits to consider:
Strengthen Your Relationship:
- Schedule regular check-ins with your partner about how you are both coping
- Share household and childcare responsibilities explicitly
- Attend couples counselling if communication becomes difficult
- Make time for your relationship beyond baby care – even 15 minutes of conversation daily helps
- Be honest about your struggles rather than trying to appear strong all the time
Strengthen Support Network:
- Join NCT classes that include fathers
- Use apps like Peanut or Mush to connect with other parents
- Consider online pages like Fathers Reaching Out; Dad.info; The Fatherhood Institute; Reddit (communities like r/daddit); Facebook groups; Andy’s Man Club
Manage Work Stress:
- Speak to your manager about flexible working arrangements
- Use any available mental health support through your employer
- Take regular breaks, even short ones
- Set boundaries between work and home life
- Consider whether work patterns need adjusting during early parenthood
Moving Forward: Taking the First Step
The journey to better mental health does not require perfection – it requires beginning. If you are struggling with anxiety as an expectant or new father, here is how to start:
This Week:
- Acknowledge that what you are experiencing is valid and common
- Try one daily stress management technique
- Identify one person you could talk to about your concerns
- Research one therapeutic option (NHS service, private therapist, or support group)
This Month:
- Make contact with a mental health professional
- Join one support group or online community
- Have an honest conversation with your partner about how you are feeling
- Establish a regular self-care routine
Remember, seeking help is not a sign of weakness – it is an investment in your family’s future. Your wellbeing matters, and support is available. The transition to fatherhood is challenging enough without facing it alone.
If you are experiencing difficulties as an expectant or new father, request a call back and we can discuss how therapy could help you. Or speak to your GP, reach out to organisations like the Samaritans (116 123), Andy’s Man Club, or Dad.info for peer support and resources.
Photo by Toa Heftiba on Unsplash