Several years ago, an interesting study was presented at the International Society For Autism Research suggesting that over 30% of fathers of teens and young adults with autism experience symptoms of depression significant enough to warrant clinical attention. That’s a striking finding. For comparison, the National Institute of Mental Health reports that 7% of American men will experience depression in a given year. Examination of contributing factors to the higher rates of depression seen among men with children with autism and other developmental disorders may help us better appreciate what it’s like to walk in the shoes of a father of a child with a significant disability.
Based upon the experiences shared by fathers of kids treated in our practice, here are four thoughts as to why they may be more vulnerable to depression…
The impact of a child with a disability upon one’s career. Fathers of kids with disabilities face a conundrum. Their presence at home may be even more important than it would be if their children were “typical,” given the impact that a child with a disability has upon everyone in the family. At the same time, the need to make enough money to pay for necessary treatments that are partially covered or not covered at all by health insurance is often present. They may have to work longer hours to pay for their child’s medical care. They may not be able to risk changing jobs if the new job provides less comprehensive insurance coverage. They may not be able to accept a promotion involving relocation when a move would result in the loss of access to needed educational and treatment services for their child.
The end result for a father of having a child with a disability may be unfulfilled career ambitions along with ongoing pressures to provide adequate financial support over and above what would otherwise be necessary to pay for costly treatments.
The challenge of providing for your family after your work life has ended. In our culture, the construct that we as men accept the responsibility of providing for our families is so much a part of our identity that when we’re unable to do so, the experience can be psychologically devastating. As the father of 20 and 17 year-old girls who are “typical,” the challenge of figuring out how I’m going to pay for their education is pretty overwhelming. But I assume that each of them will grow up to be independent and self-supporting. What if your child is going to require lifelong care and support? What plans do you have to make in the event you or your wife are incapacitated? Who will care for your child when you’re gone?
Your relationship with your wife may be different than you envisioned. It’s easy for women to invest so much of their time and emotion and energy in caring for and advocating for the needs of their child with a disability that they may not have much left to share with their husbands by the end of the day. You may have very little opportunity to spend quality time with your wife, because of the lack of available child care or the lack of funds for a night out together…hence the need for respite care. You may not get to spend the romantic weekends together that your neighbors and coworkers enjoy. There’s a very good possibility that your sexual relationship with your spouse is going to suffer. There’s also a good possibility that you and your spouse will be more isolated socially that you would be if you didn’t have a child with a disability. Where we live, parents tend to associate with other parents who share a common interest through the activities their kids are engaged in…sports, school, church, scouts, other extracurricular activities. Fathers of kids with disabilities are more likely to lack the networks of supportive relationships that other men enjoy.
You may silently grieve the loss of aspirations you had for your child as well as your inability to share experiences with your child that you dreamed of doing together. In my mind, this may be the greatest risk factor contributing to depression for fathers of kids with disabilities and the factor least likely to be recognized and discussed. If you have a child with autism in which their capacity for social interaction is impacted, that’s a huge loss. Fathers of kids with disabilities may miss out on the experience of walking out on the field with their son or daughter on Senior Night for their sports team, teaching them how to drive, having their child treat them to a round of golf, or having the opportunity to play with their grandkids.
Several years ago, a very successful businessman sat in my office and sobbed when the reality set in that his son wouldn’t enjoy the types of friendships he had enjoyed growing up as a consequence of Asperger’s Disorder. The father was regularly paying for classmates to accompany their son on lavish ski vacations in Colorado or trips to beach resorts for diving and surfing lessons in the hopes that friendships would develop that never developed. Some parents live vicariously through their kids, but we all want our children to experience the things we treasure the most. When they can’t, that hurts.