Malik* noticed that his wife, Jade, was being strangely antagonistic to their children, and he wondered why her hands were always red and dry. After discussing the issue with his doctor, Malik thought about how often Jade was now washing her hands. She was treated for obsessive-compulsive disorder and depression, as well as self‐esteem and identity issues.
It wasn’t typical for Angela’s husband to act irritable, angry and critical with their children, so Angela pushed him to see a doctor. After her husband finally agreed to go, he admitted to having an opioid pain pill addiction.
Jessica started calling her husband, Ryan, numerous times during the day, which was unusual. She was also paranoid about their grandchildren getting abducted or harmed. Ryan was concerned about his wife’s excessive anxiety and realized she needed more help than his reassurances could provide.
When Seth’s wife’s depression and panic attacks started making it difficult for her to leave their house, Seth knew he had to take action.
Each of these spouses noticed signs that something wasn’t right with their husband or wife. What are the warning signs that your spouse may have mental health issues? While the specifics can vary, there are some general changes to look for, says Dr. Karl Benzio, a board-certified psychiatrist and co-founder of Honey Lake Clinic, a residential Christian facility for mental health, mood disorder and addiction treatment.
The husbands and wives in these true stories noticed changes in their spouse and sought help, but realizing something is amiss isn’t always easy for spouses to do, Benzio explains.
“Hopefully the spouse is noticing the changes,” Benzio says. “Is he taking a sleeping pill when he didn’t before? Is she having a glass of wine at the end of the day when she didn’t before? But oftentimes a spouse might not notice changes until suddenly they realize their spouse is drinking six beers a night.”
A spouse might not see a gradual change in their loved one because it’s common for a person to have struggles for a while and then return to more normal behavior. Yet over a long period of time, that spouse’s mental or behavioral health could be slowly declining. “The spouse might not notice those changes over time because they’re so subtle and gradual,” Benzio explains.
That’s why it’s important to be alert to warning signs and talk with your spouse in a supporting, loving way about any changes you might have noticed.
Main warning signs of mental health issues
According to Benzio, fear, anxiety, depression and anger are emotional warning signs and the easiest to spot. Or does your spouse seem worried, lonely, overwhelmed or jealous? Pay attention if your spouse expresses feelings of rejection or of being neglected. You might see these emotions in the way your spouse speaks, how they carry themselves, what their face looks like or in their tone of voice. Another warning sign is if your spouse repeatedly has a hard time managing their emotions.
What thoughts are going through their minds? Are they nihilistic, negative, critical or judgmental? Or are they too grandiose, extravagant or bubbly? An unusual level of confidence or increased self-esteem might be a sign of mania or hypomania mood disorders. Are your spouse’s decision-making skills affected in a negative way? Other cognitive warning signs include if your spouse is regularly distracted, struggles with focus and concentration, feels confused or has memory issues.
Changes in sleep, energy level or appetite may indicate a problem. Is your spouse’s speech slower than normal? Is your husband or wife slower to respond to you? Or instead of being more lethargic, is your spouse fidgety and restless? Is he or she pacing a lot? Other physical warning signs of possible mental health issues include heartburn, headaches, muscle tension, teeth grinding or jaw pain and an occasional rapid heart rate.
Have there been changes in your spouse’s typical routines or behaviors? Some examples of behavioral signs include your spouse cutting themselves or engaging in more risky behaviors; abusing alcohol, caffeine, tobacco or other substances; hoarding; gambling; or doing excessive exercise, work, spending or eating. Has your spouse talked about getting rid of their possessions or attempted suicide? Has your spouse been neglecting work or home duties on a regular basis?
If your spouse has been picking his or her skin or pulling hair out in small patches, that’s also a warning sign of mental health issues. Also take note if there’s been a decrease in your spouse’s self-care routines (cleanliness) or an increase in time on screens that’s interfering with responsibilities or causing distress or conflict.
Is your spouse feeling helpless, hopeless or guilty? Have you noticed that your spouse’s values are becoming more compromised? Is your spouse not as excited about Bible study, prayer or going to church? Is their attitude about life not biblically centered? Instead of being grateful and positive, do they seem beaten down or overwhelmed?
Triggers of mental health issues
Benzio stresses that most people’s mental health doesn’t deteriorate — or improve — overnight. But triggers can accelerate a mental health decline. “There are times when someone might function relatively well, but then they get a diagnosis or experience a loss — of a job, a loved one, of finances or of structure — and then they start to crumble,” he says.
A circumstance may also trigger repressed emotions from a past experience. For example, one woman was sexually molested when she was 8 years old. She buried that experience and the resulting emotions until her daughter turned 8. That’s when this mother started feeling high levels of anxiety and fear and stopped sleeping well. With no evidence to suggest wrongful behavior, she began worrying about her daughter’s male teacher, as well as sleepovers and other situations. When someone’s past is causing present-day mental health problems, it can take a while for a person and their spouse to identify the issue, Benzio says.
Ways to help your spouse
1. Have a conversation
If you’re concerned that your spouse has mental health issues, you’ll need to talk with them about what you’re seeing. Before you do that, however, remind yourself that:
- You are both on the same team. Satan is the enemy, not your spouse.
- Part of love is helping your spouse understand when they are struggling so they can address that issue and not have to suffer any longer. “That’s what you lovingly want to accomplish,” Benzio says.
Be sure to approach your spouse in a loving, careful way, after asking them for some uninterrupted time to discuss something important. Begin the conversation by expressing your love. Benzio recommends saying something along these lines:
“I love you, and you mean the world to me. We’re married for life, but for us to move forward and to continue to live that abundant life that God has for us, there are some things I’d like to share with you that could help us move in that direction even more.”
Reassuring your spouse of your love will help them better receive the hard message you have to share. Instead of starting with, “Hey, you seem a lot angrier lately,” set the stage for that message.
“We take it for granted that our spouse knows we want to see them thrive, that they’re valued and we want them to reach their God-given potential,” Benzio says. “But in that moment, my wife might not know that unless I say it.”
Once you’ve expressed your love for your spouse, clearly present the changes you’ve observed.
2. Ask questions
Don’t make assumptions. Ask how your spouse is feeling and what they are thinking. Ask if they know of a cause for the changes you see. “Be a good detective,” Benzio says. Ask questions such as:
- Are you also noticing these changes?
- How are you feeling emotionally?
- Do you feel you are walking in the path God has for you?
- What do you find yourself thinking about during the day?
- Can you help me understand why you are struggling?
- When was the last time you felt like yourself? And what has happened since then?
3. Bring in coaches
Once your spouse sees that you have good intentions, he or she will be more willing to communicate, Benzio says. If the issue is too much for both of you to solve on your own, bring in a professional to provide guidance and expertise. Whether you talk with another couple, a mentor in the church, a pastor or a therapist, outside advice can lead you on the path to healing and restoration.
“We have accountants who help us with our taxes, we have lawyers who help write a will,” Benzio notes. “We reach out for expertise in many different areas. For some reason in our personal world, it’s a lot harder for us to say, ‘Hey, I need help and guidance.’ “
He says it’s also important for your spouse to have a medical exam and lab work, just to rule out any physiological cause of the problem.
4. Know the role of medications
If medication is prescribed for your spouse, it’s important to know its role. Psychiatric medications are an “important miracle,” Benzio says, because they help correct the natural processes of our brain chemistry. “But they are just patches, like Band-Aids, that help reduce symptoms that interfere with our ability to make good, sound decisions,” he explains.
Medications can help reduce the symptoms such as anxiety, depression and poor concentration so people can think more clearly, sleep better and more easily apply God’s wisdom to their lives. And that can make a big difference in their lives.
With medications, he’s seen people “manage their emotions better and have their depression be a 3 out of 10 instead of a 10 out of 10. They’re able to get closer to God and see their situations more clearly. They’re able to make better decisions. And decisions are the exercise of the brain, so then their brain chemistry starts to improve.”
Improved brain chemistry allows some people to decrease their psychiatric medication after six months or a year, he says. If the issues are caught early enough, some people may be able to stop taking the medication.
“But they (medications) don’t cure,” Benzio emphasizes. “They help biochemical problems but aren’t a cure for psychological or spiritual issues. I’ve been prescribing these kind of medications for 32 years, and I haven’t seen them cure anyone yet.”
5. Recognize that we all have mental health issues
As you talk with your spouse, it’s important to realize that they may feel shame, since mental health issues still carry some stigma in our society. If that issue comes up, let your spouse know that everyone has “cracks.” “We all need coaching — we all have psychological defects,” Benzio stresses. “Jesus is the only one who has perfect brain chemistry. None of us are building on a perfect rock-solid foundation.”
6. Know a husband’s challenge
It’s especially difficult for men in our society to communicate any mental health issue. “Men are called to be leaders in their marriage,” Benzio says, “and they often think: How can I be looked upon as a leader if I’m weak and have this depression or anxiety or fear? I want my spouse to look up to me, to respect me, to know that I’ll take care of her no matter what. Strong people aren’t fearful or depressed. But if I voice my feelings, if I’m weak, how is she going to trust me to be the one to take care of her? I don’t want to dump that on her.”
Because of that, many husbands isolate themselves and don’t talk about those emotions, he says.
7. Have regular check-ins
Whether or not you see warning signs of mental health issues in your spouse, Benzio says it’s good to have regular check-ins with each other about how each spouse is doing emotionally and psychologically. Make it a time when you share observations about each other and any struggles you may be having.
“If you’re having those regular conversations, it makes it part of the norm and establishes the fact that you’re a team, you’re there to help each other,” he says. “Satan is good at making spouses think they are opponents of each other instead of being on the same team. We both have the same goal: When you hurt, I hurt. When I hurt, you hurt. We’re tied together.”
The Bible and mental health issues
As a psychiatrist and a Christian, Benzio sees mental health in a way many do not. He can show secular scientists where the Bible affirms their science, and he can also explain to the Christian layperson where the Bible supports scientific understanding.
“The Bible doesn’t use scientific terms, and science doesn’t use biblical terms, but they are both talking about the same thing,” he says. “As a Christian therapist, I get to blend those and help the Christians understand the scientific elements and the science community understand the biblical elements.”
Science simply helps us understand what God has created, he explains, and that includes our brains.
Jesus: The perfect psychiatrist
“I think the mind is the coolest thing that God has created, and there’s a lot of great science about how the mind works,” he says. “Psychology is just understanding why we do what we do, why we make the decisions that we make. Jesus is the wonderful counselor, and He’s the great physician. So when we put those two professions together, we get a psychiatrist. So Jesus is actually the perfect psychiatrist.”
God knows exactly what makes our minds work well and He gave us the Bible as an instruction guide for using our minds, Benzio says. In fact, in Matthew 13:15, Jesus gives us His psycho-spiritual healing prescription: “Otherwise they might see with their eyes, hear with their ears, understand with their hearts and turn, and I would heal them” (NIV).
As a psychiatrist, Benzio interprets this verse in this way: “If you see reality clearly, you see your situations clearly. You see God for who He is, and you see yourself for who you are, including your weaknesses and frailties. That way, you see what’s going on through godly lenses. Then you hear with your ears: You hear God’s answer to the situation and reality that you’re in. Then you understand in your heart how to connect God’s answer to the situation that you’re in. And then you turn — you put that into action and make decisions based on that information. If you do that, then Jesus says, ‘I will heal them.’ ”
The Bible shows us how to look at our situations clearly, and based on that, how to make a healthy decision. Good decisions are key to a healthy mind, Benzio says. “Whenever you make good decisions, your brain chemistry balances, or is rewired in a positive way, or as the Bible says, ‘is renewed,’ ” he explains. “The more we make godly decisions, the more we renew our minds.”
The goal is to become a more consistent, godly decision-maker. “That’s the cure God has given us,” Benzio says. “Based on our decisions, our brain chemistry can change. And that’s called neuroplasticity. The Bible talks about neuroplasticity in many ways.” He points to the passages about renewing the mind, and also about what happens when you make bad decisions and end up with the reprobate mind, the degenerate mind, or become double-minded.
“When we make good decisions, our brain changes in a positive way: We can see that in SPECT scans of our brain (functional MRIs of our brain),” Benzio says.
A new mindset
Although you and your spouse may have accepted Christ’s salvation, you “don’t get a brain transplant” when you’re saved, Benzio notes. “We all have psychological dysfunction,” he says. “We all have blind spots. But we have the potential to renew our minds.”
Spouses need to keep an eye on each other’s blind spots and stay alert to warning signs of mental health issues. And if there is a problem, you can help your spouse move toward health as you talk it through, depend on God and seek support from others.
“You keep him in perfect peace whose mind is stayed on you, because he trusts in you.” (Isaiah 26:3)
*Names have been changed.