For the past six months, my 39-year-old husband has become a total stranger to me. First, he lost interest in me, then our two teenage boys, and now his job seems to be headed the same way. A girlfriend I know he was seeing has also been dumped. What is going on?
It is almost certain that he is going through a crisis of one sort or another and only a mental health specialist can help him, and I would suggest that you get him to see one as soon as possible.
It is difficult to be sure what type of crisis he might be going through but from your brief description, both a major depressive disorder and schizophrenia are possible diagnoses, and either way, your next steps are clear, because these are not the only possible diagnoses.
A while ago, we saw a young man in his mid-30s who had attempted suicide by jumping off a tall building. A hawkeyed security guard had spotted him going up the stairs on a Sunday evening and had followed him. Just before he made the jump, the lifesaver had told him not to kill himself until he had prayed and asked God for forgiveness for his past and now intended sins.
Perplexed by this interruption of his by then-clear plans, the young man agreed to the prayer session, only to be confronted by a work colleague at the end of the prayer. He had been called to the scene by the suspicious guard. Little did the lifesaver know at the time how well he had done. Most suicides are carried out impulsively and the act of interrupting the man at the crucial moment literally saved a life.
In the hospital and after several days of sedation and observation, it turned out that he was very much like your husband. At university where he studied Economics, he had to take a year off, due to what his parents and teachers believed was “emotional exhaustion”. He also had a similar episode at the age of 17, a condition forcing him to repeat a class.
During further evaluation, both his mother and his wife described distinct but less severe episodes of what they now recognised as depressive episodes, once, after he lost a job, and the other after the birth of their first son. Both were clearly stressful events but his reaction was excessive.
The pattern was very similar. First came a few weeks of social withdrawal with him moving away from friends, family and workmates. This would be followed by unexplained moodiness that was beyond what might be due to work stress. Anger outbursts directed at anyone, and everyone would confuse all around him, with the wife being the first to be blamed for not “taming her husband’s temper”.
This was soon followed by a type of tiredness that did not respond to many hours of sleep soon followed by loss of appetite that led to weight loss.
On further probing, the wife had confirmed that she had on occasion found him in the kitchen store alone at night, crying and “holding a knife”.
By the second week in hospital, it was clear that he was responding to the treatment he was undergoing. One day, during a group therapy session he broke down in tears when he heard the story of a fellow patient who had also attempted suicide by taking an overdose, and who had ended up in ICU in a coma for several days.
Their stories were so similar they described themselves as “suicide attempt twins”. Each had had an episode of depression in high school, and both were surprised to learn that 50 percent of mental disorders make themselves manifest before the age of 14 years. When they learnt that 75 percent of mental disorders manifest before the age of 24 years, they both identified with failing exams in their second year of university studies.
Our patient went through what he called a lightbulb moment. He had, as had his newest friend gone through life suffering from a very common condition, which was easy to detect, treat and which if ignored led to death.
When he eventually improved, he understood himself better, went and thanked the guard who had saved his life, thanked his mother for the support in high school and his wife for tolerating him during the depressive phases that he now says must have made him into a monster.
Back at work, he is the company's mental health champion and is additionally the mental health campaigner at his old high school. He is deeply involved in the mental wellbeing of teenagers.
This must be the silver lining to what could easily have turned out to be a tragedy.
