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Unread 11-18-2009, 09:36 PM   #1
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Default What to do about decline in personal hygiene

My 18 year old son, previously thought to be severely anxious and depressed, finally has a diagnosis that makes sense--bipolar disorder. He is on new medication, but continues to be irritable and irrational. His personal hygiene habits are truly disgusting. He does not wash with soap(this has gone on for weeks), hasn't cut his toenails in weeks and weeks, rarely brushes his teeth and hardly ever washes his face. He never washes his hands after going to the bathroom. He eats with his fingers, and not utensils. He has stopped shaving. When we make mild suggestions, he gets irrationally upset, and refuses to do anything. We considered hospitalization, but we and his support team do not think it is warranted at the moment, since he is not at risk of hurting himself. He came home from college, and for the foreseeable future, he will be living at home. I know that he is ill, but I am having a horrible time coping, and his abominable hygiene does not help. I feel like we have an alien living in our home. How do I cope??
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Unread 11-18-2009, 09:48 PM   #2
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Default Re: What to do about decline in personal hygiene

I know it is hard, but, believe it or not, it is part of the disease. Try to see if he will just do one thing every couple of hours, like brushing his teeth. Then washing his face, then showering. You have no idea how difficult this becomes. It's almost the way you feel when you come upon something so dirty that you are loathe to clean it and instead leave it alone. Washing your face can come to seem like a monumental task. See what he likes to do and try making that contingent on his being clean. The more he faces and does it, the easier it should get, but it's important that you realize how difficult this is for him. It's hard to explain, but it's similar to what I explained above. He isn't trying to offend you, I'll bet. Caring About Your Family billieJ

Last edited by billieJ; 11-18-2009 at 09:49 PM. Reason: correction
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Unread 11-18-2009, 10:02 PM   #3
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Default Re: What to do about decline in personal hygiene

I am having some of these issues myself. It is torture to take a shower. I try to manage it every few days.

Our hot water heater is broken so I am actually at my own limit of uncleanliness. One more day until we have water. I know the solution is to go to the Y or my parents' house, but it is so hard to get into my own shower 50 feet away, forget packing my stuff and getting into the car and driving 20 minutes to get a shower. I'll just wait till the water is back.
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Unread 11-19-2009, 01:42 AM   #4
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Default Re: What to do about decline in personal hygiene

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Originally Posted by billieJ View Post
I know it is hard, but, believe it or not, it is part of the disease. Try to see if he will just do one thing every couple of hours, like brushing his teeth. Then washing his face, then showering. You have no idea how difficult this becomes. It's almost the way you feel when you come upon something so dirty that you are loathe to clean it and instead leave it alone. Washing your face can come to seem like a monumental task. See what he likes to do and try making that contingent on his being clean. The more he faces and does it, the easier it should get, but it's important that you realize how difficult this is for him. It's hard to explain, but it's similar to what I explained above. He isn't trying to offend you, I'll bet. Caring About Your Family billieJ
Since I am very new to the bipolar world, I don't know what's part of the disorder and what might be something else. He doesn't see himself as being unclean. That is the scary part. He gets extremely agitated and offended, for example, if I ask him if he's washed his face with soap. All he does is put water on his face, which is now completely broken out with acne because he doesn't wash.
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Unread 11-19-2009, 03:50 AM   #5
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Default Re: What to do about decline in personal hygiene

Is there a day treatment program he can go to, where they offer social skills training and hygiene training?. Perhaps if he has some outside people that depend on him to show up clean and ready to go, perhaps over time his hygiene will improve. I understand your plight. I am bipolar, but I have never gotten like your son. However, my brother who is also bipolar, has terrible hygiene just like your son. From someone who has come from both sides of the fence, I just want to validate your feelings and tell you that your feelings are normal too. Perhaps there is a support group nearby that you can attend? Try NAMI - National Alliance of the Mentally Ill. They have some great resources for families as well as clients.
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Unread 11-19-2009, 06:00 AM   #6
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Default Re: What to do about decline in personal hygiene

This is difficult. You can have rules for living under your roof, but that may push him off an edge. Certainly he does not feel well and the lack of hygiene is indicative of that. Is he going to a counselor now. Maybe some short term goals can be made regarding his bathing and other hygienic matters.
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Unread 11-19-2009, 11:03 AM   #7
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Default Re: What to do about decline in personal hygiene

My suggestion davemike would be that since you've managed to tolerate it thus far, give it a little more time. I'm assuming this behavior is related to a period of severe depression and it might be necessary to allow the meds some time to help move him to a state where he can share your concerns.

If you feel you absolutely must address the issue, maybe focus on just one behavior and offer gentle encouragement. Try to avoid presenting your concerns as a criticism but rather as a concern for him. Meantime, here's an account from someone else who went through a similar phase and seems to have come out of it. Some of the comments might offer some additional insight for you...

Quote:

Personal Hygiene...

To illustrate the debilitating effects of depression I thought I would talk about a daily ritual that most people do without giving much thought…and I think if people who are dealing with depression have a hard time discussing depression, in general, because of the “stigma” and the “embarrassment” associated with it…then this is going to take it to the next level…

I am talking about personal hygiene…yes… the assumed daily ritual that most normal people do without giving much thought to…well, when you are depressed, life is anything but normal… and to illustrate this point I think a study of contrasts would best be employed…and again I am going to really put myself out there…for a bigger cause…

If you knew me at all during my adult life you would know me as someone who took really good care of himself…I would exercise, eat right and was very particular about my hygiene and personal appearance. The term meterosexual was very apropos , if you are not familiar with the term it has nothing to do with sexual orientation but rather someone’s personal aesthetic sense. I mean, I was a guy that was very comfortable with himself and was very familiar with the T-zone, facial moisturizers and even mattifiers for my oily forehead (although I must give most of the credit to an old girlfriend who introduced me to a lot of those type of products)…but I digress.

Over the years when I would get depressed I would go a day or two without showering as I moped around the house on the weekend. Well, over the last year as my depressive lows have gotten lower and lower my interest in personal hygiene became less and less. The two worst episodes were this last summer and more recently over the Christmas holiday. Over the summer…and I am having a hard time even writing this because it is so embarrasing…but I went 13 days without a shower…can you believe it!!! And the only reason I took a shower on the 13th day was that I didn’t want it to go to the 2 week mark…I didn't want to be known as the guy that went 2 weeks without a shower...I guess even when you are truly depressed you gotta have some standards?!? I would still brush my teeth 2 to 3 times per day but other than that…no interest.

And during that two week period I was going to an outpatient support group for men with depression 3 times per week…I was surprised no one said anything…not that it would have mattered…I suspect that they knew that. Most recently, I went 7 days without a shower. It’s like if you don’t have a reason to get up and shower you really don’t want to nor do you have the energy to spend on such a task.

I hope this helps put depression in perspective for those that have loved ones who are dealing with depression and with trying to function on a daily basis and offers some comfort to those who are dealing with depression themselves and lets them know they are not alone.

I would really be interested in hearing from others who have had similar experiences...

Source: Personal Hygiene

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Unread 11-19-2009, 11:23 AM   #8
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Default Re: What to do about decline in personal hygiene

Can you speak with his mental support team - maybe his medications need adjusting. What would he say if you ran him a bath? I agree he should know that you expect basic hygeine but you need to be gentle. Is it that he so depressed or does he have an aversion to water?
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Unread 11-19-2009, 02:54 PM   #9
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Default Re: What to do about decline in personal hygiene

I can tell you from personal experience that personal hygene is one of the most difficult and incideous parts of bipolar illness because it makes no sense and it my case, it is one of my first signs of depression. I am a 56 year old woman who used to be a special investigator with the government and had to dress in a suit and heels every single day for years and years. After my bipolar illness became so bad that I had to go on disability, it was like pulling teeth to get me to put on clothes in the morning and even more difficult to get into the shower more than once a week. I did brush my teeth at least daily, comb my hair and wash my face. But showering and washing my hair were absolutely more than I could possibly manage. The only way I can explain it is to say that my mind was so muddled with things that hurt and confused me, and didn't make sense, that seemingly unimportant things like showering or clean hair were the least important details in my world. I simply did not care. The mental pain was so bad.

Once medication began to make my life more tolerable, I was able to begin to learn about "self care". These are things that, in spite of the way we as bipolars feel on a day to day basis, we learn that we must do in order to live successfully with our illness. There is one woman I know who calls them "the nonnegotiables". The "nonnegotiables" are showering, shampooing, brushing her teeth, combing her hair, putting on a little makeup, putting on clean clothes, doing her dishes, and making her bed. These are the things that she has committed herself to do daily no matter how badly she feels and they are nonnegotiable. It has made a world of difference in her life. But it took the process of getting to where she felt well enough to learn that she needed to put this plan into place and make it work for her first. That required that her meds help her feel better first.

I know it's hard to watch your son this way. But nothing you say can help him right now. He has to feel better first. The only thing that's going to help him is acceptance from you and support and then counseling.

Best of luck to you all.
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Last edited by VickiesPath; 11-19-2009 at 03:29 PM.
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Unread 11-19-2009, 03:01 PM   #10
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Default Re: What to do about decline in personal hygiene

Quote:
Originally Posted by Vickie in Phoenix View Post
I can tell you from personal experience that personal hygene is one of the most difficult and incideous parts of bipolar illness because it makes no sense and it my case, it is one of my first signs of depression. I am a 56 year old woman who used to be a special investigator with the government and had to dress in a suit and heels every single day for years and years. After my bipolar illness became so bad that I had to go on disability, it was like pulling teeth to get me to put on clothes in the morning and even more difficult to get into the shower more than once a week. I did brush my teeth at least daily, comb my hair and wash my face. But showering and washing my hair were absolutely more than I could possibly manage. The only way I can explain it is to say that my mind was so muddled with things that hurt and confused me, and didn't make sense, that seemingly unimportant things like showering or clean hair were the least important details in my world. I simply did not care. The mental pain was so bad.

Once medication began to make my life more tolerable, I was able to begin to learn about "self care". These are things that, in spite of the way we as bipolars feel on a day to day basis, we learn that we must do in order to live successfully with our illness. There is one woman I know who calls them "the unnegotiables". The "unnegotiables" are showering, shampooing, brushing her teeth, combing her hair, putting on a little makeup, putting on clean clothes, doing her dishes, and making her bed. These are the things that she has committed herself to do daily no matter how badly she feels and they are unnegotiable. It has made a world of difference in her life. But it took the process of getting to where she felt well enough to learn that she needed to put this plan into place and make it work for her first. That required that her meds help her feel better first.

I know it's hard to watch your son this way. But nothing you say can help him right now. He has to feel better first. The only thing that's going to help him is acceptance from you and support and then counseling.

Best of luck to you all.
Right now, those unnegotiables seem simply daunting. They are good goals to aspire to.
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