Hygiene Indifference: the symptom not talked about

By ivory smith causey

Most of us have heard the saying: "Cleanliness is next to Godliness." This oldfashioned mantra reinforces a long-held, misguided belief: that being "unclean" equates to laziness and moral ineptitude. As a result, our culture often takes an unsympathetic approach to addressing issues like poverty and homelessness; far too many of us interpret these situations as a personal failing.. And, significantly, our ideas about the morality of cleanliness can shape how we view mental illness.

Hygiene is one of the many symptoms that is frequently left out of the mental health conversation This is largely because the subject is difficult to talk about. However, indifference to hygiene tasks, including showering, brushing teeth, doing laundry or brushing hair, is a common symptom of mental health conditions (particularly depression).

As a health care professional and someone living with depression, I can speak to the very real manifestations of this symptom. My personal understanding of hygiene and my professional understanding of germ theory was simply not enough to beat the confines of a depressive episode. As I bathed others and taught caregivers, I, myself, struggled to take a shower. This was difficult to wrap my head around, but I have come to understand that neither a professional designation, nor "knowing better," can shield you from mental health symptoms.

The Connection Between Hygiene And Mental Health

In my work in the health care profession, I have found that difficulty with hygiene tasks can be an early warning sign of mental illness I have seen how bipolar disorder can present in its early stages in the form of changed feelings about daily hygiene practices. This symptom can seemingly come "out of nowhere." .

Hygiene issues can also appear during more advanced stages of mental illness; I have even witnessed patients in psychosis experiencing irrational thoughts about hygiene. I have also seen how major depression can extend to hygiene practices. When experiencing the crushing weight of depression, showering can feel like an ordeal that requires exhausting amounts of forethought and effort. The number of steps feel intimidating; making sure the water is hot, washing everywhere, drying off efficiently, moisturizing, then putting on clean clothes can feel like a lot to handle with deep depression.

My Experience With Depression

When I was struggling, I found those steps to be excruciating; I would often say, "Why bother, I'll do it tomorrow." Suddenly, showering felt like a huge task - like doing an entire spring cleaning of my house every day.

During my year-long episode of depression, I saw firsthand how hygiene could fall by the wayside. And I was not even fully aware that my habits had changed.

I was embarrassed when my spouse told me, gently, "You may want to go and take a shower"

I began to keep track of my bathing habits so I could get a clearer picture of how my depression was impacting my hygiene. A "moderately" depressed week usually accompanied three showers a week. As the depression became more severe, I was shocked to realize that I had bathed only twice that week. Things I once enjoyed like pedicures and facial grooming faded away.

To make myself bathe, I would have a conversation with myself. For example, I would say (in third person), "Ivory, since it is Saturday, and Sunday is the Sabbath, you need shower that night or that morning." Essentially, I attached bathing to something else I was already doing. It was no longer performing hygiene activities; I associated it with my manageable everyday tasks as well as staying healthy.

Tips For Practicing Hygiene During A Mental Health Episode

For those who are struggling with the effort to maintain hygiene, I have a few suggestions:

1.Attach the act of bathing to the start of something, like the beginning of the work week. This built-in routine can be a helpful reminder to shower .

2 Attach showering to the end of a workweek. This adds more consistency to your routine.

3 If showering is too much of an ordeal, keep adult disposal bathing cloths handy.

4 Make agreements with supporters that you will bathe on a specific day or night. .

5 If possible, splurge on quality soaps and shampoos. This act of self-care can be fun and make for a more pleasant showering experience.

6 On days when you cannot follow a showering routine, simply cleanse your face and the perineal areas for express cleaning and put on clean clothing.

This will cover certain health precautions and likely give you more energy.

When we are having difficulty functioning, we deserve help. Struggling to practice hygiene (even when you know you "should") isn't a moral failing; it's simply a sign that we need extra support. You should not feel ashamed about voicing your struggles and reaching out to members of your support team. This journey can be difficult, but you don't have to do it alone.

Ivory Smith Causey has a B.A. in sociology from Georgia Southern University and a B.S. in nursing from Macon State College. Ivory is a registered nurse She is a member of the American Holistic Nurses Association

By Patrick

I'm worried that my curmudgeon is showing. That I'm being bad tempered and old fashioned because I'm having a bit of challenging being expected to tell people what pronouns I use.

Declaring your pronouns seems to be the new expectation - or it is being encouraged at the Unitarian Universalist Fellowship of Fredericksburg where I go to try to nurture my spirituality (you know the joke about Unitarians - "people who want to be religious, but they don't know how")

This pronoun imperative is a consequence of us being in an age of gender fluidity - a major issue in itself, that is associated with some significant mental health problems.

The Times They Are a Changing

When I was in medical school if you had a Y chromosome you were male. You wore pants not makeup, played rough games like rugby and football, drink beer, acted boorishly and everyone unquestioningly called you he/him.

If you had no Y chromosome but two X's, you were female, you wore dresses, you simpered, you shopped, you nurtured the children and you were referred to as she/her.

Sorry if I'm seeming offensive with my examples of sexual stereotypes. But the point is, your dress, behavior and pronouns were largely predicated by what sex you were. What's changed is that now, someone ' s biological sex does not determine their gender roddy (whose name is spelled without capitals) claims people are more willing to accept and disclose being nonbinary now. On a personal, roddy shared with me that their non-binary-ness became more apparent as they discovered more about themselves and the world

We are in the age of transgender, gender-ffluid, non-bbinarywhatever term you use for it -"where the brain is not tied to any one gender" explains roddy biggs, new intern minister at the Fellowship, who is gender fluid, and who goes by the pronoun "they/them" and who is sympathetic to the plight of local trans-gender youths and showing it by being instrumental in the creation of a "Safe Sanctuary" get together for local LGBTQ youths at the Fellowship once a month.

MD

around them (writing this, I still struggle with using "they" and "their" and not "he" or "his")

Conflict

It's not just me. The world as a whole has not quite caught up with this. The DMV and the INS are still stuck in the dark ages - your passport and your driving license allow no fluidity. And I hear complaints about filling out forms at the doctor's office because "you have to declare whether you are male or female."

Worse still is the position of some, mainly Republican, politicians who want to tell you what bathroom to use, books you can read, sports team you can be on- even know about your menstrual history.

Or you are liable to prosecution if you go with what is usually a very powerful imperative, to change sex, with the aid of hormones and/or surgery.

A consequence of this is that gender dysphoria - as the condition of mismatch between assigned sex and gender identity is called - can lead to not just things like shame and isolation, but anxiety, depression, PTSD, and suicide, which is "up to seven times more likely" notes roddy.

My own, personal, maybe rather trivial seeming, conflict is whether the pressure to announce my own pronouns is necessary to let transgender people know I am alert and sympathetic to gender fluidity, and will not intentionally "misgender" them (use an inappropriate pronoun), which some consider a form of verbal violence, or even hate speech.

Or whether, as M J Murray , Associate Professor of Gender and Sexuality Studies at University of Illinois notes, I should be like the people who consider a public request for your pronouns a form of "administrative violencethat isn't a request at all. It's a subtle but powerful demand that effectively disables the recipient of the request, and threatens negative consequences for any questioning, resistance or refusal."

Ah, the conflicts a curmudgeon can be subject to.