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Why is it so hard to shower when I’m depressed?

Q: I find many tasks difficult when I’m depressed, but taking a shower is particularly difficult. Why is that? And what can I do about it?

A: If you suffer from depression, you know how difficult daily efforts can be.

Cooking, cleaning, socializing — it can all feel like trudging through mud, said Dr. Lindsay Standeven, a psychiatrist and professor at Johns Hopkins Medicine.

Difficulties with grooming and hygiene are especially common with depression, she said. But because uncleanliness can be associated with laziness or even immorality, people with depression may be afraid to discuss their symptoms with their doctor. And that shame, combined with the low self-esteem possibly triggered by not washing, can further fuel depressive symptoms, Standeven said.

If you have trouble getting into the shower or know someone who does, it’s important to give yourself or others some grace, experts say.

Q: Why does depression make it difficult to shower?

A: Part of the reason is simply that maintaining hygiene – like brushing your teeth and washing your hands – requires energy, and a common symptom of depression is fatigue.

So even if you want to take a shower, you may not have the energy to do so, said Christine Judd, a psychotherapist and mental health social worker in Australia.

But there’s something particularly difficult about taking a shower. Depression can impair your ability to solve problems, make decisions and set goals, said Dr. Patrick Bigaouette, a psychiatrist at the Mayo Clinic. This can make many tasks difficult, but especially those with multiple steps.

“If you break it down, there are actually so many steps involved in showering,” Bigaouette said. A single shower might include undressing, turning on the water, lathering, washing hair, shaving, rinsing, drying, and choosing what to wear.

For someone without depression, Standeven said, going through these steps can feel seamless, like watching a flip book animation in which the transitions are almost invisible. But for someone suffering from depression, the same process can feel like flipping through one page at a time, with each additional step making the undertaking more and more daunting.

Feelings of worthlessness, hopelessness, or other types of negative thoughts: “I don’t deserve to be sober”; “If nothing matters, why bother?” — can also hinder a person’s ability to bathe, Bigaouette said.

The resulting inability to shower can reinforce the belief that one can’t do anything right, he added. This can cause a feedback loop in which poor hygiene exacerbates the underlying symptoms that prevented showering in the first place.

Q: How can I make showering easier?

A: If you’re having trouble showering, first remind yourself that your feelings are reasonable, Standeven said.

“Would you, or anyone else, hold themselves to the same standards if they were walking around sick with another illness? she says.

Setting smaller goals can help. Maybe try standing in the shower for just a few minutes, even if you’re not washing your body or hair.

You can also try breaking the process into smaller steps, Bigaouette said. Maybe you tell yourself to turn on the water first, then put one foot in the shower, then the other, and so on.

Making showering more enjoyable can also help, experts say. Treat yourself to pleasant-smelling products or listen to your favorite playlist. You can also set a reward for completing your goal, like watching a favorite TV show, Standeven said.

If your energy is low, consider using a shower seat or taking a bath. Or ask a partner, friend, or family member to help you with tasks, like washing your hair, getting your outfit ready, or providing emotional support by sitting in the bathroom with you.

Knowing you’re cared for can help combat that negative voice in your head, Bigaouette said.

And just making the effort to adopt healthy behaviors can reinforce the idea that you can accomplish something, research suggests.

Q: When should I see a doctor?

A: There is no “correct” frequency for showering. And not everyone with depression has trouble staying clean, Judd said. In fact, some depressed people may bathe too much because they worry that if they appear sloppy, others will notice that they are depressed.

The question then is: “How does this compare to your normal?” » said Standeven.

If you’ve noticed a change, talk to a doctor and consider treatment, experts said. Cognitive behavioral therapy, a form of psychotherapy, can help address some of the more significant underlying issues that make poor hygiene such a difficult cycle to break, Bigaouette said.

Gibbs is a freelance writer. This article appeared in the New York Times.

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