If someone feels like they cannot shower due to depression, it is not in their head. Extreme tiredness and cognitive effects, such as brain fog and negative thinking, can pose a personal hygiene challenge.
People with depression
This article discusses why a person can feel like they cannot shower because of depression and how executive dysfunction may play a role. It also offers tips for personal hygiene for people with depression.
Depression can cause low energy, negative thinking, and brain fog. All of these can make it difficult to maintain personal hygiene practices.
A person might find it hard to get out of bed in the morning, brush their teeth, and take a shower. They may feel the desire to do these things but not have the energy to do so.
Medical News Today reached out to Roberta Ballard, PhD, to learn more. Ballard is a clinical psychologist who provides online therapy for creative professionals and artists experiencing anxiety, depression, and burnout.
Below, she explains why some people with depression have difficulty showering:
“One reason that depression often makes it hard to shower is that decreased energy and motivation are two of the symptoms,” Ballard said.
Fatigue involves feeling too tired to do things, even when you want to do them. The added lack of motivation makes it even harder to take care of routine things like showering. In other words: “Even if I want to, I’m too tired.”
“When someone is depressed, their energy is so depleted that it is easy to feel overwhelmed by things that are usually a part of everyday life,” said Ballard. “It might take all of a person’s energy just to stay awake and fend off negative thoughts.”
Routine things such as showering appear less important, and they seem to require too much energy.
“As a result, things like routine hygiene often fall by the wayside,” she said.
Some cognitive effects of depression include brain fog, memory problems, and negative thinking. These can all make it harder to take care of oneself.
“It is particularly common to have negative thoughts about self-worth,” said Ballard. “The confusion and memory problems make it more difficult to harness whatever energy a person may have, so it is not unusual for an individual who is depressed to feel that showering is too difficult and not important.”
Motivation and self-worth may also play a role.
“Perhaps they feel as though they do not even deserve to take good care of themselves,” said Ballard.
“Basically, it can validate a negative self-image to feel gross and dirty, so summoning the energy to shower feels like a poor investment. Cleanliness just doesn’t tend to matter to someone who is deep in the throes of a depressive episode,” she explained.
Executive dysfunction may play a role in depression that can affect showering.
Executive function refers to several mental skills that help people manage their daily life. The skills work together to:
- set goals
- make plans to pursue goals
- accomplish goals
The three main skills involved in executive function include:
- working memory
- inhibiting unthinking responses to stimulation
- cognitive flexibility, which is the ability to shift mental focus
Signs of executive dysfunction include difficulty in:
- starting or completing an activity
- prioritizing an activity
- switching focus
Although personal hygiene can be difficult for people with depression, certain practices and habits can help.
Ballard recommends the strategy of breaking the task into many smaller steps.
“In isolation, each small step does not seem so overwhelming to someone who is depressed,” she said. “With this technique, a depressed individual can focus on each small step, instead of feeling overwhelmed by the entire task.”
For showering, this can look like:
- Get out of bed.
- Walk into the bathroom.
- Turn on the shower.
- Take off clothes.
- Get into the shower.
- Get wet.
- Use soap.
- Towel off.
- Get back in bed.
It may also help someone to be aware of the positive effects that personal hygiene offers.
“Paradoxically, showering or bathing is associated with reduced symptoms of depression and anxiety,” added Ballard. “The body’s natural response to warmth is relaxation, which tends to ease depressive symptoms after a shower, at least temporarily.”
Taking care of oneself may also help boost self-esteem, even if the effect is only temporary.
“Basic self-care sends an important message of worthiness to a depressed individual who may be feeling undeserving of personal hygiene,” she said.
People can try:
- Using a shower seat and movable showerhead: This can enable someone to remain in a seated position throughout the shower, which could make the process easier.
- Investing in pampering bath products: The use of scented soaps and body lotions may help make showering something to anticipate with pleasure.
- Taking a bath instead of a shower: This may seem more relaxing than a shower, particularly if a person plays music they enjoy and uses a bath bomb or bath oils.
“Usually, if someone feels depressed for 2 to 3 weeks, they should talk with their doctor or seek counseling,” advised Ballard. “If they have any suicidal feelings beyond passively thinking about dying, such as a plan to hurt themself, they should talk with a medical professional immediately.”
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
If a person cannot shower because of depression, it may stem from the symptoms of the condition, including tiredness, brain fog, increased negative thinking, and executive dysfunction.
Tips for coping with personal hygiene challenges may involve breaking the task into small steps and making the experience more pleasurable.
If someone has had symptoms of depression for 2–3 weeks, they can consider making an appointment with a mental health professional or their primary care doctor to get a diagnosis and support.