Diagnose my sister. What is going on?

[Anonymous]

My sister is 35-year-old and single and living in a major city that’s not Washington DC. Her behavior or the last few years I have felt so confused by and I’m hoping someone can help me get to clarity. I’m gonna try this pretty fact base but with some color because I am her sister.

1) she does not take care of her physical body. She doesn’t shower regularly, she doesn’t brush her hair, and she is very overweight. She stayed with us for a week and did not shower. She also doesn’t wear make up or color or hair, and generally thrifts and wears stretchy clothes. She just fundamentally does not take care of her physical body and appearance in a way that would match social norms.

2) she has an app that “rewards” her for getting things done, like washing her face. So she is obviously having a hard time doing these things.

3) she sleeps about 12 hours a night and then three hours a day. She says she has chronic fatigue.

4) she has been laid off from her last two jobs over the last three years, although she’s an engineer in tech and I work in the same space generally so that’s not necessarily a flag, but it could be.

5) when she is awake and hanging out, she is happy, bright eyed, quick to laugh, totally plugged in and lovely to be around. She talks a lot about her friends, seems to throw dinner parties somewhat regularly, and has two or three clubs she is involved with, including dedicating about 10 hours a week to a food pantry every week. She is dying to date, but never gets second dates for reasons that I would assume have to do with bullet number one.

I am deeply concerned about topics one through four but then in the end she seems like she’s OK? But the fact that she can’t take care of herself is actually putting a bit of a wedge between us. She wants to go on trips and stuff and I just don’t wanna spends many days with a woman who has BO and it’s kind of a wreck.

What the heck is going on here? Every time I “know” it’s depression or something along those lines, something that I’ve seen before, she pops up, living her life, brightly and happily, but this cannot be OK, right?

[Anonymous]

This is OP again, I just wanna make clear that the idea of not coloring your hair or wearing make up or any of the things that I mentioned is a personal choice and I grew up with a bunch of hippies who didn’t do any of this stuff. I discovered mascara personally when I was in grad school. It seems to be the actual inability or unwillingness to do basic personal care that I find to be very concerning and a huge red flag. The sister part of me does think, she’s just so pretty if she would put some concealer under her eyes and stop smelling bad she would be so much more reasonable to the world.

[Anonymous]

Yes it can be, depression isn't a permanent 24/7/365 gloom. Its also concerning to have a loved one noting the long list of things you are doing "right or wrong". That relationship may have left her crippled in some way to deal with family doing checklist criticism. You seem hyper judgmental and you are not seeing her daily.

[Anonymous]

Has she always been heavy? Did she have trouble with cleanliness growing up? Have you been to her house? Is it dirty?

It definitely sounds as though she is depressed, and the effort it takes to pull herself out of her situation (regular bathing, exercise, working) is too much, which perpetuates the depression.

Is she on an SSRI?

[Anonymous]

I’d say depression, but I had a roomate in college who had schizophrenia who was also like this. My sibling has it too, but it manifests a bit differently. He’s not best and tidy but showers, etc.

[Anonymous]

Have you asked her “how are you doing?” And then just listened?

I have a loving mom, but one who can’t listen, interrupts me when I’m talking, and tries to immediately “fix” any problem that I’m talking about. I’ve stopped telling my mom my problems because it’s infuriating. If you’re like this, I’m not surprised your sister hasn’t confided her problems to you.

Take her out for coffee. Ask her how she’s doing, and then shut your mouth and listen. Make eye contact and nod and don’t interrupt.

[Anonymous]

I'd say depression and ADHD combined.

[Anonymous]

Anonymous wrote:Yes it can be, depression isn't a permanent 24/7/365 gloom. It's also concerning to have a loved one noting the long list of things you are doing "right or wrong". That relationship may have left her crippled in some way to deal with family doing checklist criticism. You seem hyper judgmental and you are not seeing her daily.

Not OP. This seems incorrect. I think OP cares about her sister. It's not like she is judging her. She is concerned for her sister who doesn't bathe, smells, can't keep a job and wants to date but isn't getting 2nd dates. OP asking for help in this case, to me, is her being caring. But I do agree that it is hard to help someone who doesn't want it.

[Anonymous]

Anonymous wrote:I'd say depression and ADHD combined.

Also, as someone in a similar boat, GLP-1 meds have been lifesaving to me. They enabled me to lose weight and beat depression. I'm not sure why, but I have been SSRI free for the first time in 20 years. I feel much better in so many ways. I don't know if you can have that type of conversation with her, but it might be useful to explore. Not just for weight loss, but for an overall wellness improvement. To me, the mental health benefits are the real success. I love being able to lose weight, but I am so grateful for feeling more like myself.

[Anonymous]

She really should be seen by a doctor.

Not showering and skipping basic hygiene def needs to be addressed

[Anonymous]

She has an overbearing sister who gossips about her.

[Anonymous]

Anonymous wrote:She has an overbearing sister who gossips about her.

This is the OP. I’m gonna be honest —I’m very open to the feedback. If I really came to the conclusion that this was none of my business I would feel a lot better because I don’t really actually care about anyone’s shower schedule. But every time I take that position in my own head, I think no, this is not right. I’m not sure she’s OK at all.

[Anonymous]

I think you need to separate out what would be abnormal - not showering, and smelling from things that are your personal preferences (dyeing your hair, stretchy clothes, not wearing make-up). Those are irrelevant and are not in any way indicative of a problem. The showering could also be personal preference - maybe she doesn't shower every day but she does shower before going out etc.

If she has lots of friends, throws dinner parties, attends clubs and hobbiesle aren't conformists to social norms. If she is happy and healthy and and is engaged socially and recreationally - then it seems she is managing just fine and others don't share your concerns.

The sleepiness should be assessed by a doctor. It could be her thyroid or some other condition.

[Anonymous]

Maybe she actually does have chronic fatigue. She probably has an underlying medical condition. None of this points to a mental thing IMO.
Some people have rather shocking hygiene habits. My own father and my best friend from high school are both on some every 3 day shower schedule because "it's a waste of time" or "I never get time to myself." If she is obese and has a problem with yeast that would quickly become stinky.
Clothing and makeup -- tons of people out there are like this. They don't care about looking their best especially if their social group all looks the same
Sleeping that much is not normal and she should get blood work done.

[Anonymous]

How open is she about all this? Do you know about the app because she told you or you snooped? Does she seem self aware about not getting dates? Could she be exaggerating about her social life?