Diagnose my sister. What is going on?

[Anonymous]

Anonymous wrote:

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.

Omg I started a GLP-1 6 weeks ago and my depression is the best it's been as long as I can remember. I've been thinking of tapering down my SSRI and anti anxiety meds but I haven't taken the plunge yet.

Are you planning to go off GLP-1?

I am prediabetic and insulin resistant so I'm not sure I will ever go off but if I did I assume I'd need to be on the meds again.

[Anonymous]

Anonymous wrote:

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.

Good for you. Then ask her and listen (don’t judge) and tell her you’re there for her if she says she needs help.

[Anonymous]

If the OP was really judge-y, she would be insisting on a makeover at the Clinique counter. Have you seen your sister’s space recently? I kind of doubt the entertaining and hosting dinners.

[Anonymous]

Anonymous wrote: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.

This is probably the best thing you can do.
I agree with your gut feeling that something is not right. But "go to a doctor" may not be helpful when the issues are non-specific - this could be medical, mental, nutritional, some combo. She may need to see several doctors to figure it out, which will only happen if she's self-motivated to solve it. So just listening is what you can do for her.

Reconsider that trip with her, because it would give you opportunities to listen and find out what is up.

BTW, I think it can be fine to tell someone thet have BO. I mean, bosses have posted on here about having to tell employees, so you can tell your sister "dude, go take a shower before we go to dinner, you're getting stinky."

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

Omg I started a GLP-1 6 weeks ago and my depression is the best it's been as long as I can remember. I've been thinking of tapering down my SSRI and anti anxiety meds but I haven't taken the plunge yet.

Are you planning to go off GLP-1?

I am prediabetic and insulin resistant so I'm not sure I will ever go off but if I did I assume I'd need to be on the meds again.

I am insulin resistant as well. I was doing fabulously on Zepbound and Caremark pulled it out from under my feet. Wegovy is working but not as well. I also work with a registered dietitian. I have lost 55 pounds but need to lose about 25 more.

I worked with my doctor to stop the SSRIs. It's been over a year now. I still feel great.

I don't think I will ever stop taking it, but I do hope to get to a point where I could do injections every couple of weeks instead of every week. At a lower dose too. Wishing you the best with this. It truly can be such a health enhancement for so many people.

[Anonymous]

Anonymous wrote: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?

Do you know for a fact, OP, that your sister is indeed hosting dinner parties? I ask because a childhood friend of mine many years ago was struggling yet told me similar things. She lived quite a distance from me so I had no way to know that she was just telling tales so as to seem okay.

I also just want to tell the OP that she is a wonderful and caring sister.

[Anonymous]

It sounds like she had underlying autism, OP.

I know people will excoriate me because they're tired of hearing about this particular neurodivergence, but my family is rife with it, my kids have been diagnosed, my husband is autistic, we've talked to psychologists and read so much on the subject... and she has a lot of typical red flags :

1. personal hygiene issues,
2. seeking socialization but not managing to have best friends or stable boyfriends,
3. and being let go from jobs.

It may look like depression, but I bet you anything that the underlying uatism is what's actually making her struggle. She needs to be evaluated and then to talk to a therapist who specializes in treating people with autism.

Now on top of that, perhaps there's weight gain and depression caused by hypo-thyroidism, for example. Hypothyroidism is very common, particularly in women. She needs complete bloodwork to check for all sorts of medical issues.

[Anonymous]

The friends might be imaginary.

[Anonymous]

It took me 10 years to be diagnosed with hypothyroidism and Hashimotos OP.

Was similar to your sister, except I didn't have cleanliness issues. I also use an app that rewards me for doing basic self care tasks. Depression goes along with hypo thyroid issues, as well as reduced ability to lose weight and crushing fatigue.

It's also possible she is neurodivergent (autism?) but very bright and masking most of the time, which makes her exhausted and creates similar symptoms. That would go along with the personal care and job challenges.

[Anonymous]

First, maybe she really does have CFS. Or perhaps she has some other medical issue like others have mentioned.

Second, I find it very hard to believe that someone who doesn’t shower for a week and sleeps 15 hours a day is hosting dinner parties. Is she lying about this or do you think she has manic periods where she suddenly has lots of energy?

[Anonymous]

Anonymous wrote:It sounds like she had underlying autism, OP.

I know people will excoriate me because they're tired of hearing about this particular neurodivergence, but my family is rife with it, my kids have been diagnosed, my husband is autistic, we've talked to psychologists and read so much on the subject... and she has a lot of typical red flags :

1. personal hygiene issues,
2. seeking socialization but not managing to have best friends or stable boyfriends,
3. and being let go from jobs.

It may look like depression, but I bet you anything that the underlying uatism is what's actually making her struggle. She needs to be evaluated and then to talk to a therapist who specializes in treating people with autism.

Now on top of that, perhaps there's weight gain and depression caused by hypo-thyroidism, for example. Hypothyroidism is very common, particularly in women. She needs complete bloodwork to check for all sorts of medical issues.

I agree with this. I saw autism in the Op's post right away. Seeking out soft, stretchy clothes (thrifting clothes is common among parents of some autistic kids with sensory issues since they are worn-in) and hygiene struggles are often the result of sensory issues and could also be demand avoidance. Being really overexcited and eager to date but not even attempting to date would make sense. Autistic women are often very aware of social norms and socializing and interested in both, but may struggle to actually execute.

She sounds like a nice and decent person who could have benefited from the kind of intervention and support she would get if she were a child now. I think you need to consider if she would find a conversation about potential autism validating and empowering or if it would hurt her feelings and make things worse. Some people feel better with answers and others feel trapped.

[Anonymous]

It really sounds like she has mental and physical health issues that are multiplying and feeding off each other as a result of being very overweight. When you are very overweight into your mid 30s and older, you don’t have as much energy as a normal weight or slightly overweight person. Then you start to get depressed because you can’t do as much as your peers. Then your hygiene goes by the wayside because you’re depressed and/or because you don’t have the physical energy to shower, brush teeth etc. Then your depression worsens because you know your hygiene is bad. And so on and so forth. Again this isn’t about carrying an extra 10 lbs from kids or being post-menopausal or whatever. Being a few lbs overweight is vastly different than being seriously obese.

Unfortunately she has to be the one to fix this problem for herself and it will take a combination of weight loss meds/injections and lifestyle changes. You’re right to be concerned, but ultimately, you can’t force someone to take responsibility for their own health. But I really do think if she gets the weight under control, the hygiene, sleeping too much, etc. will also improve.

[Anonymous]

If she doesn't stink, showers, washes hair that's a big and potentially do-able set of goals.
That should be first.
Losing weight is a bundle of angst. Just be fat and don't be unclean and you can go farther.

[Anonymous]

Anonymous wrote:

Anonymous wrote:It sounds like she had underlying autism, OP.

I know people will excoriate me because they're tired of hearing about this particular neurodivergence, but my family is rife with it, my kids have been diagnosed, my husband is autistic, we've talked to psychologists and read so much on the subject... and she has a lot of typical red flags :

1. personal hygiene issues,
2. seeking socialization but not managing to have best friends or stable boyfriends,
3. and being let go from jobs.

It may look like depression, but I bet you anything that the underlying uatism is what's actually making her struggle. She needs to be evaluated and then to talk to a therapist who specializes in treating people with autism.

Now on top of that, perhaps there's weight gain and depression caused by hypo-thyroidism, for example. Hypothyroidism is very common, particularly in women. She needs complete bloodwork to check for all sorts of medical issues.

I agree with this. I saw autism in the Op's post right away. Seeking out soft, stretchy clothes (thrifting clothes is common among parents of some autistic kids with sensory issues since they are worn-in) and hygiene struggles are often the result of sensory issues and could also be demand avoidance. Being really overexcited and eager to date but not even attempting to date would make sense. Autistic women are often very aware of social norms and socializing and interested in both, but may struggle to actually execute.

She sounds like a nice and decent person who could have benefited from the kind of intervention and support she would get if she were a child now. I think you need to consider if she would find a conversation about potential autism validating and empowering or if it would hurt her feelings and make things worse. Some people feel better with answers and others feel trapped.

This is also my guess, coupled with exhaustion from masking (+ perhaps other medical issues). I would ask her about that app and use that as an entry point. Clearly the fact she has the app means she's somewhat self aware.

[Anonymous]

Anonymous wrote:

Anonymous wrote: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?

Do you know for a fact, OP, that your sister is indeed hosting dinner parties? I ask because a childhood friend of mine many years ago was struggling yet told me similar things. She lived quite a distance from me so I had no way to know that she was just telling tales so as to seem okay.

I also just want to tell the OP that she is a wonderful and caring sister.

I was going to ask the very same question. Seems weird that someone who struggles with dating due to hygiene would regularly have friends over. Please do check out her place.