Diagnose my sister. What is going on?

[Anonymous]

Anonymous wrote: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.

+1
Early stage schizophrenia.

[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.

Op is mean and judgement and shaming her sister online.

[Anonymous]

Anonymous wrote:

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.

Op is mean and judgement and shaming her sister online.

You seriously need help. Your resolution for 2026 is to stop trolling.

[Anonymous]

Anonymous wrote:

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.

I'm someone who is a lot like OP's sister, although more functional. I can pull it together for my job, but that pretty much uses all my spoons.

One thing that hurts is when the goalposts move. If I worked really hard to show up clean, wearing clean well fitting clothing, and someone judged me because my clothes were stretchy (they always are) and I didn't have mascara on (I never have) and my hair wasn't colored (it never has been except once with koolaid for a Halloween costume), then I wouldn't think "Oh, I'll learn how to put on mascara", I'd think WTF is the point?

I think that identifying a couple concrete things, which to me would be showering, and figuring out if there is a medical cause such as depression, thyroid, apnea, for the sleep, is a huge ask. And focusing on those, and not on all the other peieces, is appropriate.

[Anonymous]

She needs to get thyroid, fatigue (Vitamin D/B/iron/RBC), infectious disease, cardiac, and autoimmune lab panels. That amount of fatigue is not normal and also not necessarily caused by depression.

If she does not have insurance, she can order labs directly from an online provider such as Ulta Labs or Labcorp Direct.

This board always jumps to mental health issues, but suspect physical causes first.

[Anonymous]

Also endocrine labs.

[Anonymous]

Depression, ADHD, autism, thyroid, anemia, type ii diabetes or prediabetes (does she get sleepy after eating?), vitamin d deficiency. Probably more than one of these, and they make each other worse. If she wants to seek help, blood work for the physical stuff might be a good starting point. If indicated and desired, glp-1 could make sense; I know someone with a similar profile and it seems to be helping her energy level.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

I'm someone who is a lot like OP's sister, although more functional. I can pull it together for my job, but that pretty much uses all my spoons.

One thing that hurts is when the goalposts move. If I worked really hard to show up clean, wearing clean well fitting clothing, and someone judged me because my clothes were stretchy (they always are) and I didn't have mascara on (I never have) and my hair wasn't colored (it never has been except once with koolaid for a Halloween costume), then I wouldn't think "Oh, I'll learn how to put on mascara", I'd think WTF is the point?

I think that identifying a couple concrete things, which to me would be showering, and figuring out if there is a medical cause such as depression, thyroid, apnea, for the sleep, is a huge ask. And focusing on those, and not on all the other peieces, is appropriate.

I relate to this. The problem is OP is mixing in some legitimate concerns with some very superficial ones. And I get it that it's to give us the full picture and she's not necessarily judging (but maybe she is). At my largest I certainly felt like why in the world would I bother to color my hair.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

I'm someone who is a lot like OP's sister, although more functional. I can pull it together for my job, but that pretty much uses all my spoons.

One thing that hurts is when the goalposts move. If I worked really hard to show up clean, wearing clean well fitting clothing, and someone judged me because my clothes were stretchy (they always are) and I didn't have mascara on (I never have) and my hair wasn't colored (it never has been except once with koolaid for a Halloween costume), then I wouldn't think "Oh, I'll learn how to put on mascara", I'd think WTF is the point?

I think that identifying a couple concrete things, which to me would be showering, and figuring out if there is a medical cause such as depression, thyroid, apnea, for the sleep, is a huge ask. And focusing on those, and not on all the other peieces, is appropriate.

You don't need make-up or hair dye, PP. You just need to be clean and tidy, and you're meeting these essential points. I say this with love, given many of my close relatives are on the spectrum... have you considered that you might be too? The masking is constantly draining. Please consider it. Being autistic is not being "lesser than" other people. It's just a variation of the norm, and it comes with pros and cons.

[Anonymous]

As others mentioned-any idea if she had bloodwork? thyroid issues need to be ruled out. Are you sure she throws dinner parties? That's a lot of work and doesn't fit with someone who is so lethargic.

She already told you she has CFS. That may be a huge part. How is she treating it?

You said she smells. have you gently told her? Has she always had poor hygiene or is this new? How old is she? You may have posted? Usually signs of Schizophrenia come with young adulthood. Are you seeing other signs of depression? ADHD?

[Anonymous]

Sounds like depression but yes, could be other things. She's doing her best to hold it together (using tye app) but can't manage much more than that.

Does she drink? Reminds me of my alcoholic sister. She never smelled like alcohol and she was very adept at hiding it so it was not the first thing thst cane to mind and she never appeared drunk in front of us. But she lied about that and about many other things. Her social life could be a fantasy.

I think you care and don't sound judgemental at all. But know that you may get nowhere with trying to help. She may not really want it.

[Anonymous]

Posting again-I don't think people start showing signs of schizophrenia at 35. I assume she is getting help and a therapist told her about the ap. You could try a heart to heart and ask how you can be supportive. CFS may be the whole issue.

[Anonymous]

Anonymous wrote:Posting again-I don't think people start showing signs of schizophrenia at 35. I assume she is getting help and a therapist told her about the ap. You could try a heart to heart and ask how you can be supportive. CFS may be the whole issue.

No, it's not schizo, the poster who originally mentioned that is way off. But it does look like autism, on top of certain medical issues like thyroid, anemia, or other deficiencies.

[Anonymous]

Most of what you’re describing sounds linked to the core issue of constant fatigue. Being constantly exhausted is a reason why you’d never shower and put yourself together. There can be many causes for fatigue and she shouldn’t accept a chronic fatigue diagnosis without ruling other things (like sleep apnea) out. Sleep apnea treatment can be like flipping a switch for many people.

That said, there’s not much you can do if she is not confiding in you or asking for advice. She has to want to seek help. Setting up and attending appointments can be exhausting, though, in a way normal people would not understand. I would try to be supportive and let all of this go so she knows she is not judged. See her for the better parts of her personality, the fun part, so she feels understood. If she remarks about her fatigue you can offer help like booking appointments, attending with her, or asking around for good providers.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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.

I'm someone who is a lot like OP's sister, although more functional. I can pull it together for my job, but that pretty much uses all my spoons.

One thing that hurts is when the goalposts move. If I worked really hard to show up clean, wearing clean well fitting clothing, and someone judged me because my clothes were stretchy (they always are) and I didn't have mascara on (I never have) and my hair wasn't colored (it never has been except once with koolaid for a Halloween costume), then I wouldn't think "Oh, I'll learn how to put on mascara", I'd think WTF is the point?

I think that identifying a couple concrete things, which to me would be showering, and figuring out if there is a medical cause such as depression, thyroid, apnea, for the sleep, is a huge ask. And focusing on those, and not on all the other peieces, is appropriate.

I think this is a really good point about moving the goalposts. Very insightful from someone who knows what it's like.