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.

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.

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.

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?

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.

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.

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.

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.