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My Husbands Roller Coaster Of Proper Hygiene: Is It Depression?

Question:

Hello Dr. Schwartz,

My husband, for the past year, has been lacking interest in his own hygiene. Sometimes he goes for days without bathing and even wears the same clothes. I try to wash them and place out options of clean clothing. Sometimes he eats bit, mostly doesn’t, and only sweets and unhealthy choices. He’s not over-weight and is in good physical health. However, he lacks going out or doing things with family and friends. Sometimes I’ll find him drinking a few beers during the week. This is unlike him and I when I talk to him he responded back with, “I can’t f*#¥ have a beers!”

He was in the military and it was determined that he has no PTSD. Still, he goes to work and acts ok with people. I’m concerned and feel that he is in denial. He doesn’t want to talk and changes the subject. What’s really going on with my husband!??

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Answer:

It is entirely possible that your husband has depression, PTSD or a combination of both. Hygiene, drinking and refusing to go out and angry reactions are symptomatic of either diagnosis. I want to point out that if he always had poor hygiene then it is doubtful that it signifies depression. Any change or combination of changes in behavior could point to a mental illness.

Even though the military determined that he does not have PTSD does not mean they are correct. They have a history of under-diagnosing that illness during the Iraq and Afghani wars. If he has PTSD, then, depression and drinking would be part of what he is experiencing.

It is impossible to do a diagnosis without him going to a psychiatrist or to the VA for an evaluation and diagnosis. The question is how can you get him to do that in light of the fact that he reacts angrily when you point out that he is drinking too much? My suggestion is that you avoid the drinking issue and instead tell him that you notice a change in his: hygiene, over-all ways he cares for himself, including foods he chooses, and his self isolation. Make clear that you are worried about him because you love him and that you think he should be seen by an MD  because he may be depressed. Even if he at first refuses, you will have planted the idea in his head. Hopefully, he will come around and seek help.

Luck

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