Summary
A parent is worried about a nineteen-year-old daughter’s marked decline in bathing and her defensive reaction when it is mentioned. They ask whether this could be depression or an adolescent phase.
The response explains that diminished self-care can accompany depression and social withdrawal, while acknowledging that defensiveness may also have other explanations.
It says a professional evaluation is needed to know and suggests expressing concern and helping arrange one; it also cautions against assuming medication is necessarily the best treatment.
Question
Reader · Identity withheldMy nineteen year old daughter is slim, attractive and intelligent. This past year her personal hygiene has declined dramatically to where she will go up to two weeks without bathing.
While we get along most of the time, when I approach her about her hygiene habits she becomes very defensive and refuses to talk about it. Is this a sign of depression? Or just an odd adolescent phase? Please advise.
Answer
Ann LandersWhat you’re describing sounds like a classical sign of depression. Depression is more than just a low, blue feeling. Symptoms of depression include depressed (low, blue) or agitated, irritable mood, lessened pleasure in everyday activities that formerly were sought out because they were fun to do, sleep and weight changes, low energy and fatigue or nerves (as part of that agitated presentation), low self-esteem, difficulty concentrating and possibly even thoughts of death or suicide. Taken together, the symptoms of depression can profoundly change a person’s apparent personality in a short span of time.
One of the classic signs of depression is a social withdrawal. It no longer feels motivating for a depressed person to be with other people (they feel worthless or they simply don’t want company). They may lose their sexual interests and may stop caring about themselves as social objects as well.
Diminished hygiene can be a part of this social withdrawal syndrome. That your daughter is defensive may be part of the agitation that can be associated with depression, but let’s face it, it might also just be semi-normal teenage-breaking-away sort of angst.
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There is no way to know definitively if your daughter is depressed without her being evaluated by a mental health professional, so it would seem a good idea to express concern to her and help arrange for an appointment. If she is a student at university, this may be possible through the student health service. Alternatively, she ought to see a community psychiatrist.
Any general practitioner can prescribe antidepressant medications, but a psychiatrist is a specialist when it comes to depression. Don’t assume that medication will be the best solution for your daughter’s woes, please. If she is indeed intelligent as you say, she may do very well with a few months of cognitively oriented psychotherapy, which has been clinically proven to reduce depression symptoms about as well as medication, and with fewer side effects.
As an added bonus, the effect of psychotherapy treatment for depression tends to last longer than medication, once therapy is done.
