Hygiene and Mental Health

mental health hygiene
Today’s guest blog post was written by Kathleen Corcoran.

Mental health and cognitive decline can have a serious impact on a person’s ability to maintain regular hygiene and grooming routines. At the same time, changes or lack of regular hygiene and grooming routines can seriously impact a person’s mental health. Today is World Mental Health Day, a good day to consider how hygiene and mental health are woven together.

You’ve probably heard the saying “cleanliness is next to godliness” at some point. Many people subconsciously apply this moral judgement to the personal hygiene of those around them. As society’s standards of hygiene and grooming have changed over the centuries, so have the judgements on those who do not meet those standards.

This can have deleterious impacts on people already struggling with mental health or cognitive ability. Social stigma can deter people from reaching out for help, whether to mention their struggle to a therapist or ask for physical assistance. Self-consciousness about grooming standards may then contribute to isolation and loneliness.

“Unfortunately, at both ends of the spectrum, a lack of personal hygiene or an obsession with personal hygiene create additional stress and anxiety for the sufferer,” says Carla Manly, PhD, a clinical psychologist and author.

mental health hygiene
When mental health issues get in the way of regular showering or bathing, many people turn to alternative methods of maintaining hygiene.

Depression

Maybe chicken flavored toothpaste makes oral hygiene easier?

The fatigue and lack of motivation that often characterize depression make otherwise routine tasks monumentally impossible. Executive dysfunction can be paralyzing in the face of all the minor steps needed to shower or bathe.

Additionally, depression sometimes causes sensory issues that make bathing physically painful. The temperature changes, scents, or lights can be overwhelming for someone with severe depression.

Instead of traditional bathing practices, those with mental health challenges might turn to alternative methods of hygiene. Dry shampoo, mouthwash, and wipes can enable someone with depression to stay clean when everything is difficult.

Alzheimers and Dementia

People with cognitive decline issues, such as Alzheimer’s and dementia, often have trouble maintaining regular bathing and grooming routines. They may bathe repeatedly, forgetting that they have already done so. Or they may forget to bathe entirely. Alternatively, they may have physical issues that prevent them from bathing. Issues with regular bathing can lead to health complications, such as skin infections or gum disease.

People who can live alone may be able to address this by setting alarms or writing reminders. Maintaining a routine for daily grooming and hygiene can help it become automatic rather than something to remember. Adjustments like hose attachments and rubber mats can remove some of the physical impediments to routine bathing.

mental health hygiene
People in advanced stages of dementia may require help from caregivers to perform regular bathing and grooming.

Nurses, caregivers, and health aides can help patients who need more assistance with bathing. Keeping up habits established over the course of a lifetime can make assisted bathing easier. Bathing at the same time, using the same products or scents, might make a patient less agitated. Focusing on hygiene rather than grooming can help eliminate stress.

Ablutophobia

mental health hygiene
Humans with ablutophobia are not alone in the animal kingdom.

Many young children fear taking a bath or shower, but they generally grow out of it as they become more familiar with the routine or associate the bath with pleasant sensations. However, some people develop ablutophobia, an extreme fear of bathing or washing. This may be due to a sensory processing disorder, a traumatic experience, changes in brain function, or an underlying anxiety disorder.

When people with ablutophobia try to perform routine hygiene or grooming rituals, they may experience the symptoms of a panic attack or dissociation.

In the short term, people with ablutophobia can use alternative forms of cleaning, such as wipes or dry shampoo. However, treating ablutophobia will ultimately require psychotherapy or medication, which may allow a patient to uncover and address an underlying cause.

PTSD and Anxiety Disorders

Both post traumatic stress disorder (PTSD) and anxiety disorders can cause difficulties with regular standards of cleanliness. These mental health challenges can cause people to go to either extreme of hygiene and grooming. Sometimes people avoid bathing entirely because it triggers traumatic memories or causes a spike in anxiety. At other times, people fixate on removing dirt, performing ritualized grooming behaviors, controlling elements of their environment, or perfecting their outward appearance.

At either extreme, a person will likely feel an increased sense of social stigma and isolation, compounding the pain from mental illness.

Some people may prefer to take dust baths rather than water baths.

Short-term solutions may include changing the method of bathing, such as cleaning body parts individually to limit vulnerability, or switching from baths to showers. Changes to the bathing environment may also help, such as removing or installing locks on doors, turning down the temperature of the water heater in the home, or removing harsh scrubbers.

“The ultimate goals with such behaviors are to reduce a sense of being violated and ‘dirty’ and to increase a sense of safety,” says Carla Manly.

Schizophrenia

People struggling with schizophrenia often have difficulty maintaining regular routines and lose interest in daily activities. This includes habits like showering, brushing teeth, or changing into clean clothes.

Additionally, many medications to treat schizophrenia have side effects that contribute to problems with hygiene or grooming. Antipsychotic drugs often cause dry mouth, which can lead to gum disease, cavities, and halitosis. These medicines may also cause incontinence, which makes maintaining hygiene very difficult.

Some people find written reminders or alarms helpful to encourage regular hygiene or grooming rituals. Adjusting medications or dosages may help with side effects. Chewing gum and drinking lots of water can help with dry mouth, improving oral hygiene.

Bottom Line: Hygiene and grooming serve two different functions in our lives. When mental health issues make everything more difficult, focus on hygiene rather than grooming.

YOUR TOXIC ENVIRONMENT

Not the air you breathe, not the water you drink, not asbestos in your house or lead based paint. I’m talking about toxic people in your life! As part of Mental Health Awareness Month, let’s talk a bit about how to recognize the toxic people in your life and what to do about them.

Toxic People

A toxic person is anyone whose behavior adds negativity and upset to your life. Lillian Glass first used the term in her 1995 book Toxic People: 10 Ways of Dealing With People Who Make You Miserable.

I’m not the first to recognize the threat toxic people pose to one’s well-being. Clinical psychologists and other counselors frequently see people struggling with toxic people in their lives. And there are a ton of self-help books out there.

In 2018 Oxford Dictionaries named “toxic” as its Word of the Year, citing a 45% increase in look-ups of the word and an expansion in the scope of its application.

Toxic people are more common than you may think.

Researchers suggest that toxic people represent possibly 5-10% of the population and maybe cause 95% of the damage to humans. Toxic friendships are all too common: 84% of women and 75% of men report having a toxic friend at some point.

A 2015 study suggests that, though men and women may display toxic personality traits differently, toxic personality shows up equally across the entire population.

Identifying Toxic People

Your own gut reaction to toxic people will likely warn you to limit interactions with them. From WebMD, here are some warning signs that you’re dealing with a toxic person:

  • You feel like you’re being manipulated into something you don’t want to do.
  • You’re constantly confused by the person’s behavior.
  • You feel like you deserve an apology that never comes.
  • You always have to defend yourself to this person.
  • You never feel fully comfortable around them.
  • You continually feel bad about yourself in their presence.
  • You consistently dread spending time in this person’s company.

Just like there are signs you’re around a toxic person because of how the person makes you feel, there are signs you might see in toxic people themselves that highlight their toxicity.

The most common signs include:

  • Toxic people are often controlling, wanting his/her way in matters large and small. They often say, “You should….”
  • They are unwilling to compromise, even on seemingly minor issues.
  • Toxic people are typically highly critical.
  • Their mood toward you seems to run hot and cold, i.e., they are inconsistent.
  • Their “wounded ego” constantly needs bolstering.
  • Toxic people are often narcissistic, focusing mostly on themselves.
  • They tend to exaggerate.
  • They are preoccupied with projecting an idealized image, whether that’s of a perfect family, a benevolent philanthropist, or simple physical attractiveness.
  • They have a negative attitude about other people and about life in general.
  • They often abuse alcohol or other substances.
  • They don’t respect the boundaries of others, sometimes physically, more often psychologically; i.e., making plans on others’ behalf, not keeping secrets, bringing up hurtful topics.
  • They expect others to “know” or guess what they need without actually asking for it (and then take offense when those needs are not met).
  • They’ll use non-toxic words but in a toxic tone of voice.
  • They will never admit to their own wrong-doing.
  • Through all their stories, they are always the victim.
  • They’re judgmental and not afraid to share.

So How Do These People Get into Your Life?

  • Friend by History:
    • This is a person whom you have known forever.
      • Maybe you went to elementary school together, or you were neighbors growing up.
    • Now you feel guilty ending the relationship.
  • Friend by Proximity:
    • This is a person who comes as a package with someone else in your life.
      • Maybe it’s your partner’s best friend, or your friend’s brother who always tags along, or your best friend’s childhood friend.
    • You feel guilty because you don’t want to put “your” person in an awkward situation.
  • Friend by Context:
    • This is a person who you see all the time in a specific area of your life
      • Someone you work with everyday, maybe someone on your flag football team or someone who lives across the hall, perhaps someone in your bridge group.
    • You feel guilty brushing them off because you see them all the dang time.

How Toxic People Negatively Impact You?

The negative effect toxic people can have on those around them goes both deep and far. And it’s not just personal: a toxic employee or manager can negatively impact their entire business.

  • As Babita Spinelli, L.P., J.D. explains, toxic people will find ways to blame you for everything, control you, suffocate you, and invalidate you, which can lead you to abandon yourself.
  • When a toxic person has a hold on you, you’ll find yourself accommodating them, making poor choices, and getting caught in drama. This all leads to an overall diminishing of self-esteem and self-worth, and even anxiety and depression, says Spinelli.
  • A more insidious effect of toxic people is that they’re energy vampires, meaning they seem to drain the very life out of people around them just with their presence. “They cause you a lot of distress that you may even justify because you can’t understand why it’s affecting you so badly,” Perpetua Neo, DClinPsy notes, adding that toxic people will often make you question your reality.
  • Children with toxic parents can develop a variety of mental traumas as they grow up, including depression, anxiety, eating disorders, hypochondria, and Post Traumatic Stress Disorders.
  • Children surrounded by toxic adults may grow up to be toxic adults themselves.
  • Teachers with toxic personalities can harm students’ academic performance, interest in school, and self-esteem.
  • Toxic employees can cost a company revenue and hurt an organization’s reputation both with customers and within an industry.
  • Toxic bosses decrease employee productivity, increase employee absenteeism and turnover, and have an overall negative impact on the entire organization where they work.

Are You a Toxic Person?

Could you be a toxic person? Take this quick test from Truity:

It is simply a fact that I am smarter than the average person.

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People who want to get close to me need to understand that I have strong emotions and that I must be true to myself.

InaccurateAccurate
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Most people spend too much time and energy trying to achieve goals that don’t really matter.

InaccurateAccurate
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Everyone lies—I’m just better at it than most.

InaccurateAccurate
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The best way to avoid being disappointed is to expect the worst.

InaccurateAccurate
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I often have to push people to do things in a way that meets my high standards.

InaccurateAccurate
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I do not like to be treated like one of the crowd.

InaccurateAccurate
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If any of this sounds like you, don’t despair! Most people do not have a permanent, entrenched personality disorder; they may be simply going through particularly toxic phases. The first step to fixing a problem is generally admitting that the problem exists. Deliberate efforts on your part to shift your perspective and your responses to those around you can help you break toxic patterns of behavior.

As Hannah Baer writes, “Research demonstrates that believing others have fixed traits which don’t change (including, say, “toxic” personality pathology) yields defensiveness, failure to listen, and failure to set boundaries (because what good can it do if they can’t change?).”

On the other hand, you might recognize someone you know in this quiz. Many times, people who are toxic are dealing with their own stresses and traumas. To do this, they act in ways that don’t present them in the best light and usually upset others along the way. Or maybe it’s just the alcohol! But you are not the therapist for such family members, friends, coworkers, neighbors… Attend to your own well-being first.

How to Deal with Toxic People

Paracelsus, a 16th century Swiss physician and philosopher, famously said, “Dosis sola facit venenum (Only the dose makes the poison).” Though his claim that poisons can cause harm only if ingested in a high enough concentration may not be entirely true for toxic chemicals, it is a good guiding principle when dealing with toxic people.

There is a chance that the person is not genuinely toxic and is just reacting to particularly high levels of stress in their own life. In this case, you might be able to bring their toxic behavior to light, leading them to change on their own.

  • Confront the person about the toxic behavior. This is best done in a calm, non-argumentative way. For example, “When you do/say X, I feel Y.”
  • In the case of someone you’ve known for a while, ask yourself if their behavior has always been problematic or if it has become more toxic over time. If the person has become more toxic, you may be able to have a discussion about what has changed, when it changed, and whether it might change back.
  • Discuss the negative behavior you’ve noticed, including specifics.
  • Often, a person displays toxic behavior in response to power imbalances in a relationship, such as a work supervisor or a parent. In such cases, addressing the unequal power in the relationship might remove the trigger for toxic behavior.

If you realize that you are unlikely to cause a genuinely toxic person to change their personality in any fundamental way, your best option may be to minimize your “dose” of exposure.

  • Set and enforce clear boundaries.
  • Spend as little time as possible with the person.
  • Change the subject when they bring up problematic conversation topics.
  • Limit conversation to relevant topics. For example, only talk to a toxic coworker about work-related topics. With a problematic bridge partner, only discuss future bridge games or strategies.
  • Leave yourself options for escaping bad encounters if necessary.
  • If your boundaries aren’t respected, follow through with concrete actions, including breaking off contact.

It may be best to break off all contact with a toxic person, preserving your own sanity and peace of mind.

  • Stop all meet-ups, phone calls, messages, social media connections, etc.
  • Avoid reminiscing about the “good times” or reliving painful memories.
  • Don’t give in to the urge to look them up online or ask mutual acquaintances about them.
  • Focus on personal healing and self-care.
  • Maintain healthy and supportive relationships with others.

Bottom Line: Purge your life of toxic people. You know who they are!