The Dirty Side of Mental Illness

“Midwest or Dirty South
Clean dressed or dirty mouth” -Big Rube

My son got braces in February. He had a small gap between his front teeth that he never liked. I think it’s adorable. Adorable must not be the look he’s going for because he lobbied to get braces for years. Thanks to decent insurance coverage, he was victorious. Now his smile is full of metal and blue rubber bands. It’s still adorable.

Because of COVID-19 safety protocols, my son’s orthodontic appointment was virtual last month. The orthodontist assessed the straightening of his teeth using our laptop’s camera. In just two months, the gap is closing and my son’s satisfaction with his smile is increasing.

I’m happy that he will be happy with his smile. I wish I could experience the same happiness. I hate my smile. Maybe hate is a strong word. But I try not to look at it much. My teeth are crooked. They once were straight but, when my orthodontist died, I suppose I didn’t follow through with the retainers. That’s only part of the story. The other part is depression.

It’s often discussed how depression affects mood, motivation, and sleep. One less talked about characteristic of depression is its effect on hygiene. When depressed, it’s not only difficult to muster the energy for work, school, or relationships. It can also be difficult to find the will and energy to do common tasks like shower, brush teeth, and comb hair. When you combine depression’s inner pain with the physical pain and fatigue many of us experience, hygiene can take a back seat.

There have been times I did not shower for days. I allowed my outer self to look and feel and smell as bad as I felt inside. I’d isolate so no one would know. Sometimes, to pass, I’d throw on some deodorant, throw on a relatively clean shirt, and spray on some essential oils. I’ve worn many “I just can’t do my hair today” ponytails. My teeth would get brushed but not for the recommended two minutes and maybe not twice daily. And forget about flossing which brings me to my current dilemma.

Nearly 20 years ago, I was told that I had the early stages of periodontal disease. I was in my 20s and felt nasty. I underwent some treatment at the time, but I noticed the following trend. When I felt well, I’d make all my appointments and follow through with the correct toothpaste and flossing routines. And when I was depressed, I wouldn’t. I’d feel ashamed of my gums, too preoccupied to floss, and too tough on myself for not following through. It was just another indication that I was a failure. So, here I am with unhealthy gums and shifting teeth and a smile I don’t like. It’s a vicious cycle. I don’t feel good and don’t take care of my teeth which makes me not feel good and avoid taking care of my teeth. And when I feel good, I don’t want to smile because I didn’t take care of my teeth and their crookedness is a cause for the shame of the lack of hygiene I had during a depressive episode. Almost like a punitive reminder.

How Mental Illness Affects Hygiene

Preoccupation with thoughts and emotions can dominate one’s time and actions at the expense of basic hygiene tasks. I lost days to depression.
Severe fatigue makes it difficult to leave my bed some days. This was another way I lost days.
The physical symptoms associated with mental illness can impede hygiene efforts. When I have a migraine, it hurts to do anything to my hair. In addition, when I’m anxious, I experience nausea and increased gag reflex which makes brushing my teeth a chore.
Mental health concerns can also lead to excessive hygiene practices. Sometimes the need to feel better is addressed through over-showering, over-scrubbing, and over-brushing. This was the case for me in high school as I attempted to wash away a traumatic experience.

How To Address Hygiene During Mental Health Challenges

Teeth: I use mouthwash on the days when brushing seems too much. Also, once the dentist offices open up again, I’m making an appointment.
Hair: Protective styles (for me, twists) are helpful. I’ve heard about, but have not tried dry shampoos.
Bathing: I get in the shower and let the water rinse over me even if I’m unable to do much scrubbing. Some find shower seats useful. I’ve also heard that people use baby wipes to freshen up.
Talk it out: I confess that I’ve never talked to my therapist about hygiene but I’m sure it would have been helpful in the past.

Why would I publicly announce that I’m a nasty ass? Well, as the tagline above states, “The revolution will not be stigmatized.” People who experience hygiene-related illnesses are not irredeemable. We’re doing the best we can while experiencing a mental disorder. Treatment goes far beyond popping a pill and sitting on a couch once a month. Compassion, for self and others, is necessary for all facets of mental illness. Even the dirty ones.

Categories: : Wellness