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Major Depression, Terrible Personal Hygiene. Is This A Mental Health Issue, Suggest?

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Posted on Wed, 3 Oct 2012
Question: My son suffered a major depression 2 years ago and has been under mental health care. He has been slowly rehabilitated and is undertaking studies at college. He is now 22 years of age and has never worked a day in his life. He moved out of home and is staying with friends several hundred kilometres away whilst undertaking studies. They report that he is unmotivated to do chores with the family ~ his personal hygiene is terrible ~ won't keep his room tidy ~ fails to pay rent (5 weeks behind) and never speaks or exhibits courtesies like pardoning or excusing himself e.g. he expects folk to move out of his way without any communication. I fear he may be experiencing another depression or mental health issue and am at a loss to understand what is happening. If you can offer any advice, it would be appreciated. Thank you, XXXXXXX
doctor
Answered by Dr. Ram Choudhary (1 hour later)
Hi XXXXXXX,
I can understand your worries, and the kind of scenario you are describing- aloofness, lack of selfcare, not concerned about etiquettes of day to day life, not careful about his carrier and a history of suicidal attempt really are very much suggestive that he has again slipped into severe depressive episodes.
It appears that the young man has got intrinsic depression- which is resistant to treatment. such cases are managed by hospitalization and management by combination of drugs. Electroconvulsive therapy also remains a possible treatment option for people who do not respond to combination of anti-depressants.
I would advise you to give him a cover for sometime with someone in the family to whom he is emotionally attached or atleast likes/talks.
I doubt if he is still taking his medicines while he should have been.
We should also be considering the possibilities of schizophrenia. This. would mean an entirely different line of management with anti-psychotics.
In any case please get him re-evaluated and his drugs revised by some Psychiatrist of that locality.
Hope this helps
Regards
Above answer was peer-reviewed by : Dr. Aparna Kohli
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Follow up: Dr. Ram Choudhary (31 minutes later)
Could you please elaborate on "Intrinsic Depression" I don't like the sound of Electroconvulsive therapy. It sounds archaic and what guarantee is given that no permanent brain damage would occur?
doctor
Answered by Dr. Ram Choudhary (12 hours later)

Hi,

Thanks for the query.

Intrinsic means from 'within'. Intrinsic depression also known as endogenous depression refers to depression that hasn't been triggered by an obvious external cause.

Some people become depressed as a result of bereavement, job loss, relationship breakup, general life stress, etc. Others become depressed for no obvious reason. The implication used to be that intrinsic depression was more the result of a chemical imbalance, and extrinsic depression the result of stress.

Today's medicine uses an Electroconvulsive therapy that is absolutely safe and there is no evidence of a long term permanent brain damage or memory loss. When required it can be used as an additive treatment.

I hope that clears your doubts! Let me know if you need any more information.

Regard
Note: For further guidance on mental health, Click here.

Above answer was peer-reviewed by : Dr. Prasad
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Answered by
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Dr. Ram Choudhary

Internal Medicine Specialist

Practicing since :2001

Answered : 2270 Questions

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Major Depression, Terrible Personal Hygiene. Is This A Mental Health Issue, Suggest?

Hi XXXXXXX,
I can understand your worries, and the kind of scenario you are describing- aloofness, lack of selfcare, not concerned about etiquettes of day to day life, not careful about his carrier and a history of suicidal attempt really are very much suggestive that he has again slipped into severe depressive episodes.
It appears that the young man has got intrinsic depression- which is resistant to treatment. such cases are managed by hospitalization and management by combination of drugs. Electroconvulsive therapy also remains a possible treatment option for people who do not respond to combination of anti-depressants.
I would advise you to give him a cover for sometime with someone in the family to whom he is emotionally attached or atleast likes/talks.
I doubt if he is still taking his medicines while he should have been.
We should also be considering the possibilities of schizophrenia. This. would mean an entirely different line of management with anti-psychotics.
In any case please get him re-evaluated and his drugs revised by some Psychiatrist of that locality.
Hope this helps
Regards