I can tell you from personal experience that personal hygene is one of the most difficult and incideous parts of bipolar illness because it makes no sense and it my case, it is one of my first signs of depression. I am a 56 year old woman who used to be a special investigator with the government and had to dress in a suit and heels every single day for years and years. After my bipolar illness became so bad that I had to go on disability, it was like pulling teeth to get me to put on clothes in the morning and even more difficult to get into the shower more than once a week. I did brush my teeth at least daily, comb my hair and wash my face. But showering and washing my hair were absolutely more than I could possibly manage. The only way I can explain it is to say that my mind was so muddled with things that hurt and confused me, and didn't make sense, that seemingly unimportant things like showering or clean hair were the least important details in my world. I simply did not care. The mental pain was so bad.

Once medication began to make my life more tolerable, I was able to begin to learn about "self care". These are things that, in spite of the way we as bipolars feel on a day to day basis, we learn that we must do in order to live successfully with our illness. There is one woman I know who calls them "the unnegotiables". The "unnegotiables" are showering, shampooing, brushing her teeth, combing her hair, putting on a little makeup, putting on clean clothes, doing her dishes, and making her bed. These are the things that she has committed herself to do daily no matter how badly she feels and they are unnegotiable. It has made a world of difference in her life. But it took the process of getting to where she felt well enough to learn that she needed to put this plan into place and make it work for her first. That required that her meds help her feel better first.

I know it's hard to watch your son this way. But nothing you say can help him right now. He has to feel better first. The only thing that's going to help him is acceptance from you and support and then counseling.

Best of luck to you all.