I work with people with mental illness, and my brother and father are bipolar. Based on this experience I would never dispute Prudie's premise that a lot of people with mental illness have serious hygiene issues, but where on earth does she get off assuming that the LW's brother is mentally ill with no evidence other than the fact that he stinks and doesn't wash his clothes enough? The LW said nothing about any other changes he'd noticed in his brother. One would think there would be notable changes in his temperament or personality if mental illness (or drugs, for that matter) were the underlying cause of his newfound slobbiness. Mental illness and drug abuse were probably worth mentioning as possibilities, and I think Prudie was smart to encourage the LW to consider that his brother could potentially need help beyond reminders to shower more often, but geez, talk about jumping to conclusions! Having B.O. is hardly grounds for a psychiatric diagnosis.

Prudie's advice seemed pretty sensible to me. Something has to be wrong for the brother to go from a well-groomed young man to a complete, stinking slob. Maybe it's a severe case of depression, or it could be mental illness. The LW should do more than give the brother a lecture on showering more often. Maybe go over to see his home to see if it's even more messy than he is. LW should perhaps make a greater effort to be a (sister or bro?) to him to find out what is going on with him.

It isn't really jumping to conclusions. Think about the cliche statement "who in their right mind......?" When people start suddenly doing things that make absolutely no sense given their prior behavior, would you really say that the same mind is guiding them as before? Or are they somehow not in their right mind? And once you accept that, drugs or mental illness are your first choices for not being in your right mind. Granted he could have also gotten his heart broke or decided to join a commune where washing is discouraged but the first two are the more likely options.

I thought Prudie was very astute to pick this up.

but going from caring about your appearance to the lack of hygiene described in the letter indicates something's going on-- it can't hurt to have him speak to a professional. It's one of the symptoms of major depression.

The article did state that he could have possibly been on drugs, and that the lack of hygeine was a sudden change.

I am a psychology major, and I know a few people who are bipolar. I think that really bad hygeine is usually a sign of a serious mental illness, like schizophrenia, bipolar, and in the elderly, Alzheimer's. I think that in order to not care or notice an extreme body odor there has to be something seriously wrong.

I am far from being completely normal. I have major depression and PTSD. But I have never had a hygeine problem that bad. However, I have an ex who was bipolar (and refused to take medication) and he would go WEEKS without taking a shower or brushing his teeth. His BO was so bad that people could tell what room he had been in or what hallways he had walked down and he didn't even notice and it didn't bother him at all. He seemed to not even be aware when people gave him strange looks, and he thought that all he had to do to cover his stench was to spray on so much Axe that it gave me an asthma attack.

The top poster did state that she was aware that bad hygiene can be a sign of mental illness (I missed that the first time I read it). She's just saying that she thinks Prudie was jumping to conclusions because that's the only symptom the writer mentioned, and that it's not enough for a diagnosis, and Prudie didn't even say "maybe" -- she called for an intervention.

Oh and good luck with school! My dad was from SE Indiana, and we used to stay at my grandparents' farm out there when I was a kid.

My dad was from SE Indiana, and we used to stay at my grandparents' farm out there when I was a kid.

I knew there was a reason you were so brilliant. You come from a long line of brilliant people. (Not that I'm biased toward Indiana people or anything! :-P)

...isn't a clue enough for you? mentally ill can be interpreted to mean many things, whichever suits your purpose. for one side, mentally ill is only someone diagnosed by a psychiartrist with one of the known, and treatable, mental afflictions like schizophrenia, etc. for the other side, mentally ill is someone who has had a drastic chracter change, regardless of whether medicine was able to diganose it or treat it. since medicine today, in the US, is a paint by the numbers enterprise, a lot of mental illness goes undiagnosed. but, any professional would consider the LW's brother's situation as a symptom of mental illness. The most common one in this country is depression. Either chemical, or environmental, meaning, there unhappiness is a healthy reaction to living in a cesspool. Only medical tests can tell.

I love it when you threadjack with paeans to my fabulousness.

The LW's brother obviously needs help of some kind since he's not doing well on his own. He may or may not receive a DSM-IV categorical diagnosis but the description of his behavior indicates that a professional intervention shold be seriously considered.

Actually, Alzheimer's can appear in the 40's. It's rare, and once Alzheimer's was considered ONLY the "early onset" variety, not the "senile dementia" which tends to be pegged Alzheimer's now.

Apparently we have a bit of a diagnostic breakdown here.

Yes, there is probably an issue that is occurring in this man's life which may have involved a 'trauma or momentous change'.

Mental Illness is always a point.

This man may also have a chemical imbalance within his pituitary glands or other failures.

Then we have another disorder that no one even thought of: that of a serious brain injury. Whether it be a stroke, traumatic, acquired or otherwise this condition can alter one's persona, habits and hygiene. Unfortunately 90% of MD's cannot diagnose this condition (unless it is a severe condition and he is laying comatose).

Substance abuse of any kind OR dual diagnosis of any variety could also be a factor.

Recently I worked with an individual who had and did the very same "diagnosis" that the writer originally described. After much investigation and inquiry, the neighbors told me that he had fallen down, struck his head the door steps and lain unconscious for nearly 1/2 hour. He was never taken to the ER or examined by a qualified neurologist (brain specialty). This man is now living with a life long disability, cannot remember yesterday, let alone bathing or fixing a meal. And yes, depression and anxiety are some of the symptoms.

For more information visit www.biausa.org

It is obvious that these folks need to visit again and be honest with this man. Regardless of what may be wrong, he needs help... be gentle, understanding and transparent.