Dear Dr. Michelle:
My daughter is a twenty-two-year-old bio engineering student. She is a hardworking girl, but she takes care of her hygiene poorly and her room is not walkable. Everything is on the floor. She gets mad when I talk to her about hygiene. A little background, my daughter has PCOS. I have spent a lot of money on laser hair removal, with not great results. When she was younger, she was bullied because of her condition and would come home crying. She does not want to go to a therapist. I’m not sure how to help her or what to do for her.
Jay
Dear Jay:
Thank you for reaching out. I am interpreting your reference to PCOS to be Polycystic Ovary Syndrome. I know it is very difficult to watch someone you love deal with the effects of a medical condition like PCOS.
For our readers, PCOS is a hormonal disorder in women that can lead to menstrual irregularity, enlarged ovaries and an increase in male hormone levels which can result in excess hair growth, acne, and obesity. The exact causes of PCOS are unknown.
Learning to Let Go
As a parent to a 22-year-old, you will have limited influence over how your daughter manages her emotional, mental, and physical symptoms related to her PCOS. You want the best for your daughter, but ultimately it is up to her to choose how she is going to manage her life with PCOS. Part of your solace will come only by letting go of your desire for her to respond differently to her condition.
To successfully let go, you will want to come to terms with the fact that nothing you do is going to change your daughter or her decisions. She is the only one that can find her happiness and peace or choose to take care of herself and address her self-esteem. You can provide her with support and information about how you feel and what you are willing to do to help, but it must be given without the expectation that you will get her to change.
To move into this acceptance, start by evaluating how your daughter’s choices impact you directly and then divert your attention to those things rather than focusing on how you want your daughter to address her condition differently.
Establishing House Rules
For instance, assuming that it is your house, see yourself as a landlord who is allowed to establish some basic house rules. Could you reduce your daughter’s rent or continue to allow her to live there for free if she agrees to follow the house rules. If your daughter’s hygiene is affecting the condition of the house, you can and should set up appropriate boundaries. For example, since her bedroom seems to be an issue you can establish the rule that she must clean it once per week, that she keeps her bedroom door closed when it is messy, or that you must be able to see the floor. You can also have rules about her not taking food into her bedroom to prevent smells, pests, and mold.
Regarding your daughter’s physical hygiene – while you cannot ultimately control how she takes care of herself, you can provide her with information about how her hygiene is affecting you. I know this is a very difficult conversation, but the only way to address physical hygiene is to talk about it directly. Without shaming or ridicule, if your daughter has body odor either due to lack of showering and/or lack of washing her clothes, you need to inform her and then deal with it as a house rule. As a condition of reduced or free rent, you can have the expectation that she washes her clothes every week and that she showers a minimum number of times per week.
Support Her Medical Treatment
You can also support your daughter with her medical treatment. As you are already aware, PCOS is a medical condition in which there is no cure. As such, ongoing medical treatment, to include medication management, should be a priority. If she is not under the care of a specialist, this would be my first recommendation.
Medical oversight by a specialist can help your daughter find the right combination of medications, it can link her to other resources when certain interventions don’t work, it can keep her educated about new treatment developments and it can expose your daughter to external experts who can provide feedback about how to address hygiene and self-esteem.
Examples of your support for her medical care may include helping her find the right doctor, attending appointments with her if she wishes or letting her go alone, giving her rides or letting her borrow the car, and even keeping her on your insurance until she ages out of parental coverage.
You mentioned that you are currently supporting her by paying for laser treatment. Only you can decide if you are able or willing to continue offering that help. Remember that your support should be about your care and concern and not be offered because you have an expectation that she changes her behavior. If she refuses your support, you will need to let it go.
I am sorry that your daughter carries a past of being bullied and ridiculed by others. You are right to suggest therapy. She is most likely carrying those past wounds into her adult life, and it is sure to affect her self-esteem. But once again, you will not be able to influence your daughter to receive this type of help. She needs to decide if this is something she wants. She is the one that must be motivated to engage in such a process.
Finding a Support Community
While therapy may not be her thing, being connected to a community of other people who are dealing with PCOS could be an alternative she is willing to consider. Being connected to people who share experiences is not therapy, but it can sometimes be a more powerful form of help. Here is a link to a national organization that offers a lot of resources and a community of support related to PCOS.
Keep in mind your daughter is still young. She will continue to grow and mature and future experiences in her life will most likely lead her to make different choices. What she might not be willing to do now, she may be willing to do in the future.
Dear Dr. Michelle blog posts are informational in nature. The posts are not meant to take the place of consulting your physician, mental health professional, or other qualified health providers regarding your well-being or the well-being of others. Submitting a question does not establish a client/therapist relationship.
