AuDHD & Hygiene

Why is showering so hard with AuDHD?

Hygiene is one of those areas of life where shame can show up really quickly. There’s this assumption that if you’re functioning in other parts of your life, things like brushing your teeth and showering should just be automatic. 

But just like with the vast majority of assumptions… that’s not exactly how it works. 

First off, and most importantly, struggling with these things isn’t a moral failing. It’s also a lot more common than one might think (given the frequency with which people tend to  discuss it). 

I’ve worked with numerous high-performing (by external measures) clients. People who are working full-time and thriving professionally, managing households, relationships, children, and deadlines. These people perform with a level of competence that looks like ease. And then we get into the details of everyday life and this pattern emerges of waves of fatigue and paralysis that hit as soon as the work or school day ends. There are things that are assumed to be simple that feel disproportionately hard; things like bathing, showering, flossing, brushing their teeth. And there’s also a pattern of embarrassment around speaking about this, as though it’s something that should have been figured out long ago. 

So, what exactly makes these things feel so hard for so many people? 

For people with AuDHD, there are continuously overlapping dynamics. Although AUDHD is a newer term, we know that it doesn’t mean that someone has autism and then ADHD, in a clear, separable way. Sometimes they cancel each other out, sometimes they augment one another, and sometimes it’s somewhere in-between. This is all happening within the individual, and is often impossible to recognize the overlaps and interactions of ADHD and autism from the outside. But we do know that these conditions continuously interact and build-on each other. 

That said, there are some patterns that tend to align more closely with one or the other. So, going forward, I will be categorizing traits and struggles for the sake of clarity. 

For someone experiencing autistic traits, transitions can be extremely difficult. Getting into the shower means stopping one state and entering another. It’s a sensory and cognitive shift. And then the reverse is true – once you’re in, leaving the shower is its own transition and can feel just as hard. 

There’s also a sensory experience to consider. There’s the pressure and temperature of the water, the feeling of being wet, the smell and textures of products, and the general change in environment. None of these is necessarily a neutral or pleasant experience for someone who struggles with change, transition or sensory sensitivities. The same goes for teeth-brushing and many other tasks necessary to maintain healthy hygiene

For someone experiencing executive dysfunction, common in folks with ADHD, the hardest work tends to be related to starting and following through with tasks. Showering isn’t a single task, it’s a massive list of small tasks, which can feel daunting and overwhelming. First, the decision needs to be made to start. Get up, get undressed, turn on the water. Adjust the temperature. Have a moment of doubt when you realize you wanted to work out today and maybe that means you should shower later instead. Realize you have a commitment later that day and so decide that the shower should, indeed, happen now. Decide whether you should wash your hair today, tomorrow, or the day after, and run through the consequences of each in your mind. Get in the shower and move through all the steps. Get out, dry off (hope you remembered to get a towel out for yourself), and get dressed again. 

Each of those steps requires executive functioning and decision-making. Lumped together in a brain that is already working at capacity, they can feel a whole lot bigger than they “should.” 

What can help

I’m going to repeat myself: struggling with hygiene tasks isn’t a personal or moral failing. It doesn’t make you irresponsible or any less of an adult. Missing a shower, skipping a step, doing the “bare minimum” — none of that is the end of the world, nor does it say anything meaningful about who you are as a person.

Because of this, before we get into strategies for managing hygiene with AuDHD, I want to encourage you to check in with your own values and preferences. What is it that you want, regardless of what you may struggle with? Do you want to feel clean? What does that clean look like? Do you want to feel comfortable? What gets you there? Or are you holding yourself to a standard set by someone else, a standard you were told was necessary? 

If what you’re currently doing works for you, fantastic. If there’s something that’s not working for you, maybe this can be a place to start. 

There isn’t a single fix for any of this. BUT as a neurodivergent therapist who works with neurodivergent clients, I have racked up a pretty good list of tips and tricks to make some of these processes simpler and easier. 

1. Simplify the process. Use an all-in-one product in the shower instead of a multi-step routine. Try to work towards letting go of the idea that you need a full routine in order for it to “count.”

2. Reduce sensory load where possible. Try unscented shampoos and shower products, and/or unflavoured toothpaste. 

3. Set yourself up for predictability. Have a single ready-to-go post-shower outfit (like a robe or PJs) to minimize decision-making. 

4. Make a deal to only hold yourself to the first step. When starting feels like the hardest part, try going into the bathroom and turning the water on. Promise yourself that if, at that point, you still don’t feel like you can shower, that you have a guilt-free pass to stop right there. For a lot of people, getting through that first step makes everything that comes after run more smoothly. 

5. Add in something that makes it easier to stay engaged. Music, a podcast, a tv show, even a book can help with boredom and follow-through while doing something like brushing your teeth. 

6. Adjust the sensory environment. Add things like a warm towel (toss it in the dryer for 10 min) or a space heater to your routine. Matching the temperatures of the air and water as closely as possible can help reduce the shock of transitions. 

7. Build-in a reward. Think small, repeatable things/moments of pleasure that can be added to your routine: a favourite snack, time dedicated to watching a specific show, clean PJs, or your favourite outfit. 

8. Use external structure and timing cues. If time-blindness is a struggle, try using a timer or a set number of songs to guide the process of bathing/showering. You can even assign steps to specific songs (one for getting-in, one for shampooing, one for rinsing, etc.). 

The goal here isn’t to force yourself into doing these things perfectly but to better understand what’s making it hard, and to hopefully make it a bit easier. 

If it’s hard, there’s a reason. When you can start to understand that reason and name it, you can start creating systems that fit who you are and what you want.