Showering with Depression, Trauma and Pain

naked woman under water in shower

Showering with Depression Strategies – occupational therapy tips – YouTube

Showering can be so hard for people experiencing depression, disability and trauma. It’s really a complex task that requires a lot of thought, prep and both physical and mental energy!

Here are my tips:

Skills Needed

  • Processing skills
    • Reading bottle instructions
    • Concentration such as have I washed my hair with shampoo? 
    • Ability to identify clothing orientation 
    • Problem-solving based on the weather
    • Timing with a newborn and listening out for crying 
    • Timing when other people are home
    • Negotiating with others when you can use the shower
    • Time limits on how much hot water is available 
    • Identifying which soap should be used where 
    • Problem-solving such as washing your hair based on social events occurring 
    • Motivation to get undressed 
  • Sensory skills
    • Gauging how hit the water temperature should be
    • Ability to tolerate different noises such as the fan, lights and the cold
  • Sensitivities
    • Undressing 
    • Comfortability with our body 
    • Presence of scales and mirrors present in the bathroom 
    • Vulnerability of being naked 

Here are my tips:

  1. Routine:
  • Keep a routine of what time you normally shower to keep consistent.
  • Pair showering with daily tasks such as going for a walk.
  • Use an app to help remind you to shower. 
  • Start small. Baby wipes and a face wash can be a good alternative if you don’t like to get undressed or you find showering exhausting.
  • Set a goal of how many times to shower a week. I had a three-day rule. 
  • Make sure there is a towel ready for you to use!! Or keep the towels under the basin if possible so no one has to come to bring you a towel. 

2. Create a sensory safe environment

  • Think about your shower environment and how you will feel more safe and secure… What do I mean?
    • If fear is a concern, shower at a time when you feel the most mentally strong.
    • Shower when you can not hear people on your driveway (if you live on a shared driveway)
    • Shower when you are stronger at managing the “voices” in your head.
    • If you feel safer, shower when you know someone you trust is home.
    • Time your showers with others by notifying them in advance when you are planning to have a shower
  • In winter I have a hot water bottle ready for me in bed. That means straight after showing, I hop into a warm bed. Being cold is a significant need that I am aware of meeting
  • Use a portable heater if possible to help you in the process of getting undressed and dressed again.
  • If you don’t like the sound of water use a non-slip mat or earbuds to reduce the sounds.

3. Have a support

  • Have a friend check-in and ask when was your last shower
  • Shower with a buddy. My buddy was Lily my dog. Showering with her is more about looking after her rather than myself. It has made this dreaded activity fun.
  • Perhaps showering with a familiar and safe object – this could be a doll or playing a familiar song. 

4. Minimise Body sensitivities 

  • If you are sensitive to your body try to position your self so you are not spending a great time looking at yourself.
    • If you want to have a bath place a washcloth over your body to minimise discomfort with looking at these areas
    • Decide what clothes you are going to put on before showering. Standing in the cold and naked may be a sensitivity for you. Try to identify your triggers
    • Use a sensitive soap for your scars and skin.
  • For those who can not look at their body can you shower in a comfortable t-shirt? 
  • Use a big sponge so that you do not have to handle genitalia areas

5. Fatigue

  • Keep it simple. Don’t do everything in the shower – e.g. shave, wash hair, trim nails, and do teeth. 
  • Sit to shower. I sometimes don’t have the energy to stand to shower. So I sit. Not everyone is able to do that so maybe think about a safe shower chair/stool you could use.
  • Let you hair air dry if it’s not too cold. Lifting the hair dryer can be exhausting and extremely noisy for some people. So perhaps towel dry half and do the rest with the hair dryer.
  • If you don’t want to wash your hair use dry shampoo or place some talcum powder on the roots of your hair. This will prevent your hair from having that greasy look.
  • If there is enough natural light in the shower leave the fluorescent lights off. This will help reduce fatigue associated with any glare caused by artificial lighting. 

6. Staying Focused

  • Sportscast your shower it will help you focus. “Next I am going to put on my socks.”
  • Have different shaped/ coloured shampoo bottles to your conditioner. I don’t know how many times I’ve washed my hair with shampoo over and over without conditioner. This is so frustrating.
  • Have music playing to help stop you from daydreaming in the shower.
    • Music playing may also help with hearing outside noises, such as the neighbours, which may increase feelings of vulnerability.
  • Space – try to remove items out of the shower area to create more space, reduce distractions and to minimise gunk that might collect 

7. Clothing 

  • Put on clothes that will help you feel motivated for the day – regardless if you are leaving the house or not. But make sure you are wearing comfortable temperature-sensitive clothes. 
  • After showering, wear something comfortable that is the best sensation – e.g. perhaps you do not like certain textures. 

Finally Rewards Yourself! It’s a big task!

Please add your strategies below!!

Until then… Have a day,   

Love Laura

Founder of OT for BPD

Published by Beyond Personality Disorders

Founder of My Potential Mental health Advocate; Occupational Therapy Teacher and Researcher Australia “As an occupational therapist diagnosed with BPD I will use this page to share about the various interventions and strategies that are helpful to those with BPD. I will also share about the positive and sometimes challenging approaches that health professionals have used in my treatment in emergency, inpatient, outpatient and community settings. I hope that by sharing my lived experience I can help improve the experience of those struggling to understand Borderline Personality Disorders (BPD) and also support those living with BPD and other mental health challenges Most importantly we will share how occupation can powerfully help change lives!" Laura

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