I don't think you actively choose not to do it I think you are not capable of doing it. At least that is how I get. It gets so severe that I spend most of the time in bed. I can go weeks without showering or shaving, only brushing my teeth occasionally. I have 0 energy and 0 motivation. I know all the things too. Go for a walk, eat right, go out with friends, be around people you will feel better......on and on. No ****ing way. I am just not capable of doing it. Even if I choose to do it I can't. It takes a monumental amount of effort to take a shower and go see my pdoc. And then I look better than I am because I took a shower for the first time in three flippin weeks.