I have been writing down my struggles with self-care and giving it to my pdoc at every visit and that has helped her a lot with understanding how much I am struggling. I always present better than I am so if I give her the truth about showering and how hard even brushing my teeth is then she has a better picture of how I am really feeling. If she asked I would tell her this probably but I can't just volunteer it and she doesn't know to ask (she does now but she didn't) because to her I was coming showered and wearing clean clothes. So writing really helps.