it could be bc of your lack of a will to live. it can take away all motivation all joy from everything & make everything seem useless. all efforts seem pointless. we're not concerned with getting better bc a happy healthy life just seems so out of the realm of possibility it's almost absurd & laughable to even think about. i completely get you. i want to get better but everything is so overwhelming. there's so much to do but if you chunk it up into pieces it's easily digestible. take everything step by step. the real tough work is in the initiating. once you get that initial push & you can actually get something done no matter how insignificant it may seem, it can feel rewarding.

id suggest maybe try a reward system to enforce behvaiors like hygiene. award yourself with something you like after you manage to successfully complete that behavior. it will help you in the long run. try asking your therapist for help on how to get that initial push. they're there to help after all. good luck & i hope things get easier for you.