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Holy fucking shit. Does he have serious mental illness? I've never seen or heard of someone being even remotely like that and not have some form of mental illness. Dude needs some kind of therapy either way, goddamn.
Refusing to do normal human tasks to the point where it interferes with your ability to meet your life goals is sort of definitionally mental illness.
Nope, no mental illness.
Just grew up in a house where it was normalized and unshamed, apparently. Which is why the only thing that can make him "shower" is the doctor visit, under threat of not seeing the doctor/getting refills if he didnt.
Growing up in a house where something unhelpful is normalized is essentially a mental illness. His brain is wired incorrectly for normal social behavior. He could rewire it with a lot of effort and attention. Being unable to do so, or even realize there's a problem, is part of the illness.
Yeah idc how you spin it bathing 2 times per year and having sheets so dirty they're black and crack when they move is serious mental illness.
If his home was like that growing up it just means his parents had a mental illness as well.