Hughes' obsessive-compulsive disorder (OCD) becomes increasingly severe, manifesting in extreme germaphobia, repetitive behaviors, and ritualistic routines. His fear of contamination dominates his daily life.

Hughes begins using painkillers to manage chronic pain and various ailments. His reliance on these medications escalates, leading to addiction and further impacting his mental and physical state. He often isolates himself in darkened rooms, dependent on his staff for even basic needs.

Hughes becomes increasingly reclusive, rarely appearing in public and communicating almost exclusively through his staff. He moves from hotel to hotel, maintaining strict control over his environment and isolating himself from the outside world.

Hughes' physical health declines significantly due to neglect, poor diet, and substance abuse. He becomes emaciated and frail, further contributing to his reclusive lifestyle.