sibling with BPD

[Raypri]

My sister has been sick for a long time, but the BPD diagnosis is new (previously diagnosed as bipolar ocd). Feeling overwhelmed and unsure of how to help her.

[Kwamina]

Hi Raypri and welcome to bpdfamily

I'm sorry you are dealing with a sister with BPD. This is quite a challenging disorder.

What led up to her getting this BPD diagnosis after previously been diagnosed as bipolar and ocd? Did anything happen recently that lead to her being re-evaluated? Now that she's been diagnosed, is she getting targeted treatment for her BPD?

It isn't easy dealing with a BPD family-member so I can understand you feeling overwhelmed. Many of our members have siblings with BPD and know how difficult this can be.

Can you tell us a bit more about your sister's behaviors? What would you say are her most difficult or worrying behaviors? And since when has she been exhibiting these behaviors?

Take care

[Raypri]

My sister had been doing really well. She ended up graduating college, which was a huge accomplishment and took seven years of hard work while dealing with her Bipolar/OCD diagnosis. She found a job and was working 30 hours a week and saving money. In January 2015, things started to take a change for the worst. She began seeking out harmful relationships, lying, spending money recklessly and getting aggressive... .on the verge of violent. She ran away from home and when she returned asked to go into the hospital.

She spent two weeks at an acute care mental health facility, which she had gone to previously. She received ECT, which had helped in the past. This time, it didn't help. She got more depressed and distant. From the acute care facility, she was admitted to an inpatient mental health facility. She went through a two week diagnostic program where she was diagnosed with BPD. This was heartbreaking after going through multiple doctors, three hospitalizations, ECT and thousands of dollars on something she didn't have.

She is now completing an ten-week inpatient program learning more about BPD, receiving therapy and medication adjustments. This program is almost over, but we've been told she'd benefit from going to a step-down program. We've been able to give my sister the opportunity to receive care that most never get the option to do, but it has taken all that we have and we're not sure how we'll continue to pay for the treatment she needs. If there is anyone out there who has advice on how to navigate the healthcare system and find the money to pay for ongoing treatments, I'd be grateful for your suggestions.

I struggle interacting with my sister because I don't know how to interact with her in a way that doesn't feed into her BPD. For example, recently she called me and told me she was getting kicked out of her treatment facility because of her eating disorder so she needed someone to come pick her up. (The eating disorder is something she developed while in the treatment facility. I think so she can focus on that instead of other issues.) I yelled at her on the phone. Told her she needed to eat all she could and beg them to let her stay. I got worked up and so did my mom, other sister, dad and stepdad. Later, we found out that it was a lie. My sister had kissed another patient and had lost privileges as a result. She wasn't comfortable so wanted to leave.

Looking back, I know I didn't handle that situation correctly. But, the only way I think it could have been handled correctly would be for me to have never picked up the phone and to have let the situation pass. However, I worry about doing that because I think over time it will lead to me just not being part of my sisters life or not having her be part of mine. How can I be close to her, but not feed in to the BPD?

[Littlebean03]

Hey, sorry to hear about your issues with your sister.  Hugs to you! I also am dealing with a sister with (undiagnosed) BPD.  A few strategies that a few mentors on here have given to me that have helped:

From Kwamina:

https://bpdfamily.com/content/values-and-boundaries

https://bpdfamily.com/message_board/index.php?topic=167368.0

From Suze:

https://bpdfamily.com/message_board/index.php?topic=160566.0

I've struggled with thoughts of terminating our relationship,  but I think that if you have the energy to continue with the relationship that I would strongly suggest you to.   People with BPD need 100x more patience than the rest of humanity.  It has helped me to think of my sister as a child.  Because it is the best way for me to understand why she does what she does.  She had the maturity, the reasoning(or lack there of) the self entitled-ment, and the choice making skills of a child.

It's good you are asking for help and advice.  Can you ask anyone at the facility if they'd be willing to talk to you and gove you advice?  Or if there's a support group near you?  Also it might be worth a try for you to find a counselor near you who has experience with BPD.  Who could maybe help you talk through your frustrations, and to  learn some useful skills for dealing with your sister.

Hope this helped and good luck!

[Raypri]

Littlebean03: Thank you so much for your support and sharing those helpful links. The phrase you said about thinking of your sister as a child really resonated with me. This type of thinking may better help me stick to the boundaries I set with her and also help me manage any anger I experience as a result of her actions. I looked for support groups in my area, but didn't find any. It is so nice that there is an online community like this. Thanks again. I'll be sending good thoughts to you and your sister.

[Kwamina]

Hi Raypri

The links Littlebean03 posted to you go to very helpful articles. When dealing with someone with BPD, being able to set and enforce boundaries and being able to assert yourself, is very important. I hope you'll check these links out.

In January 2015, things started to take a change for the worst. She began seeking out harmful relationships, lying, spending money recklessly and getting aggressive... .on the verge of violent. She ran away from home and when she returned asked to go into the hospital.

It's very unfortunate that after doing so well, your sister's behavior started to deteriorate. Looking back, was it totally out of the blue that this happened? Or were there perhaps already signs that there might have been something going on with your sister before January 2015? Did anything perhaps happen right before her behavior started changing that might have triggered her in some way?

Looking back, I know I didn't handle that situation correctly. But, the only way I think it could have been handled correctly would be for me to have never picked up the phone and to have let the situation pass. However, I worry about doing that because I think over time it will lead to me just not being part of my sisters life or not having her be part of mine. How can I be close to her, but not feed in to the BPD?

Something that might help you is mindfulness:

"Mindfulness is a type of self-awareness in which we learn to observe ourselves in real time to see and alter our reactions to be more constructive."

We have an article about this subject:

Triggering and Mindfulness and Wise Mind

Another thing that might help you is this excerpt from our article about fear, obligation and guilt (FOG):

Don’t respond the moment a demand is made. Give yourself time to think and assess the matter.  We want to respond - not react.

... .

Let go of your emotional ties to being controlled, at least briefly, and try to be an independent observer. Gather the information you need to construct a wise response - one that is neither enabling nor confrontational. Likely there is a long history of bad, demanding behavior and enabling responses / resentment, so this is going to take some discipline not to be triggered or to overreact.

... .

Focus on the demand at hand, not all the past history. Assess how significant a particular demand is.  Remember that there are different levels of demands, and know where to be strong and where to be flexible... .