I am tired, I feel helpless and worried about my sister

[Our abuse recovery guide]

My younger sister (24F) has been struggling with her mental health for almost 8+ years now. She was diagnosed with chronic depression, then BPD, and then CPTSD. She has been a victim of bullying in school and sexual abuse in the past. She has had a string of failed relationships which have always brought out the worst. She has also had multiples instances of self-harm and at least 3 suicide attempts. She's been in therapy and on medication ever since her diagnosis 6-7 years ago. She wants to feel better but is also tired of this whole "healing process", this state has become the normal for her. Therapy and medication, she tries to stick to it as much as she can, but does not focus on lifestyle changes to accompany it.

My parents and I try to be as supportive as possible, and it has led to us walking around eggshells around her and trying to give her everything she wants because we are scared she will resort to self-harm if we deny. She talks about wanting to die a lot, especially when stressed and it has become a way of life for her. And a major point of fear and decision-making basis for us.

Both of us grew up in a household where we were expected to excel academically and in life. I somehow managed to cope with things on my own, despite my own troubles and trauma, never got therapy and have built a support system comprised of my partner, friends and drowning myself in work.

She lives in another city for college and she had been getting better after undergoing rounds of rTMS treatment. She does well in college, but over time she has lost touch with all other activities in life like her hobbies or fitness goals, she binge watches the same shows over and over again, and "bedrots" a lot. It's hard to get her to change these patterns. There's also a lot of self-loathing, and anxiety about the future and not wanting to do anything. She is also very impatient and feels pathetic a lot.

Every time she is romantically involved with someone, she loses sight of everything else in her life and her whole life revolves around this other person. She doesn't contact us until things have gone bad and she's in a terrible place and we urge her to talk. She recently went through a failed situationship with a friend/classmate she spends a lot of time with. He is emotionally mature and has been supportive and understanding since he carries some guilt about her being hurt because of him not wanting to continue the situationship. This affected her very badly. I left my job and moved cities to be with her and help get her back in a functional state. She got the rTMS treatment and was doing well for sometime. I moved back home after that and have been working here ever since. She's at home for her summer break right now.

When she came home for summer break this time, she brought him along since they had decided to do their internship together at an org in my hometown. He's also living with us (which i thought was a bad idea but we couldn't do anything about this since she had already decided) (I did express concern to her and she said everything is fine between them now). She and him are mostly fine and i thought things were okay, but i could see her mood deteriorating over the past few weeks. Not wanting to go to work, wanting to quit the job, wanting to be left alone and not eating or taking meds on time, and most importantly wanting to go back to her city.
Things were still okay until recently my grandpa fell ill and the house has been chaotic due to hospital runs, too many people and other logistics. My parents are looking after grandpa at the hospital while I juggle work, home logistics and my dementic grandma.

Sis has not been helping out with the grandpa situation much and i said that's ok but i asked her to take care of herself and wait for a few days until the day to go back comes (which is about 4 days later). But she kept insisting about wanting to go.
Two nights ago when my parents were at the hospital she took a bunch of pills after an argument with him and we had a very difficult time managing everything. My dad (he's a doc) had to rush back and we managed. It was not too much over the limit so nothing disastrous happened. She's done a round of therapy and an online meet with her psych and is on new medication and I'm overseeing it, and keeping a close eye on her.

I am super worried about the next few days until she goes and how she's going to handle things after going back with all that medication on her hands. She and the guy have planned to take a break and not see each other for sometime after they return. She keeps telling me that she will feel much better after going back where she will have her space and set up a routine and once college starts again everything will be okay. But i know about her obsessive tendencies and idk how things are going to go between them. She gets super affected by these things and i cant stop thinking about it and being hyper-vigilant. I'm not in a state to quit my job again and go be with her in another city again. I am also supposed to submit my post-grad thesis this week and i'm unable to get any work done because my mind is occupied by these thoughts and I am dreading everything.

For the longest time, I also feel terrible for my parents and also for myself because we have done everything we can, and i will keep trying but sometimes i wonder how much longer will this go on, especially when she does not seem to notice or value the efforts we put in for her. There is no regard for us and she always seems to be annoyed by us and shutting us off, until she needs money or help of some kind. I think she wants to care but she's too occupied with her own state to think about anyone else or what any of us are going through.

I have not been able to do anything, but reading on this forum has been helpful, so i am posting here now to get some help.

How do i go about this? How do i help her? How do i not worry so much? How do i make this situation better? Anything helps at this point.

[ch0p]

My younger sister (24F) has been struggling with her mental health for almost 8+ years now. She was diagnosed with chronic depression, then BPD, and then CPTSD. She has been a victim of bullying in school and sexual abuse in the past. She has had a string of failed relationships which have always brought out the worst. She has also had multiples instances of self-harm and at least 3 suicide attempts. She's been in therapy and on medication ever since her diagnosis 6-7 years ago. She wants to feel better but is also tired of this whole "healing process", this state has become the normal for her. Therapy and medication, she tries to stick to it as much as she can, but does not focus on lifestyle changes to accompany it.

My parents and I try to be as supportive as possible, and it has led to us walking around eggshells around her and trying to give her everything she wants because we are scared she will resort to self-harm if we deny. She talks about wanting to die a lot, especially when stressed and it has become a way of life for her. And a major point of fear and decision-making basis for us.

Both of us grew up in a household where we were expected to excel academically and in life. I somehow managed to cope with things on my own, despite my own troubles and trauma, never got therapy and have built a support system comprised of my partner, friends and drowning myself in work.

She lives in another city for college and she had been getting better after undergoing rounds of rTMS treatment. She does well in college, but over time she has lost touch with all other activities in life like her hobbies or fitness goals, she binge watches the same shows over and over again, and "bedrots" a lot. It's hard to get her to change these patterns. There's also a lot of self-loathing, and anxiety about the future and not wanting to do anything. She is also very impatient and feels pathetic a lot.

Every time she is romantically involved with someone, she loses sight of everything else in her life and her whole life revolves around this other person. She doesn't contact us until things have gone bad and she's in a terrible place and we urge her to talk. She recently went through a failed situationship with a friend/classmate she spends a lot of time with. He is emotionally mature and has been supportive and understanding since he carries some guilt about her being hurt because of him not wanting to continue the situationship. This affected her very badly. I left my job and moved cities to be with her and help get her back in a functional state. She got the rTMS treatment and was doing well for sometime. I moved back home after that and have been working here ever since. She's at home for her summer break right now.

When she came home for summer break this time, she brought him along since they had decided to do their internship together at an org in my hometown. He's also living with us (which i thought was a bad idea but we couldn't do anything about this since she had already decided) (I did express concern to her and she said everything is fine between them now). She and him are mostly fine and i thought things were okay, but i could see her mood deteriorating over the past few weeks. Not wanting to go to work, wanting to quit the job, wanting to be left alone and not eating or taking meds on time, and most importantly wanting to go back to her city.
Things were still okay until recently my grandpa fell ill and the house has been chaotic due to hospital runs, too many people and other logistics. My parents are looking after grandpa at the hospital while I juggle work, home logistics and my dementic grandma.

Sis has not been helping out with the grandpa situation much and i said that's ok but i asked her to take care of herself and wait for a few days until the day to go back comes (which is about 4 days later). But she kept insisting about wanting to go.
Two nights ago when my parents were at the hospital she took a bunch of pills after an argument with him and we had a very difficult time managing everything. My dad (he's a doc) had to rush back and we managed. It was not too much over the limit so nothing disastrous happened. She's done a round of therapy and an online meet with her psych and is on new medication and I'm overseeing it, and keeping a close eye on her.

I am super worried about the next few days until she goes and how she's going to handle things after going back with all that medication on her hands. She and the guy have planned to take a break and not see each other for sometime after they return. She keeps telling me that she will feel much better after going back where she will have her space and set up a routine and once college starts again everything will be okay. But i know about her obsessive tendencies and idk how things are going to go between them. She gets super affected by these things and i cant stop thinking about it and being hyper-vigilant. I'm not in a state to quit my job again and go be with her in another city again. I am also supposed to submit my post-grad thesis this week and i'm unable to get any work done because my mind is occupied by these thoughts and I am dreading everything.

For the longest time, I also feel terrible for my parents and also for myself because we have done everything we can, and i will keep trying but sometimes i wonder how much longer will this go on, especially when she does not seem to notice or value the efforts we put in for her. There is no regard for us and she always seems to be annoyed by us and shutting us off, until she needs money or help of some kind. I think she wants to care but she's too occupied with her own state to think about anyone else or what any of us are going through.

I have not been able to do anything, but reading on this forum has been helpful, so i am posting here now to get some help.

How do i go about this? How do i help her? How do i not worry so much? How do i make this situation better? Anything helps at this point.

[wantmorepeace]

Dear chOp,

My sister has bpd too.  She is much older than your sister and has refused to ever be diagnosed or see a therapist, so I have stopped imagining that she can get better (took me a long time).  It is great that your sister is in therapy and has a diagnosis!  There's a chance for her to get better AND that is on her, not on you.

The most important thing is for you to do is to figure out how to take care of yourself in this situation for a lot of reasons, including that you matter. 

That doesn't mean that you can't learn to respond to her in ways that are less likely to solicit outbursts.  You can.  But when there is an outburst, that is not your fault or responsibility!  (Has taken me a really long time to understand that too. And I wish it hadn't.)  And learning how to protect yourself is equally important.

It is true that some therapists are better than others at dealing with bpd.   Many don't know how.  Dialectical behavioral therapy is an evidence-based approach that's been used for awhile.  I'm no expert, but saw this recent article in the New York Times -- https://www.nytimes.com/2026/04/21/well/mind/bpd-borderline-personality-disorder.html  --- that said that mentalization-based treatment and transference-focused psychotherapy also have evidence supporting them.

I don't know what the implications are for you.  Maybe you already know that your sister is receiving one of these -- in which case, that's great.  If she's not or you're not sure, I'm not sure what the implications are.  Probably not the best to go lecturing her about what kind of therapy she needs!!  Also, because she has multiple conditions, there may be a specific approach that's better for her.  Maybe somebody else here who is a professional or who has experience with this situation could provide you with advice.  Or, if you're not seeing a therapist, you may want to do that and discuss with them.  Pick somebody who understands bpd AND its effect on family.

You mention that you are struggling with the feeling that she has no regard for you and the rest of the family.  I've been struggling with that quite a bit too after my sister tried to pull me into triangle that would have been terrible for me.  What I tell myself these days is that she cares about me in the way she can, which is very limited.

[Pook075]

How do i go about this? How do i help her? How do i not worry so much? How do i make this situation better? Anything helps at this point.

Hi Chop and welcome to the family.  I'm so sorry we're meeting like this and I've been in a very similar situation with my BPD daughter.  The advice I'm about to give will sting at first, but you need to hear it.

How do I go about this?

Right now, you have your hands very full with grandparents and all the other stuff going on at home.  Your dad is a doctor, which is great, and he knows the best path for your sister.  Let him make the decisions about her while you focus on you (and grandpa, grandma, etc).

How do i help her?

Someone with BPD goes through a range of hieghtened emotions and they crave attention.  Grandpa was sick so he got all the attention.  Grandma struggled so she got all the attention.  And suddenly, your sister is in a crisis.  That all tracks.

There's nothing you can say or do to help your sister.  She will either take her meds or she won't.  Either she takes therapy seriously or she won't.  Nobody can force her to want to get better...she has to want it.

How do i not worry so much?

Focus on what you can directly control, and accept that you can't do anything for the things you can't control.  You have to let this go and realize that your sister is an adult and she will always struggle until she makes different decisions in life.  You can be a good brother and support her, talk to her, etc.  But you also have to draw a line in the sand when it comes to the abusive behavior. 

Walking on eggshells only makes things worse in time, which increases your worry over what's going to happen next.  You must find a different path and it's focusing on what you can actually control.

How do i make this situation better?

I'm so glad you asked this question last, because it's honestly the most important thing you've talked about.  You must focus on your mental health and what's best for you.  If your sister is in crisis, lend support...but not at your own expense.  You come first in all situations, which means you must prioritize Chop over your sister.  If it's too much, step back and let dad be the doctor. 

None of this is on you and it's not your responsibility.  It's great you're a loving brother, but there must be limits.