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

[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.

[Methuen]

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.

Ch0p I am wondering what your parents said about this.  Did you do this on your own, or did they encourage it?

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.

I hear in you a sense of personal responsibility and obligation towards helping and supporting you sister.  Do I have that right?

It sounds like you have gone above and beyond for your sister.  Sadly she is unable to be appreciative, or empathetic to what others may have given up to support her. It sounds like her needs are a black hole sucking you in.

You are recognizing that none of your actions to date (including quitting your job and moving to stay with her) have made a sustainable difference to her long term wellness.  And I think you are recognizing that the level of support you have been giving her isn't sustainable for YOU because you have your own life to live.

Ch0p, she has therapists, a psychiatrist (or a doctor), parents, access to mental health supports at college, and two parents.

I hope it is ok if I suggest that this is not your burden to carry or hold. 

You are not a therapist or a psychiatrist.  BPD is so complex that therapists and psychiatrists often struggle with these clients.  So if they struggle, why are you feeling it is your job to jump in and rescue her from herself?  It is an unreasonable expectation you have for yourself. Like Pook says, she also has a father who is also a Doc.  But in regards to her, his hat is primarily to be her dad.  She also has a Doc or psychiatrist for the mental health piece including medications to manage her well being and safety.

My heart goes out to you.  It really does.  I get what you are afraid of here.  But that fear sounds like it has been controlling your life.  If you continue with the level of support and rescuing you have provided, her needs will take you down too.  And you will have allowed it.  Even enabled it.  There are adults around her with more experience and more power than you have to support her. 

IMHO, this is not your burden to carry.  But I understand that cultural values and expectations can sometimes be at play too.  I'm not sure if that fits for you.  Even if it does, I still believe with my heart that this is not your burden to carry.  There are adults, with life experience (parents) and expertise (docs and therapist and college counsellors) who can support her.  And ultimately, she needs to learn that she is capable of supporting herself, which may sometimes mean checking herself into a facility if she is feeling at risk of self-harm.

My best friend has a sister like this.  The sister is now around 50.  The problems started as a teenager.  Both the mother and father have passed away in recent years.  My friend lives about 800 miles away from her sister, and travels every 6-8 weeks to see her, and also continue with executor duties for her now deceased parents.  The sister goes through cycles of managing, until she doesn't.  Then she checks herself into care and gets treatment, until she is well enough to be released with supports, as she lives semi-independently.  I am sharing this story so that you can see that there possibilities other than you being rescuer.

You go work on your post-grad thesis.  That is what you should do.  And let the older life experienced and "expert" (psych) adults support your sister.

Your thoughts? 

You can continue to assure her you love her etc etc., but it is not your job to fix her or protect her from herself.  Others can carry that responsibility.

[Notwendy]

Ch0p- like the others, I am wondering how it is that you are carrying so much responsibility for your sister.

It's admirable that you are helping with your grandparents, and you have a kind heart for your sister, but it seems you are carrying a large load for people in your family, and sometimes it's possible to help too much and carry too much responsibility, to the point of self neglect.

Trying to keep a balance between self care and helping others is not being selfish, it's maintaining ones own emotional health. You seem to be a strong person who has overcome some challenges- and as you mentioned "drown yourself" in work- but sometimes that too is not in the best interest of your own emotional well being.

Your own resilience, academic ability, and being a strong person are positive qualities, but excelling in some areas does not mean we don't have emotional needs ourselves.

I can relate to this in some ways. I grew up with family dysfunction. We kids were able to do well in school, and while this is a good thing in general, doing well academically also means the family dysfunction remained hidden to other adults. However, I was also parentified and made to feel overly responsible for my BPD mother's feelings.

While it is fortunate that I didn't grow up to have BPD or issues that affected my function as an adult, what I eventually had to work on was the over focus on other people's needs, and overfunctioning for them. These traits were "normalized" in my family. In fact, this was a way to gain approval from my parents. I also learned that these family patterns can be passed down from generation to generation. It's possible your parents or one of them also took on this behavior in their own family of origin, and so it also was a "norm" for them.

You mentioned your father is a doctor. I don't know the situation for him but historically, doctors have had to put aside their own needs and be available for the well being of others. While this is admirable, it can also take a toll on families. One possibility is that- while your father was working, some of the family care load went to you, especially with a sister with mental health issues. Your father is probably a very positive role model for you, but you are your own individual person.

While this may not be the norm for you in your family system- it may be that you are taking on too much, and this requires some self examination. I also assumed that if I got good grades and did well at work, I must not have been affected by my family dysfunction, and while these were good qualities, it didn't mean that there wasn't room for personal work.

As they say on an airplane, put your oxygen mask on first. Before we are able to be of help to someone else, we need to have own basic needs met. While your focus has been on helping others, it may be that you are feeling overly responsible for her.

Therapy isn't only for people with mental illness and a functional deficiency. It can also help people who are over functioning find a balance and to deal with the emotions that come from " less of helping too much"- because it can feel like doing something wrong when it actually is not. For a strong person- it's not easy to reach out, but it is OK to do so. You reached out here- and that is a positive step for you too. Many here also "get it".

[CC43]

Hi ch0p,

Wow, there's a lot going on with you, your sister and extended family.  You've come to the right place.

Much of what you write about your sister sounds like classic BPD.  What I see is some disordered thinking, such as rushing into intense relationships, thinking that a relationship will make her feel better.  Generally, I don't like it when young adults move in together early on in a relationship, as the relationship becomes all-consuming.  When it comes to BPD, your sister will likely become too reliant on the relationship for her "identity."  I think that's just too much pressure on one relationship and one person.  Why?  Because when there's a snag or disagreement, the pwBPD tends to "blow up" the relationship, and with it, her very identity.  I think that moving in together, early on in a romantic relationship, is basically setting herself up to fail.  You can't control whether your sister moves in with a new boyfriend, but my opinion is that your parents shouldn't allow it in their own home.

I'm going to be blunt here and give you my perspective.  If your sister is threatening suicide or making suicidal gestures, she is NOT in a good place.  In my opinion, it's typical for suicidal gestures to occur when someone else close to her is getting attention, such as with a sickness or an event, like a sibling's graduation, wedding, vacation or trip.  Now, maybe your sister didn't want to go to the hospital after she ingested some pills, and maybe the family didn't want to see her suffer by spending yet more time in the hospital getting therapy.  But I think that dynamic is part enablement, part denial and part clouded judgment as a result of living in a FOG of fear, obligation and guilt.  Let me guess:  after swallowing some pills, your sister didn't want to go to the hospital, but she wanted something else--to change her living situation, to get away for a while, or maybe just be left alone in her room to do whatever she wants.  I've seen that several times with the pwBPD in my life.  But here's the thing:  if she's enabled to avoid facing the natural consequences of her own behavior--a suicide attempt lands her in the hospital--her family is enabling dysfunction.  My guess is she'll want to go back to college (not really to study, but to get away from her current situation and to have some fun).  But right now, I think she's not ready.  Sending her back to college would be setting her up to fail, because her life looks too dysfunctional right now.  If she's not able to stick to her doctor's orders (e.g. taking meds as prescribed), and she can't fulfill her commitments (e.g. the internship), and she's not helping out around the house but rotting in bed instead, then guess what?  That's exactly what she'll do in college.  Sure, she'll SAY she wants to go back.  Her parents will want her to graduate.  But reality is, she'll be set up to fail.  And you know what?  Your sister doesn't take setbacks in stride.  She doesn't learn from mistakes.  She doesn't stick it out when the going gets tough.  No, what she has learned is to self-destruct.  Every time she self-destructs, her family rescues her.  Basically, your sister makes all the decisions, but other members of the family face the consequences.  Do I have that about right?

And now about you.  I totally get all the stress BPD dysfunction causes.  I also understand the sacrifices that you make, in the name of saving or protecting your sister.  Here we talk about walking on eggshells, doing everything in our power not to destabilize a loved one with BPD, out of a combination of love and fear.  But here's the thing.  A pwBPD has endless needs, while you do not have endless resources.  You could sacrifice your time, finances, hobbies, relationships and very health, and yet it wouldn't make any difference to your sister.  Let me guess:  you've been bending over backwards for your sister for YEARS, but has she gotten any better?  My guess is she has not.  In fact, she's gotten worse.  Why?  Because she's facing an adult's world with adult-sized pressures and stresses, but she has the emotional skills of a young teen at best.  She's finding out she's not functioning very well as an adult, and she's distressed and ashamed because of that.  She doesn't really know who she is and what she wants, let alone how to make her life happen.  She can't figure it out and feels intense shame.  But rather than take responsiblity, what does she do?  She embraces a victim mindset.  She blames everyone else for her troubles, and in the process, she abdicates responsibility for her life.  She expects others, including YOU, to take care of her, to over-function for her, to make her the center of your life.  But even if you do that, it won't be enough.

I'd say, you need to focus on YOU.  You deserve to have a life that doesn't revolve around your BPD sister.  I know, even just thinking about her consumes a ton of your mental bandwidth.  It's not fair that you think about her, probably more than you think about yourself!  So my advice to you would be to get busy.  You are not responsible for your sister.  She's 24, she's an adult.  If your parents want to take care of her, then great.  But it's not your job.  You get busy with your life--studies, work, friends, hobbies, self-care.  I think you need to have a talk with your parents about boundaries.  You can't continue to take care of your sis, as it means she avoids getting the help she needs.  You are NOT a therapist, and you're not trained to deal with BPD . . so don't!  You are not a babysitter of a 24-year-old sibling.  You are not supposed to be on suicide watch.  (Trust me, I was on suicide watch for something like three years . . . and it makes zero difference.)  My frank advice would be for you to leave your parents' home ASAP.   Sure, you can help out from time to time, but you need your own place.  Find some roommates, house-sit--do what you need to do to reclaim your own time and space.  My guess is, once you have your own time and space, your whole life won't be about your sister anymore.  She'll still be in your thoughts, but much less.  OK?