How do I help my sister

[amanda.lynn]

Hi everyone. I am new to this site and am looking for help. My sister has struggled with Mental Health for years now and has been diagnosed with BPD, PTSD and opioid dependence disorder. She has had two inpatient stays at a Psychiatric hospital and they have tried her on many different variations of medications - no luck yet. Recently she has been trying to get sober but when she stops using, she can feel her emotions which she has difficulty regulating. For the past few days she has been very suicidal but the hospital keeps turning her away. There are waitlists for every inpatient treatment center in the city and the hospital will not make any suggestions on how I can help or what steps she should take next.
 Please if anyone has any ideas I would love to hear them!

[Turkish]

That's frustrating that she's being turned away.  A dual diagnosis (mental health+substance abuse) is hard to deal with (we mostly see it on the Parents board). Have you called a local suicide ideation hotline? That may help you in the interim know how to talk to her

How do you feel that you are doing talking to her?

[Kwamina]

Hi and welcome to our online community

There's a lot going on with your sister and I'm sorry to hear that treatment and medication so far have not had the desired results.

She has also been suicidal these past few days. Is suicidal ideation something she has struggled with before (as far as you know) or is this something new?

We have some resources here that might help you as you try to deal with her suicidal ideation:
Dealing with suicidal ideation in others

What is your sister's living situation? Do the two of you live together?

Take care

The Board Parrot

[amanda.lynn]

Thanks for replying so quickly!
For the longest time it felt like trying to talk to her was pointless because she was so deep into her addiction but now that she is trying to recover (she claims to be off street drugs, went to detox and attends NA meetings) we've started getting closer again. Something that I am having a hard time with is not knowing what family members can do to help. From what I can see online there are two main pathways that the experts seem to push for: family treatment programs such as the Family Connections program or to completely cut them off and walk away (Jordan Peterson). Please help because I really don't know what to do!

Yes the suicidal ideation is something that she has struggled with on and off for awhile now. All of the previous times (that I am aware of) the hospital was able to help her or provide her with supports that could help her. After writing my post yesterday I got a call from her psychiatrist and he explained that he thinks that he use of the mental health system isn't helping her and is enabling her by providing her with the attention that she wants. Is this a common thing? I'm sorry I guess I don't know as much as I thought I did about BPD and should keep researching it. Thanks so much for the resources and I'll give the suicide hotline a try as well.
She is currently staying with a friend of hers but she has struggled with maintaining housing for the past two years. I live about an hour and a half away from her right now but I drive through her city fairly often (maybe once a month) and always try to connect with her then.
Thanks so much for the support. It really helps to hear from others who know more about this than I do!

[Harri]

Hi.  I haven't had a chance to say welcome yet, so welcome!   

I got a call from her psychiatrist and he explained that he thinks that he use of the mental health system isn't helping her and is enabling her by providing her with the attention that she wants. Is this a common thing?

Did he by any chance mention what you can do to help her?  I don't know how common it is to use the medical community as a source of validation and attention for her poor coping skills but it does happen and can become a very dysfunctional cycle.  For some it validates that they are helpless to cope on their own and that it is up to others to take care of them.  For others it may be attention seeking. I am sure there are other reasons as well. 

I thought of this article when I read your post:  What Does it Take to Be in a Relationship:  What Can a Family Member Do?  It paints a clear picture of what you can expect from yourself in terms of helping your sister. 

Have either of you tried calling her psychiatrist directly when she is feeling suicidal?  I wonder if that might get a better response especially given what he said about the system enabling her behavior.  What do you think?

[amanda.lynn]

That is a fantastic resource and had things I can start putting into action. Thank you.
It was not her ongoing psychiatrist it was the one who was on call in the ER when she arrived there yesterday but I think trying to connect with him is a great idea.
His suggestion for me was to stop talking to her and said that he was surprised that she had supports in her life. He said that people with such a long mental health history often push everyone away and no longer have supports. After reading that resource that you suggested I can see that he was right about this but if possible I would like to try being that caretaker that is discussed in the article. Does anyone have experience trying to fill that role? It sounds like it can be quite the balancing act. Are there such things as coaches that can help someone through this?

[Harri]

Hi.  I am glad you found the article useful.  It is true that a lot of pw BPD (people with BPD) do push away those who try to help them and you are right, it is a balancing act.  It is very difficult to take this on alone.  Having a support network for you as well as your sister will be vital.  It is all too easy to burn out.

It is disappointing that the hospital psychiatrist said to stop talking to her without knowing you and what you want to try.  Sometimes a family member is left no option but to cut or reduce contact, but that is a personal choice that no one should make for another person.  I can't stress enough how important it will be for you to learn about boundaries, communication tools and about the disorder.  Even then, you can not fix her.  The good news is that she is working on sobriety and seems willing to get professional help.  That makes a huge difference.

Most of us who post on this board have tried but do not have people who have the diagnosis and are willing to work on their self.  There really is a big difference.

You might find it beneficial to rad on our Bettering a realtionship board where the primary focus is on using the tools we offer here.  Here is a link: https://bpdfamily.com/message_board/index.php?board=6.0 to the bettering board.  I am not saying you should be posting there, though you can if you choose to.  It is just where a lot of people are working on improving things for themselves and trying to work with their  pwBPD.

As for a coach, I am not sure.  There are coaches for everything.  Sometimes what can help is having a therapist of your own to help you maintain boundaries, balance and good and healthy expectations for yourself.  Self care will be critical for you.

[LoveOnTheRocks]

Hi Amanda-Lynn:  I am newer to this board and learning along with you, so I don't trust myself to fail to disclose a disclaimer to that extent.  That said, I have a DDBPD (diagnosed daughter) and have worked very closely with her condition for many years, so I know what it is, and how difficult it can be, even when you would give all you have to help them get better.  I now know that however my daughter gets better is going to be completely up to her and while I don't condone the things she does and does not do, I do love her and am learning to just accept her so that I can continue to love her. 
I see your goal as coach and I shudder, because the word coach scares me.  It scares me because things go very slow with BPDs and accepting them where they are, how they are and whom they are is, at least for me, the first step to having a decent relationship with my DD.  My husband and I were saying yesterday that we had to do that and not offer much advice (she takes our advice as criticism even if it isn't).  We need to love her, use the skills to enable us to have the best communication with her that we can, and accept that we will see things we find unacceptable, and realize that these things may not be ok for us, but for now, they are ok for our daughter.  Whatever results she gets will best be achieved working with a trained therapist, and our daughter is willing to do therapy, so I anticipate we will see some results.  She has a lot going on in her head all the time, and as painful as it is for me, I must remember she is the one who is in the most pain, and alleviate it any way I can (without enabling, etc!)... .just love her... .that's what I want to do... .just love her the best I can (and it's not perfect, not always easy, and we still have to do boundaries and so forth). 
It took me years to just accept that she has a mental illness.  Now that I know how it is, what it is, and what I have done to make things worse where our relationship is concerned, I can work on making them better.  Some of the books these folks have recommended are useful, and the articles and videos on this site are helpful.  All of that said, and this is for me, I have to do this as I can.  I get overwhelmed with grief about my life with my daughter and about her life now and in the future, and I have to put the subject down for a spell... .then pick it up when I feel like I am in a place to work with the information and get something from it.

[amanda.lynn]

Thanks Harri. I live in a small town so I started researching online counselling this afternoon. Does anyone have experience with BetterHelp or TalkSpace? Those seem to be the most popular ones that I could find. Thank you for that link to the relationship board. I will have to spend some time over there as well.

Thanks LoveOnTheRocks. I really appreciate hearing from people who know more about this than me. And I understand that this could look different for every person but if you have any suggestions please let me know. Feel free to be blunt haha. When you say boundaries what exactly do you mean? I think I have done this with my sister, but I am not really sure. For example, she knows that I will not tolerate a lot of her negative symptoms (rages, I will not condone or agree with a lot of her lifestyle choices and addictions) and she knows that if she tries to do that with me I won’t engage at all. The exception is when she is suicidal – then I always try to convince her to seek help.
I also have a hard time sometimes understanding where to draw the line with enabling. I do not give her money or anything she can sell but are there other things I could be doing without knowing it that are accidently enabling her behaviour?
I am starting to realize that even though I have this idea in my head of the role I want to play in supporting my sister that it likely won’t look like how I imagine it. And I so much appreciate everyone helping me understand that I need to have a strong understanding that this is a life long thing that I can not fix for her, but I am hoping that I can walk along side her in case she is ready and willing for help.

[Harri]

Hi again.  Sorry I do not have any experience with online counseling so i can't help you there.

I am glad LOTR (love on the rocks) responded so helpfully to you.  I forgot to mention that we also have a board for parents of people with BPD who are also quite skilled with the tools and boundaries and can be a great help to you.  So we have you covered in several ways!  
 
It sounds like you know about boundaries in that you are not accepting her rages or addiction behaviors.  Here we relate boundaries to personal values.  So if your personal value is that people treat each other with respect, you would have a boundary that says "I will not accept verbally abusive behaviors" and then have a set of actions that *you* take to protect yourself from such behavior.  That can be telling her you are hanging up the phone, ending the conversation, etc.  By making our boundaries a reflection of our personal values we avoid a lot of pitfalls that can occur when boundaries are not applied appropriately and become more of a form of control.

Here is an article on boundaries that explains this better than I can:  
Setting Boundaries and Setting Limits See what you think and if you have questions go ahead and ask.  We often work things out on the board with each other.  There are other things that can help with this including the communication tools I mentioned earlier.  Boundaries work best when used along with other tools.  I don't want to give you too many links all at once though.  You can check out the library section of the site as well and see what catches your eye.  

As for enabling behaviors, I always think of them in terms of keeping to my side of the street and not over doing with care taking.  Knowing what is mine vs. someone else's responsibility or right to take care of.  Knowing where I begin and end in relation to another.  Get too far into their territory and we risk violating their boundaries.

Does that make sense?

[turquoise1]

I am new to the group as well.  It is comforting there are others going through the same things.  I have a BPD sister as well, and am just trying to learn as much as I can.  I did sign up for TalkSpace last week , and have found it to be helpful so far.
Hang in there!