Sister with BPD wants to live alone

[bdpSister]

My younger sister (37yo) was finally diagnosed with BPD 3 years ago. She had a really though crisis at that time, and on top of that, she became extremely paranoid and started hallucinating for the first time, that I know of. Her psychiatrist gave her some medications and among them was Zyprexa, which is an antipsychotic (our dad was diagnosed with schizophrenia more than 30 years ago, and still needs to take that medicine).

Well, she got better for more than 2 years, moved in with her boyfriend in another state, got a job, kept it and even got promoted (this is a huge deal with her, it's one of the longest jobs she's ever kept). Then one day she felt pain in her lower abdomen and it turn out that she was pregnant and had a miscarriage. That was the first hit. For some reason after that, her new psychiatrist took her off Zyprexa. And slowly everything started to get worse. So I think she has BDP and something else, but I'm no doctor.

Right now she's going through another crisis. She used to love her boss but suddenly started hating her, accusing her of laboral abuse, and quitted. She also says her boyfriend is abusive and "left him", but still lives with him. I wish I could believe her, but this is a pattern that has repeated itself so many time...

Two days ago, she woke up very early and left the house on foot. When her ex got up, he couldn't find her and called us worried. She didn't answer the phone. Some hours later, he got a call from the hospital. She had walked to her old job and told them there that she couldn't feel half of her body. They called and ambulance and she was at the hospital believing she had a stroke. When she was checked, they couldn't find anything and brought in a psychiatrist, who told her she was having a crisis and needed to see her regular psychiatrist as soon as possible. Her appointment is tomorrow and she says she'll go (I believe her), but she's giving herself "therapy" to recover from the "stroke".

Her ex he thinks that best thing for her right now is to come home so she can have our support. My mom agrees. My dad doesn't get involved. So my mom and me are the ones trying to figure out how to help her. I'm not sure how I feel or what to think. Maybe coming home would be good for her, I don't know. She wants to stay there and find her own apartment to be independent. That is what I want for her. I want her to be able to achieve her goals and do good in life. But how is she going to it without a job? At the bottom of my heart I have hope that she can make it, but she proves me wrong every time. I refuse to give her any more money. My mom says she won't do it either. But I feel guilty about telling her no. So, if she wants to stay there, she need to find and keep a job (an impossible task in the middle of a crisis).

Also I have difficulty being honest with her. I'm always very cautious with my words and my tone and it drains my energy so much. I've witness her attacks on my mom, my brother, my husband, her numerous boyfriends, friends, strangers, etc. For some reason, I've never been a target of these attacks. She listens to me and even when I say something she doesn't like, she won't get mad directly at me (even though she'll do whatever she wants and not tell me about it). I'm glad about it, but algo feel guilty because i'm never direct or totally honest in the way I speak to her. Usually I try to ask her specific questions so that she'll get my point through her own answer. But it is complicated, and requieres a lot of mental energy.  So I don't know if coming home is the best thing for her right now or not. I think it is, but I wish she could achieve her goals of being independent. She told me she's not coming back, but if it is what's best for her, how can I to try to convince her? I'm feeling very confused and powerless right now. I even feel afraid that she will read this post, know that I wrote it and get worse. Maybe that doesn't make sense I don't know. I feel really confused. I want to help her but I'm not clear on how to do it. I also want to be able to help my mom in dealing with her, but don't know what to do right now.

I need guidance and support. Thanks.

[Riv3rW0lf]

Hi bdpSister

First, welcome to the forum!

It seems like your sister is either very far toward the end of the borderline spectrum or maybe has another condition with it, I've read it often is comorbid with other mental illnesses or disorders.

I've known one person that walked barefoot in winter time, she was manic. She would go through phases when she was just completely off.. elsewhere. Between phases, she was good at playing the life game, as long as she kept on her medications. I am no professional, but like you hinted, I think your sister might have more than BPD.

I can only imagine how hard it is to feel like you have to basically support your sister through her life, almost make her decisions for her. It's already a headache navigating our own life, so having to navigate someone else's life on top of it is rough.

Did she go to her appointment with the psychiatrist? Will they get her started back on her medications? From the sound of it, she did better when she was taking them.

It is a tough choice, but in the end, you are not responsible for her and I'd advise is to start detaching yourself from this guilt and responsibility you feel. It doesn't mean that you cannot try and help her, but I think, with anyone that has BPD or other disorders (my brother is bipolar, a 'soft' drug addict, and suicidal at times), we have to truly accept that:
1) we cannot save then
2) we shouldn't enable them
3) we can try and help all we want, in the end, it is THEIR life and THEIR decisions. If you don't have power of attorney, then no matter what you want for her, in the end, she will do whatever she wants and feels like doing, and it won't be your fault, nor responsibility to save her.

It is hard, they are family, but she is an adult... My brother almost commited suicide last July and said I saved him when I texted him and cared at the right time. This was both a godsend and a curse, because if he does end up commiting suicide down the road, I will feel guilt. But truthfully, I am already doing the best I can, managing my own life, my own problems, and I cannot be held responsible for his happiness or lack thereof... And so, I am already accepting that it might happen, and it won't be my fault. I don't wish it. I help him when I can. But I also have to hold boundaries in place, to stay sane...

[livednlearned]

they couldn't find anything and brought in a psychiatrist, who told her she was having a crisis and needed to see her regular psychiatrist as soon as possible. Her appointment is tomorrow

Any word on whether she went?

It's tough for the family when these crises occur.

I noticed the psychiatrist didn't say she needed intensive family support. The recommendation was to see her regular psychiatrist -- a lot of these episodes are beyond what family can support and the long-term family dynamics can sometimes complicate recovery.

When they are adults, sometimes the best you can do is check in and make sure they're ok. Your sister may have had a psychotic break or something in that ballpark (based on the breakdown of her relationship) and it might be best for someone skilled to help her get back on her feet or figure out how to repair the relationship.

I am finally comforted knowing that I don't have the skills to rescue or fix people with severe mental illness. I can only be kind and have healthy boundaries, and when asked, offer advice that worked for me.

The silver lining of my stepdaughter's first psychotic break was that she entered therapy. It wasn't the correct dx and the meds weren't right but she began learning how to get help when she needed it. My own T pointed out that psychotic breaks are a way of asking for and getting help. While S25 is nowhere near healthy and will likely struggle to a degree I can only imagine, she is now seen by a team of specialists. If that fails her, she will likely be back with more symptomatic behavior and the care will increase.

Radical acceptance is extremely hard in practice but it can lead to a sense of peace knowing that the definition of things being ok for loved ones will likely be vastly different than how you define the same.