By way of background, my sister was diagnosed with BPD at 17. She is in her early 30s now. Since her diagnosis my sister has completed various stints in both inpatient and outpatient DBT programs and also seen different psychologists on and off. She’s also tried different medications (for depression) but is currently unmedicated. 

In the past, my sister has been very verbally abusive to my parents and I. Attacking us all with cutting words and threats of physical violence. She’s presented to the hospital, suicidal, on days which are significant to me and others (ie my university graduation, Mother’s Day etc), and we’ve always rushed to her aid. We’ve all read up on BPD, and have tried to love and be there for her. My parents have spent tens of thousands of dollars on her various therapies as well. She loses her job regularly and I am always there to help her find another, buy her clothes to make her feel confident, etc. All we want is for her to be happy. 

However lately she is struggling again. She is so so angry about her perceived lack of success compared to others. She says awful things to and about our younger siblings, who she perceives as getting an easier ride than she had. She has a total sense of entitlement to people’s time and money. For example one of my younger siblings is studying, and my parents are helping them out financially. She wants an equivalent sum paid to her. She wants to meet someone and have a family but struggles with interpersonal relationships. She is gleeful when the relationships of people she knows break down. Social media is terrible for her, yet she can’t stay off it.

Recently, she had a huge blow up with my parents and younger brother. Said awful things to everyone, and stormed off. No one reached out for a while - it was the end of months of run ins. My mother reached out the other day, and she was hurtful and attacking again, leaving my mother in tears.

I haven’t reached out. I’ve always been a bit of a mediator, but right now I don’t have the bandwidth. I recently had surgery and am immobile. My husband and I are also doing IVF, and had an early lost last cycle. I’m mentally exhausted. My sister also never contacts me just to see how I am, so I’m a bit hurt over that too. 

My sister refuses to get help. She spends lots of money going out, but does not prioritise her mental health. She expects that we will continue to drop everything for her always, and gets angry if we don’t. She also does not respect boundaries re what people are willing to talk about - her expectation is that she will just unload and unload and we will just take it all, including deeply personal attacks.

Please, please give me some advice. I love my sister and desperately want her to be happy. But we’re all at a total loss as to how to help her, when she refuses to help herself.