How can I support my twin sister who has BPD?

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Anonymous #1
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My twin sister has BPD she is under the care of a psychiatrist and the crisis team and she is getting help from various emotional support from mental health charities. So care wise she is getting all the help she can get. She is on an antidepressant and a mood stabiliser so that’s her medication sorted.

She is frequently having break downs and she engages in self harm. Yesterday she had to go to hospital to get stitches and she had a mental health assessment however they didn’t admit her to hospital. Part of me would have preferred if she was admitted as I think she is a danger to herself when she has a breakdown. I try to safe guard her and be there for her. I am mentally drained though and it is hard to supervise her 24/7. She is an adult (19 years old)

I think she would be a lot safer in hospital, when she has breakdowns she doesn’t want to tell anyone what is wrong and just screams on top her lungs and cries and then wants to harm herself. I don’t know what to do anymore. I am constantly on edge just waiting for another breakdown to happen.
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DrawTheLine
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(Original post by Anonymous)
My twin sister has BPD she is under the care of a psychiatrist and the crisis team and she is getting help from various emotional support from mental health charities. So care wise she is getting all the help she can get. She is on an antidepressant and a mood stabiliser so that’s her medication sorted.

She is frequently having break downs and she engages in self harm. Yesterday she had to go to hospital to get stitches and she had a mental health assessment however they didn’t admit her to hospital. Part of me would have preferred if she was admitted as I think she is a danger to herself when she has a breakdown. I try to safe guard her and be there for her. I am mentally drained though and it is hard to supervise her 24/7. She is an adult (19 years old)

I think she would be a lot safer in hospital, when she has breakdowns she doesn’t want to tell anyone what is wrong and just screams on top her lungs and cries and then wants to harm herself. I don’t know what to do anymore. I am constantly on edge just waiting for another breakdown to happen.
Could you speak to her psychiatrist or some of the people who care for her and ask what you could do to help? Have a look at this link which should help a bit:

https://www.mind.org.uk/information-...ds-and-family/
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Anonymous #1
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(Original post by DrawTheLine)
Could you speak to her psychiatrist or some of the people who care for her and ask what you could do to help? Have a look at this link which should help a bit:

https://www.mind.org.uk/information-...ds-and-family/
The problem is that she is an adult so I don't have much say in her care unfortunately.
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DrawTheLine
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(Original post by Anonymous)
The problem is that she is an adult so I don't have much say in her care unfortunately.
I still think you should talk to them because they might have some advice for you on how to make it a bit better at home. There is support out there for carers, so you aren't alone and you can get some help.
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glassalice
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(Original post by Anonymous)
My twin sister has BPD she is under the care of a psychiatrist and the crisis team and she is getting help from various emotional support from mental health charities. So care wise she is getting all the help she can get. She is on an antidepressant and a mood stabiliser so that’s her medication sorted.

She is frequently having break downs and she engages in self harm. Yesterday she had to go to hospital to get stitches and she had a mental health assessment however they didn’t admit her to hospital. Part of me would have preferred if she was admitted as I think she is a danger to herself when she has a breakdown. I try to safe guard her and be there for her. I am mentally drained though and it is hard to supervise her 24/7. She is an adult (19 years old)

I think she would be a lot safer in hospital, when she has breakdowns she doesn’t want to tell anyone what is wrong and just screams on top her lungs and cries and then wants to harm herself. I don’t know what to do anymore. I am constantly on edge just waiting for another breakdown to happen.
Has she had a 'social care' assessment? People with complex health needs, under certain circumstances can be allocated a personal budget to pay for carers to regularly come to your house (for example).

Its extremely unlikely that she will be admitted to psyc hospital for any longer than a couple of days if her difficulties are mainly 'BPD' centric.

Your not responsible for what she does to herself when she is struggling. You can't control her mental state. She is the only one who can ultimately work to help change this.

On a slightly different note, does she claim disability benefits (PIP) ? If so (depending on your circumstances) you may well be able to claim carers allowance. It's not very much, but it might be able to help on the finance side.
Last edited by glassalice; 4 weeks ago
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Anonymous #1
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(Original post by glassalice)
Has she had a 'social care' assessment? People with complex health needs, under certain circumstances can be allocated a personal budget to pay for carers to regularly come to your house (for example).

Its extremely unlikely that she will be admitted to psyc hospital for any longer than a couple of days if her difficulties are mainly 'BPD'

Your not responsible for what she does to herself when she is struggling. You can't control her mental state. She is the only one who can ultimately work to help change this.

On a slightly different note, does she claim disability benefits (PIP) ? If so (depending on your circumstances) you may well be able to claim carers allowance. It's not very much, but it might be able to help on the finance side.
She doesn't have a social care plan and she is not claiming any benefits usually she lives at uni in another city however she is currently home . I know I am not responsible for her mental health but i am having a hard time seeing her having a break down. Her only issues are bpd and self harm. I just want to see her happy once again. I am trying to be there for her but nothing I do seems to help. She doesn't want to talk about her issues or open up and will just sit there crying her eyes out and screaming.
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glassalice
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(Original post by Anonymous)
She doesn't have a social care plan and she is not claiming any benefits usually she lives at uni in another city however she is currently home . I know I am not responsible for her mental health but i am having a hard time seeing her having a break down. Her only issues are bpd and self harm. I just want to see her happy once again. I am trying to be there for her but nothing I do seems to help. She doesn't want to talk about her issues or open up and will just sit there crying her eyes out and screaming.
Presumably she managed her mental health better at university. How was she able to do that?
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shebk
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Is she a university student?
By the way, you mentioned mental health charities, which mental health charities? How do they work?
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Anonymous #1
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(Original post by glassalice)
Presumably she managed her mental health better at university. How was she able to do that?
Her MH wasn't that good at uni either but it is only at home I had fully witnessed her breakdowns. At uni if she had a breakdown it was out of sight as she doesn't live at home when at uni.
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glassalice
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(Original post by Anonymous)
Her MH wasn't that good at uni either but it is only at home I had fully witnessed her breakdowns. At uni if she had a breakdown it was out of sight as she doesn't live at home when at uni.
I may be wrong about this as BPD encompasses a wide range of difficulties, but I am wondering if she is struggling to deal with the amount of support you are offering. Ie. Maybe having someone there all the time is actually evoking really difficult emotions for her.
If she doesn't want to talk to you, I think it can actually be counter productive to try and make her.
Make sure she knows that when she wants to talk you will always be there for her. Some people with BPD may struggle with a fear of being abandoned.

Personality disorders are weird and difficult to understand.
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Anonymous #1
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(Original post by glassalice)
I may be wrong about this as BPD encompasses a wide range of difficulties, but I am wondering if she is struggling to deal with the amount of support you are offering. Ie. Maybe having someone there all the time is actually evoking really difficult emotions for her.
If she doesn't want to talk to you, I think it can actually be counter productive to try and make her.
Make sure she knows that when she wants to talk you will always be there for her. Some people with BPD may struggle with a fear of being abandoned.

Personality disorders are weird and difficult to understand.
She seems to resort to self-harm in order to avoid dealing with her fear of abandonment and uncomfortable feelings. I am very dedicated to her and try to provide support by making sure she eats as she also has an unhealthy relationship with food and I do most of the cooking. I offer to give her hugs as a means of comfort despite the fact that I have giving hugs since I have autism. Also having autism makes me have a hard time understanding her. What hurts me the most is when she says things like I don't love her. Since it is clearly not true because if it was then I wouldn't bother to put up with some of the things she does.
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ClaudiaVan
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I’m a youth mental health first aider who’s been through mental health challenges myself. (Was in a hospital for 4-6 months aged 16 back in 2014 and have Autism, OCD, Anxiety, Depression, Bulimic tendencies, struggled with self harm).

The best thing I would say is to make sure you are able to support her by supporting yourself.
Be empathetic but let her have her space when she needs. Most importantly, make sure you are there for her to talk to, (2 ears and 1 mouth for a reason I was always told!) and don’t judge, perhaps offer some coping strategies that help you or do more activities together / walks/crafts/yoga and mindfulness etc.

It may be useful to read up on supporting someone who has BPD- websites like NHS, YoungMinds, MQ and Mind are all professional websites.

You may also find some support groups for caters or family members that run in your local area or online (professionally run) that you can share and support each other in.

It must be a difficult situation you are in, but you are only one person and doing the best you Can- and she will appreciate that!
Last edited by ClaudiaVan; 4 weeks ago
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Anonymous #1
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(Original post by ClaudiaVan)
I’m a youth mental health first aider who’s been through mental health challenges myself. (Was in a hospital for 4-6 months aged 16 back in 2014 and have Autism, OCD, Anxiety, Depression, Bulimic tendencies, struggled with self harm).

The best thing I would say is to make sure you are able to support her by supporting yourself.
Be empathetic but let her have her space when she needs. Most importantly, make sure you are there for her to talk to, (2 ears and 1 mouth for a reason I was always told!) and don’t judge, perhaps offer some coping strategies that help you or do more activities together / walks/crafts/yoga and mindfulness etc.

It may be useful to read up on supporting someone who has BPD- websites like NHS, YoungMinds, MQ and Mind are all professional websites.

You may also find some support groups for caters or family members that run in your local area or online (professionally run) that you can share and support each other in.

It must be a difficult situation you are in, but you are only one person and doing the best you Can- and she will appreciate that!
What was it like in a psychiatric hospital? How easy is it for someone to be admitted? I try to always ask her if she wants to talk or go out for a walk or do something fun e.g. watch a movie or go cycling but overtime I feel a bit worn out sometimes as breakdowns are difficult to deal with and what makes it the worst is that she would harm herself and last time she needed stitches safe guarding is very tough especially if there is 1 person who has to do it.
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Anonymous #2
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(Original post by Anonymous)
My twin sister has BPD she is under the care of a psychiatrist and the crisis team and she is getting help from various emotional support from mental health charities. So care wise she is getting all the help she can get. She is on an antidepressant and a mood stabiliser so that’s her medication sorted.

She is frequently having break downs and she engages in self harm. Yesterday she had to go to hospital to get stitches and she had a mental health assessment however they didn’t admit her to hospital. Part of me would have preferred if she was admitted as I think she is a danger to herself when she has a breakdown. I try to safe guard her and be there for her. I am mentally drained though and it is hard to supervise her 24/7. She is an adult (19 years old)

I think she would be a lot safer in hospital, when she has breakdowns she doesn’t want to tell anyone what is wrong and just screams on top her lungs and cries and then wants to harm herself. I don’t know what to do anymore. I am constantly on edge just waiting for another breakdown to happen.
As much as we may want to, we cannot fix another person. The best and only thing we can do is work on ourselves, and even this is not easy. You are not responsible for your sister, even though you think you might be able to help her if only she were willing. She's not.

Release yourself from the burden and guilt of not being able to help her. You can't help her. Feeling bad about it will not help her, it will only make you feel bad. You don't have to feel bad.
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ClaudiaVan
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(Original post by Anonymous)
What was it like in a psychiatric hospital? How easy is it for someone to be admitted? I try to always ask her if she wants to talk or go out for a walk or do something fun e.g. watch a movie or go cycling but overtime I feel a bit worn out sometimes as breakdowns are difficult to deal with and what makes it the worst is that she would harm herself and last time she needed stitches safe guarding is very tough especially if there is 1 person who has to do it.
For me being in hospital was a live saver (literally), but I did feel very triggered in there but it made me a better person as I think to myself now ‘I’m never going back to a place like that’.

Sorry you are struggling to handle your sister engaging in self destructive behaviour- are there any techniques she has that are less dangerous? Sometimes when people with BPD are in a manic episode they often engage in behaviour that we may think is dangerous and hazardous and become a danger to themselves, however you should never take the things away (that are used like sharp objects), merely control the environment and give choices, but it is important we encourage them to seek new strategies and coping mechanisms.

Safeguarding is difficult; but there may be help available for this. Due to the current situations it can be very tough as services are limited at the best of times but we have to find other ways to help like support groups and reaching out to charities.
It can be tiring and difficult as someone who cars for someone with BPD, and because you are a twin you naturally feel that connection and wanting to help to ‘fix’ the person, but it is not your responsibility; all you can do is be there for her as much as possible but let her know that you need time for yourself too- self care is important.

You will get through this
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Anonymous #1
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(Original post by ClaudiaVan)
For me being in hospital was a live saver (literally), but I did feel very triggered in there but it made me a better person as I think to myself now ‘I’m never going back to a place like that’.

Sorry you are struggling to handle your sister engaging in self destructive behaviour- are there any techniques she has that are less dangerous? Sometimes when people with BPD are in a manic episode they often engage in behaviour that we may think is dangerous and hazardous and become a danger to themselves, however you should never take the things away (that are used like sharp objects), merely control the environment and give choices, but it is important we encourage them to seek new strategies and coping mechanisms.

Safeguarding is difficult; but there may be help available for this. Due to the current situations it can be very tough as services are limited at the best of times but we have to find other ways to help like support groups and reaching out to charities.
It can be tiring and difficult as someone who cars for someone with BPD, and because you are a twin you naturally feel that connection and wanting to help to ‘fix’ the person, but it is not your responsibility; all you can do is be there for her as much as possible but let her know that you need time for yourself too- self care is important.

You will get through this
She is receiving help from her crisis team, psychiatrist and once a week someone from a self harm charity calls her and a mental health specialist calls her every 2 weeks . So that's a lot of special help she is getting , she is currently on a waiting list for therapy.

She has very few coping strategies apart from self harm, crying and screaming. I feel like she is very dependent on me e.g. She didn't like being left alone and wants me to be there physically and tries to accuse me of attempting to abandon her constantly.

What do you mean by self care and how can I self care? I am just used to talking care of people for many years now . I am very independent and I don't take expect anything from anyone. I don't like to talk to anyone about my mental health except non family and friends as I don't like to burden others with my problems

Content Warning - Self Harm

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At what point will they need to admit her to hospital? If at all. Especially if she continues to self harm really severely to the point that she needs stitches. When she is at uni I would spend a minimum of 1 hour a day usually a lot more on the phone with her. Needing to reassure her and " be there for her"
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ClaudiaVan
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(Original post by Anonymous)
She is receiving help from her crisis team, psychiatrist and once a week someone from a self harm charity calls her and a mental health specialist calls her every 2 weeks . So that's a lot of special help she is getting , she is currently on a waiting list for therapy.

She has very few coping strategies apart from self harm, crying and screaming. I feel like she is very dependent on me e.g. She didn't like being left alone and wants me to be there physically and tries to accuse me of attempting to abandon her constantly.

What do you mean by self care and how can I self care? I am just used to talking care of people for many years now . I am very independent and I don't take expect anything from anyone. I don't like to talk to anyone about my mental health except non family and friends as I don't like to burden others with my problems

At what point will they need to admit her to hospital? If at all. Especially if she continues to self harm really severely to the point that she needs stitches. When she is at uni I would spend a minimum of 1 hour a day usually a lot more on the phone with her. Needing to reassure her and " be there for her"
To answer your q’s:

What strategies do you have to ensure you are looking after yourself? It is important to take time for you and to explain that to your sister sometimes you need time to yourself as it is important you support yourself and stay mentally as healthy as you can.

I really cannot say what she would be classed as for hospital, they usually section if it’s a danger to herself or others and cannot be treated on the outside. Usually only after drastic actions as places of safety do people get sectioned or stay in hospital- unless it is more restpite for the family in which it’ll costly and private hospitals or wellbeing centres. If she is already receiving help and on waiting lists- has crisis teams involved, it would be their decision to recommend the type of support needed; residential in hospital, day patient or home support.

Sending virtual hugs and positivity to you and your sister!
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glassalice
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(Original post by Anonymous)
She seems to resort to self-harm in order to avoid dealing with her fear of abandonment and uncomfortable feelings. I am very dedicated to her and try to provide support by making sure she eats as she also has an unhealthy relationship with food and I do most of the cooking. I offer to give her hugs as a means of comfort despite the fact that I have giving hugs since I have autism. Also having autism makes me have a hard time understanding her. What hurts me the most is when she says things like I don't love her. Since it is clearly not true because if it was then I wouldn't bother to put up with some of the things she does.
Don't feel bad about struggling to understand her because your autistic. Many NT's (neuro-typicals) wouldn't have the patience & kindness you have for her.

(Original post by Anonymous)
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At what point will they need to admit her to hospital? If at all. Especially if she continues to self harm really severely to the point that she needs stitches. When she is at uni I would spend a minimum of 1 hour a day usually a lot more on the phone with her. Needing to reassure her and " be there for her"
Normally crisis teams are very reluctant to admit people with BPD to hospitals
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I don't necessarily agree with any of these reasons, I just thought it might be handy for you to know them though.

-Hospital intensifies SH behaviour/ attachment issues
-BPD can be disruptive to other patients
-Some psycs view BPD as being more of a choice than an illness
-Little clinical evidence that hospital is beneficial to BPD patients

I have known of people to wake up in ICU post SH and then be discharged straight back home as soon as they are 'medically (physically) fit'. So even if she does do something 'bad' she won't necessarily be admitted.


However they will admit people for time limited (normally 3 day) crisis stays.

There are specialist PD l rehab hospitals that some people who are really high risk for a really long time get set to. Most people stay there for 12-18 months.
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