Is it ok to choose to (temporarily) not interact with my depressed teen sister? What's the best way to provide very distant support?
September 12, 2011 1:17 AM   Subscribe

Is it ok to choose to (temporarily) not interact with my depressed teen sister? What's the best way to provide very distant support?

Ok I'll try to summarize this and keep tabs and add details/answer questions as needed. Kind of rambly, but I'd really like to hear input from those who have been depressed/have had depressed close family/friend on how to interact.

Also, WARNING: I am not depressed/have never been depressed and mental illness is hard for me to understand. I have also been known to be and consider myself to be not very emotional or sensitive or emotionally-sensitive so if I come off as a little brash or insensitive I am not trying to be and please bear with me.

My sister has been on anti-depressants for about a year and a half (she is now 17) because she has 0 coping skills. (Like if her best friend hangs out with another friend and she's not invited she cuts herself. Or if her friends move away to college she can't function for a month.) I have always been kind of against her taking meds because she's so young. Also I remember being a teenager was kind of difficult, I was also moody and would get bummed out often but I got through it (writing in my journal, talking to my best friend/cousin, etc. etc.) and I thought maybe my sister was just being a puss about it. I also thought that Dr's were reaffirming this "depression" (which was not really depression because how could you be depressed so young?) by quickly giving her meds. I feared my sister would become addicted to these things (she kind of is) and would never turn into an adult, would become a hollow person, etc.

I now know this isn't necessarily the case and I decided I would stop judging her/her doctors and just drop my weird sense of responsibility to help her since there's nothing I could do and it has nothing to do with me anyway.

She called me about a week ago and told me she was in a mental hospital and I had no idea how to react. She also told me she had been in before (for 6 days) and was now back again because she was having breakdowns everyday. She has since been transferred to a less intense place (after about 5 days), more like a group home setting. I didn't find out she was in the hospital before because my parents told her not to tell me because they didn't want me to stress out.

I eventually went to visit her yesterday with my parents (it's about 2 hours away from my parent's house) and my sister was acting kind of irritable, strangely calm/"hollow" and even kind of cocky, bragging she was the "smartest kid at the mental hospital". I didn't react at all but her behavior kind of pissed me off. It's also hard to watch my parents deal with this because the financial and emotional strain is so great. I feel like she's acting incredibly selfish (which I know is an inadvertent side effect of being depressed) and she keeps demanding things from my parents like asking them to bring her McDonalds or buy her particular shoes, etc. and is acting like she's entitled to these things because she's depressed. I also found out that she called my parents at 6pm to come visit her (they both have work in the morning) because she was "feeling down" even though they had gone to visit her thursday, friday, saturday.

Because I cannot understand her behavior and keep interpreting it as a selfish and because I am in such a different place at 22, trying to develop my personality into a positive, productive, happy adult interacting with her really throws me off, makes me angry/in a bad mood. I feel like I can't really be supportive/helpful to her anyway so I just don't want to interact with her for awhile. My parents and everyone finds this absolutely appalling and I know that it seems heartless and selfish of ME but continuing to talk to her/talk about her situation with my family members is so incredibly exhausting and draining that it's really impacting me negatively. I am in my last semester of college and just got a full time job so I don't have much time and these are things that (while I know my sister is really important) I NEED TO FINISH.

ALSO! (this could be important and is kind of fucked up) I feel like my parents (my mom particularly) NEED me to reaffirm that they're still good parents because I've turned out ok. My mom calls me almost every day to see how am I'm doing/what I'm doing, which I'm ok with, and is being overly lovey. However my mom will also occasionally in the presence of my sister, talk about me or my past in a positive way and my sister will snap at her for "comparing" us. I feel like me doing so well makes her feel worse about herself so maybe my presence is inadvertently bad for her self-esteem.

I still want to be supportive to my parents and I am proud of them and developing a new respect for them seeing how wonderfully supportive and courageous they are being. But I don't want to talk to her/visit her. I know she wants me to but it throws me off so hard every time.

I guess my question, is is this REALLY ok? My parents don't think it's ok, I know if I told her this is how I feel she wouldn't think it's ok. Am I being a HUGE SELFISH ASSHOLE here? Should I suck it up and just perform my duty as an older sister despite the emotional energy/time it drains from me?

Can I just call her every once in awhile and be like "Hey, hope you're feeling better, I love you." Is that enough?

And if it is ok to feel like this, to distance myself, how can I explain that it's ok to my parents? Because they feel that I should be equally supportive/involved by calling her/visiting her/having long deep conversations with her about her problems/etc.

Also, I forgot to mention I don't live at home with my parents and my sister. I live about 40 minutes away and go home maybe 2-4x a month.
posted by ad4pt to Human Relations (43 answers total) 5 users marked this as a favorite
 
Mentally ill people often do obnoxious things that are hard to understand. That's why they aren't normal teens, but patients who have to be in the hospital. People often become egocentric under stress, too.

If you're afraid your sister's mental illness will rub off on you then it's reasonable to stay away. Explain to your parents that you feel like you're teetering on the edge of coping and you don't want them to have two kids in the hospital, so you're staying out of the way for the benefit of everyone.
posted by tel3path at 1:27 AM on September 12, 2011 [4 favorites]


Yes, you are being selfish and don't have a good working understanding of depression. It's always ok to take care of yourself, though.
posted by By The Grace of God at 1:42 AM on September 12, 2011 [16 favorites]


In this post you come off a little self-involved and a little judgmental of your sister. You know what? That's a totally textbook thing that happens when someone one loves is going through depression -- people get angry because they feel helpless, they doubt the sincerity of the illness/symptoms because they don't want to believe it's real, they don't want to see the person because they don't know what to say. Or what would be OK to say, or helpful to say, because maybe all you want to say is "Just frickin' cut it out! Just stop!" ... and you know you can't say that.

I think you pretty much have to go, at least the usual 2-4x month you ordinarily would. I think if you didn't go, you'd feel bad (and so would your parents). Sometimes you do have to just show up. But it's OK to be angry and frustrated and whatever you feel, and it's OK to express that to your parents, and to be real and be yourself while your family works through this.

The other thing is that anger is almost always fear in disguise. You maybe could spend some time with that idea, and see if it rings true for you.
posted by pH Indicating Socks at 2:28 AM on September 12, 2011 [14 favorites]


Is there a way you could interact with her that you could handle? Playing a board game or something, or watching a funny tv show, perhaps, where it's not about discussing feelings but still allows her some time with you? In turn, it might allow you to understand her experience and illness even a little bit. Depressed people can be really unpleasant to be around, but it's definitely easier if it's not just heartfelt conversations and talking about yourselves or your feelings.

I think one aspect of becoming an adult is having to give back to your family and to make time in your life for this, even when it's inconvenient and you're busy, even when it would suit you better next year. Your sister is likely dominating your parents' lives right now, so all three of them might appreciate your participation - I'd bet this isn't impacting them positively at all either and I doubt they're enjoying any of it, but they're doing it.

You can make your own decisions and should definitely look after yourself, but I would suggest (respectfully) not taking the above advice about mentioning the potential for two kids being in hospital, as unless it's a concrete plan, it sounds extremely insensitive and attention-seeking.
posted by carbide at 2:32 AM on September 12, 2011 [1 favorite]


Sometimes, without necessarily ceasing to love them, you do have to cut your contact with a member of your family. It's legitimate to protect yourself when necessary, and it may also be better for your sister if you stay away rather than perhaps quarrelling and doing irrevocable damage to the relationship.

I would try to keep things neutral and under-stated though, and if you're discussing the matter at all put the emphasis on the fact that you have a lot of demands on your time rather than on your sister's selfish/annoying qualities. Send her cards or flowers.
posted by Segundus at 2:35 AM on September 12, 2011 [2 favorites]


There's a lot we don't know about mental illness, but we do know that for many people, it truly is an illness -- there are genetic and biochemical causes that make the brain not work as it should. If your sister had, say, cancer, you wouldn't blame her for that, right? She can't help having a mental illness either.

(Causes of Depression at the Black Dog Institute could be a good place to do some reading.)

I think you need to stop comparing yourself to your sister. "I got through my teen years, why can't she?" isn't a helpful attitude, because your sister is not you. Apparently, you aren't pre-disposed to mental illness. She is, and the fact that you're so unwilling to even attempt to understand her condition is what stands out most to me. You seem almost afraid of empathising with her, and it may be useful for you to try to work out why.

You may also find benefit in talking to a psychiatrist. Not only for yourself, but because they, with their medical background, can help you understand what we know about depression.

Best wishes to you and your family.
posted by Georgina at 2:41 AM on September 12, 2011 [20 favorites]


I would suggest that you do some reading on depression and anxiety, and some reading about cutting.

It's not a selfish thing to be ill, nor is it weird to ask for creature comforts while confined on a mental health unit -- those places are exhausting, and the food is terrible, and you need to have shoes for the shower, and you need shoes without laces, and ... it's just awful. It's awful, and the most helpful thing in the world is to have a loved one present, patient, listening, chattering inanely, playing cards with you, distracting you from your pain.

People become dependent on psycho-pharmaceuticals, in the same way diabetics become dependent on insulin or asthmatics become dependent on inhalers. It's not an addiction; it's a need. Medication is a tricky thing, one that often -- especially in the psychiatric realm -- comes with awful side effects. It's not something you'd want to be on if you weren't sick. You gain weight. You feel groggy. You might lose your sex drive. You feel jittery if you miss a dose. This isn't something a person wants. But illness must be treated.

Mental illness is illness.

Cutting is indicative of severe, real pain. You may never have experienced it, but it is every bit as bad as breaking a bone and worse. Except with a bone you can have it set and put in a cast and know when it will heal. With your mind ... you never know if you'll be the same, or if so, when.

Losing your mind is one of the worst things that could ever happen to you. No one wants to be crazy. It's not fun. It's not a choice.

Being hospitalized is also up there on the list of worst things in the world.

While you're there, though, you learn to take small victories and celebrate them. Being the smartest, the best dressed, the most interesting to the doctors, the best artist, the best singer, the best at drawing others out -- these are the sorts of things that remind us we are still human, even if we are sick. These are the things that remind us our "real" selves are still inside of us and alive.

So yeah. Mental patients brag about weird things. Sometimes, if the only thing you can say for yourself is that you kicked ass at foosball today ... well, at least there's one thing you can say for yourself. You might not have much will to live, you might be wondering how to turn a spork into a shank, but regardless you are still here and alive ... and kicking ass at foosball.

But I digress.

If you can't be there for your sister right now, and if this stresses you out too much, that is totally one hundred percent fine. But you need to communicate it in a way that does not turn your sister into the bad guy. You may feel that way about her right now, and that's understandable. You and your family are under a lot of stress. You might look into what support NAMI offers in your area -- from education about mental illness to help coping with a mentally ill family member.

It's hard, and I'm sorry your sister is in poor health. Even if you can't understand -- yet -- please do try to find a way to reach out. Send flowers. Maybe try to make a phone call. Keep your distance, especially if you think you might say something hurtful. But please, be as kind as you can.
posted by brina at 2:47 AM on September 12, 2011 [48 favorites]


I mean this in the nicest way possible. Your sister upsets you because she wants to be the center of attention, while you want the center of attention to be you. To me, your post reads like a problem with control.

You are in control of you. You cannot control others. Yes, you are showing a lack of understanding about what your sister is going through -- she has a deadly illness. However, you're an adult, and can make all your own choices. Of course you can choose to not be around. Others can control how they want to respond to your choice. When weighing your options, consider the long-term effects of not being supportive when your family needs you the most. This could possibly shatter your relationship with your sister, and weaken your relationship with your parents. That may be ok with you, though.
posted by Houstonian at 2:48 AM on September 12, 2011 [6 favorites]


That should probably read: potentially deadly, Houstonian, am I right? Just trying to sort of un-shake the boat.

Depression is not coupled to age. Even young kids can be depressed.
posted by Namlit at 3:15 AM on September 12, 2011


Look, you're defining yourself by what you're not.

"I am not depressed/have never been depressed"
"I have also been known to be and consider myself to be not very emotional or sensitive or emotionally-sensitive"
"I was also moody and would get bummed out often but I got through it [...] my sister was just being a puss about it."
"I feared my sister [...] would become addicted to these things (she kind of is) and would never turn into an adult, would become a hollow person, etc."
"[...] drop my weird sense of responsibility to help her [...] there's nothing I could do and it has nothing to do with me anyway."
"my sister was acting kind of irritable, strangely calm/"hollow" and even kind of cocky, bragging she was the "smartest kid at the mental hospital". I didn't react at all but her behavior kind of pissed me off."
"I am in such a different place at 22, trying to develop my personality into a positive, productive, happy adult interacting with her really throws me off, makes me angry/in a bad mood."

and
"I am in my last semester of college and just got a full time job so I don't have much time and these are things that (while I know my sister is really important) I NEED TO FINISH."

"I feel like my parents (my mom particularly) NEED me to reaffirm that they're still good parents because I've turned out ok."
"I feel like me doing so well makes her feel worse about herself so maybe my presence is inadvertently bad for her self-esteem."

It's not that you aren't being a HUGE SELFISH ASSHOLE (like your sister) but that it's not enough to say that. Your sister can't cope with her mental illness. Your parents can't cope with her mental illness. You can't cope with her mental illness. You also have the full weight of pressure coming down on you to hold your fulltime job and finish college - the necessary steps to become the "adult" that your sister is not. You sense pressure not only from yourself and the world, but from your parents, in order to prove that they have one high-functioning kid and therefore reassure them not only of your competence, but of theirs.

In the face of all this, visiting your sister not only reminds you of someone who seemingly doesn't have responsibility and still gets to be a kid, but has escaped from that by being all the things you're not. In her presence, your negative emotions and fears grow so big that they're impossible to deny. You're at risk of blowing your cover and becoming "emotional" which, in your experience, is the first step down the slippery slope to not upholding the family's good health and losing everything, including your parents' esteem.

It may be an exaggeration to say you're at risk of ending up in the hospital but you clearly perceive that your mental health is at risk, and it is. But you're locating your sister as the cause of it, when in fact, the cause is that you (and maybe others) are not allowing you to be vulnerable. I'm not saying it's purely a matter of perception, you're at a precarious time in your life and it's a very unforgiving world for those who make mistakes during this time. You're also at risk of lashing out and saying something which will make your sister's condition worse.

My suggestion would be that you first acknowledge your own vulnerability, if only to yourself, and also try to seek out some kind of counseling or support group to talk about all this. If you need a little time to collect yourself and figure out how to relate to your sister in ways that heal rather than hurt both of you, I don't think it's the worst thing in the world for you to ask for that.
posted by tel3path at 3:31 AM on September 12, 2011 [17 favorites]


At this stage in your life, it seems perfectly appropriate to protect yourself by limiting contact.

One way of framing this to your sister and your parents, is that you don't blame her and you feel sympathetic towards her, but seeing her upsets you so much that it throws you off what you need to do in your own life. Whether or not this is actually true is irrelevant. It gets you off the hook in a way that is as gentle as possible towards other people involved.
posted by zachawry at 3:47 AM on September 12, 2011 [1 favorite]


Hey, I just wanted to say that I really feel for you. I was a boomerang kid and happened to be living with my mom and my sister (8 years younger than me, 17-18 at the time) when my sister's depression got out of control and she had to go to the hospital. I remember it being a complete emotional rollercoaster. I was so tired of her and the way she was acting. Her medication really wasn't working for her at all, and she would throw these gigantic, selfish tantrums, breaking things and telling my mother that she hated her.

I was so so worried for her while at the same time, I was really angry at her for her selfishness and lack of control. I actually cornered her once and told her she was being a selfish jerk. She told me, "I know. I'm sorry." When she went in the hospital, she behaved sort of similarly to your sister, telling us that the nurses loved her and didn't know why she was there. I would cycle between being totally annoyed with her and weeping, just wanting her to be okay.

When she got out of the hospital and her medications and therapy were in better order, she was a whole new person. She is the sweetest, most loving girl and doing really well and happy in college. All I can tell you is that whatever you're feeling, it's okay to feel. If you need to cry, do it. If you need to tell someone, anyone, everything, find someone soon. All I can hope is that your sister gets better and does as well as my sister. You'll be so glad she went into the hospital.

As for your mother, I remember when my sister was finally gone there was such an overwhelming sense of relief that someone else was finally taking care of her. However, that was coupled with guilt that she had actually gotten so bad that she had to be hospitalized. My mom and I talked a lot in those days because it was the first chance we'd gotten to analyze things without the worry of setting my sister off hanging over us.

My advice I guess would be to have empathy. I had to realize that whatever my sister and mother were going through was way more painful than what I was dealing with. It made it easier to be patient and compassionate with them. At the same time, you're dealing with a lot, and it's not your fault and it's not fair, but you still have to deal with it. Be kind to yourself and your family. Hopefully, things will get better soon.
posted by alittlecloser at 4:12 AM on September 12, 2011 [2 favorites]


I think it is inappropriate of your parents to expect you to do so much (take their daily phone calls, act as support for them and your sister) when you are finishing up school and starting a new job!

(Nicely) tell your parents to suck it up and be the responsible adults in this situation. They are the parents, not you. They should seek professional assistance and attend support groups to help them through this time. Tell them (nicely) to quit leaning on you, a 22 year old.

You are totally right - this is well beyond your pay grade. You worry about yourself, let your parents handle their business on their own. You might also attend a support group meeting or speak with your sister's doctors to gain insight. But you absolutely shouldn't be involved in this situation as a primary player.

Draw a boundary with your folks. Send your sister flowers regularly and nice cards, etc (nothing triggering) and let your patents fulfill their role in the life of their 17 year old daughter, as they should.

You are legit to feel put upon. They shouldn't have lied to you the first time your sister was hospitalized, but swinging the other way with daily contact is now too much in the other direction.

Tell your parents to seek out support groups and therapy on their own. Limit daily contact to a quick check-in email or voicemail. Don't pick up the phone every time your mom calls, especially if you are busy when it rings.

Good luck to you and your family.
posted by jbenben at 4:14 AM on September 12, 2011 [10 favorites]


carbide: doing something together like a game is a really good idea and this "I think one aspect of becoming an adult is having to give back to your family and to make time in your life for this" really resonates with me.

Georgina: Thank you for the link to the big black dog institute. I feel kind of embarrassed now at my total lack of education about depression.

tel3path: This is exactly what is happening I think and thank you for breaking that down for me because I definitely wouldn't have realized that on my own.

alittlecloser: "telling us that the nurses loved her and didn't know why she was there."My sister said the exact same thing! Thank you for your post, it's comforting that someone can relate and it's good to hear a happy ending and that resolution is possible.
posted by ad4pt at 4:29 AM on September 12, 2011 [1 favorite]


I wanted to come in really quickly and just mention that while it's very important that you not try to control other people's reactions and emotions (because doing so is pointless, the staff in my program keep reminding me,) depression often comes hand in hand with increased rejection sensitivity. Please make an effort to keep your messages to your sister positive in tone. It's not her fault your parents may be expecting too much from you.

I personally am in a partial hospitalization program right now, and one of the things I'm very worried about is inadvertently demanding too much in terms of support and altered behavior from my family and coworkers. I'm definitely more fragile than I want to be. I wish I wasn't. I'm working on it. Your sister is, too - being in this kind of program is hard work.

And I second the recommendation to take the NAMI classes for family members. They're exactly useful for a lot of the stuff you're asking about.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 4:57 AM on September 12, 2011 [2 favorites]


Don't feel bad about feeling the way you do. Any kind of major problem like this with one person can create a great deal of stress in other members of the family. I do have to say it's a bit selfish to not want to visit her, but not something to feel guilty about. It's hard on you. Your parents should recognize this too and not give you a guilt trip. And at the same time, you shouldn't have to worry about your future because you end up spending so much time with your sister that you don't have enough time to focus on school/work. I think the best thing for you to do is keep semi-regular visits.

However, there is a certain aspect here that makes it seem like your sister craves attention, and submitting to this isn't necessarily going to help her. Making sure she knows that you support her and want her to do well is important, but acquiescing to her demands is likely to reemphasize the selfish aspect of her behavior. Don't think of this as something she is doing on purpose, though. Think of it as a problem she can't control. So I'd say when you visit her, don't talk about her problems. Talk about good things -- good memories, things she might like to do in the future, what's going on is your extended family, stuff like that. This will give her the confidence that you are there for her without reinforcing the idea that she has to have a problem for you to give her attention.
posted by DoubleLune at 5:26 AM on September 12, 2011 [1 favorite]


I don't have much time, but I wanted to say one thing.

I know that your sisters' experience and behavior seems bizarre and inexplicable and selfish to you. Maybe a thought experiment would help. Have you thought about emotions and thoughts your sister must be experiencing, such that the only thing she feels she can do in response is cut her own flesh? I mean, it's scary to think about - somebody who matters hugely to me was once a cutter, and I found it terrifying - but it might help you understand the depth of misery she's going through. I'm not saying you'll know exactly how she feels. But we're all human beings, and to a certain extent empathy can help you understand where she is right now. What would it take before you started thinking cutting yourself was an appropriate action? Seems like it would never, ever happen, right? It's a dark, dark place, that you've never been too, but that doesn't mean it's not real for her right now.
posted by Cygnet at 5:37 AM on September 12, 2011 [2 favorites]


Should I suck it up and just perform my duty as an older sister despite the emotional energy/time it drains from me?

Personally, ad4pt, I think you're doing things the right way. Don't feel bad or guilty that you're "not being supportive enough." How many times have we seen an AskMe that was something along the lines of, "I'm 20 years old and because of my deep abiding love for my family, I live at home so I can help my family take care of this other relative and help manage the house and drive my parents to work every day, but I don't have any friends and my career/school is going nowhere. How do I get over this unhappiness?" ?

And if it is ok to feel like this, to distance myself, how can I explain that it's ok to my parents? Because they feel that I should be equally supportive/involved by calling her/visiting her/having long deep conversations with her about her problems/etc.

What your parents are going through is rough. This is one of those things that makes it hard to be a parent. What they shouldn't be doing is expecting you to carry that burden to make them feel better about the rough patch they're going through, and I think that's what they're doing.

If your sister's in crisis, and it's important, going home 1x or 2x month might not seem out of bounds. But how long are you going to continue doing that? A year? 2 years? 5 years? The rest of your life to "be there for your sister"?

You are in a spot where you have to be developing your life and career and personality. Your sister has her own long term row to hoe, but you can't let her illness be what defines all your interactions with your family and your life.

nthing everyone who says you should read up more about depression and mental illness, not necessarily to empathize with your sister but at least to have a better understanding of what's going on.
posted by deanc at 5:40 AM on September 12, 2011


You are not an awful person for not being able to cope with your sister. Mental illness is *incredibly* hard to deal with, and sometimes the answer IS terminating or minimizing contact.

If you think the right answer is to let her go, let her go. It doesn't mean you can never reconnect when she's in a better place, but she may never get to a better place.

Your decision regarding this will have huge consequences. There will be lots and lots of people who will pressure you because they cannot relate to your decision. Starting with your parents, as you know, who, involved as they are at this point in time, cannot relate to your point of view.

Think hard. Decide what you are and aren't willing to do, and whether what you want is worth the price. This will be a tradeoff of one stress for another.
posted by Ys at 5:51 AM on September 12, 2011 [2 favorites]


I think it’s unfortunate that the mental-emotional disorder “depression” shares a name with a particular emotional state. The emotional state often comes up while you’re experiencing the effects of the disorder, but it’s not necessarily pervasive, and isn’t really the crux of the problem.

It’s sort of like the difference between being an alcoholic and being drunk. Alcoholics can go for months without a drop of alcohol and still be alcoholics, because if they imbibe even once, they will fall off the wagon. Conventional wisdom says you never fully recover from alcoholism; I don’t think that’s really the case, but the only way to find out is to have a drink and see what happens, and I can understand why recovering alcoholics might prefer to assume that it won’t end well.

Likewise, I can enjoy myself when I’m depressed; I can make friends; but then I’ll miss a meal or get caught in the rain or my neurotransmitters will just kinda zig when they shoulda zagged, and I’ll get… the other kind of depressed, and forget what I enjoy and who my friends are.
posted by LogicalDash at 6:09 AM on September 12, 2011 [1 favorite]


I also thought that Dr's were reaffirming this "depression" (which was not really depression because how could you be depressed so young?) by quickly giving her meds.

Just as a point of anecdata, I was suicidally depressed at age 13 to the point where I cried myself to sleep every single night for almost a year straight, and made a suicide pact with a friend. Meds helped me feel better in a matter of months. Your sister is definitely not too young for this to happen to her.
posted by Lobster Garden at 6:22 AM on September 12, 2011 [6 favorites]


I was diagnosed at clinically depressed at age five. FIVE. What on earth does a five year old have to be depressed about? Nothing really - except that my brain was wrong.

Depression is not about sadness, it's a chemical imbalance. You've gotten some really good advice about how to react to your sister and your parents upthread, but I wanted to chime in that you could benefit from some reading about what depression is and what it isn't, in order to more compassionately understand your sister's situation.
posted by peanut_mcgillicuty at 6:36 AM on September 12, 2011 [4 favorites]


I think other people are doing a good job helping you to re-address your mindset about this. I will add that horrendous depression in young people is very real, and that while people are pretty flip about using the term "suffering from mental illness," the emphasis tends to be on the curing the mental illness part and less on the oh-God-virtual-chasm of suffering. Feeling like you literally have no ability to cope with the world around you is destroying.

But what I really came in to say is that you might fond some answers in this thread helpful. I asked how I could support my sister from very far away, and while I was 100% on board with this program, the reality is that I could have done many of those things while having very little contact with her. I ordered a funny badge, a single candle, a single soap from Etsy and had them posted right to her several days apart. I bought numerous $1 samples from Etsy of... eye shadow, lip balm, whatever. I ordered a Starbucks gift card and had it emailed to her. I sent like 2 postcards as I hate writing. I spent maybe $25 on this project.

I also rang all the time but you don't have to. Getting things by mail is special these days. The tiny little gifts are magical in the points and "thinking of you" department.
posted by DarlingBri at 6:46 AM on September 12, 2011 [7 favorites]


First of all, I'm glad your sister is getting the help she needs. I struggled with severe depression and first started self harming when I was very young. I had no support and had to deal with everything on my own.

Second, it is perfectly fine for you to limit your contact. You have to deal with your own life. She is your sister, not your child.

I think it is great that you are trying to educate yourself. I can tell who the people are in my life who truly care about me because they have taken the time to familiarize themselves with my conditions (Celiac Disease, depression, anxiety.) They ask the hard questions because they really want to understand.

I think one way you could stay in contact with her would be to write her letters. You can send her fun little postcards, quick little notes, or even care packages. Then you don't have to worry about what to say on the phone and you can write things when you get a spare moment. It gives you some distance while still being supportive. Getting mail is a great thing and I think your sister might really like it.

Feel free to MeMail me if you want somebody to chat with or if you have specific questions for somebody who deals with mental illness who won't get offended.
posted by TooFewShoes at 7:10 AM on September 12, 2011 [1 favorite]


Well, since you asked, you do sound selfish. Stop judging her and start being more compassionate. Other people deal with this type of stress all the time and there's no reason why you can't.

...Except it's not that easy, right? You can't just decide to get over it and be done with it.

It's going to take you a lot of time to unravel these thoughts about your sister, and you'll feel like you're working against your own mind, and it's going to be exhausting, and you will need to be patient with yourself and forgive yourself, repeatedly. That's what struggling with depression is like, too. Whether or not you have any diagnosable mental illness, it's incredibly hard to think your way out of something that's established itself in your mind as true. Even if that "true" thing is absolutely wrong.

So it's understandable that you're still judging her a little even though you've decided not to. She's going through something similar.

If you don't know much about depression, it is hard to understand what the depressed mind is like, and very hard not to get impatient. It's hard not to get impatient even if you have been depressed yourself. Not only that, but you're the only person looking out for you right now. Everyone's in this for themselves: your sister's ill and not mentally ready to reach far beyond her own world, of course, but also, your parents are looking for some sort of respite and for reaffirmation that they're not fuckups. They may be preoccupied with helping your sister, but it sounds like there's some selfishness in there too. And that's understandable. Your reaction is understandable too. Supporting a depressed person can eat up other people's lives, and you all have to hang on to yourselves.

Sometimes you can only help one person. Usually, that one person is you.

For now, it might actually be better for everyone if you kept your support at arm's length. Flowers, care packages, occasional phone calls. If you visit your sister and silently fume and judge her, she'll pick up on it, and it won't help her. It's okay to take some time and distance to work on yourself - not only your studies, but reading up on depression and gaining a better understanding of what your sister is really going through. And you don't have to be a dumping ground for her misery. You're not equipped to do so, anyway. Let your parents know it's not your presence that's going to help your sister, it's your understanding, and you're going to need a little bit of breathing room to gain that.

Depression can hit when you're young, and it can require medication (and needing medication to treat an ongoing illness is not the same as being addicted. I don't think it's even possible to develop an addiction to antidepressants). It's often the very thing that prevents a person from implementing or even learning the skills to keep herself out of depression, and that's why it sucks so much for the sufferer, and gets so frustrating to the outside observer.

Here's a way to think of it, though: if you're asking yourself "why doesn't she...?" it means, on some level, you believe that she can. If you start to lose patience with her for not pulling herself together, spin it in your mind so you start thinking that she can pull herself together, she can develop coping skills, and she will. It'll take her a long time, but she will. If your sister knows you believe she'll kick this - instead of your getting pissed at her for not having done it already - it will help her immensely.

Good luck and stay healthy. Keep taking care of yourself and keep working towards understanding.
posted by Metroid Baby at 7:23 AM on September 12, 2011 [3 favorites]


How often are you thinking about visiting her? I think that if I were in the hospital and my sister just didn't want to visit me at all ever, this would probably all but end my relationship with her and seriously impair her relationship with my parents. Yeah, send her nice things like DarlingBri suggested, but you should also visit her occasionally. (How often really depends on how far away it is from you.) You should also phone her.

The support phone calls from your mother are something you can stop doing daily.

But honestly, I think being part of a family is balancing your needs against everyone else's, and yeah, sometimes you sacrifice what you want for the rest of your family. It doesn't sound like you're anywhere near giving up your entire life to take care of your sister.
posted by jeather at 7:43 AM on September 12, 2011


tel3path: This is exactly what is happening I think and thank you for breaking that down for me because I definitely wouldn't have realized that on my own.

Know what tel3path did? How tel3path took what you wrote here, then helped you see a different angle on what you had said? And how that was helpful?

That's what therapists can do. They can take what you're feeling and thinking, and they help you make sense of it. You don't have to be sick or broken to benefit from a therapist.

If you're in college, your school likely has a counseling center. You may want to check it out. Not because you're sick or anything, but because you seem to be struggling to understand your emotions and you have a lot to learn about mental illnesses. You and your family are going through a really tough time. It's normal to need some help sorting out your thoughts and feelings, given everything that's going on. Meeting with a therapist will also give you some insight into what your sister is going through, which could very well help you interact with her. If the resources are available to you, what have you got to lose but an hour of your time?
posted by meese at 8:45 AM on September 12, 2011 [7 favorites]


You've done some reading about depression. Do more. It's a real illness, it's not something anyone chooses. If she's being hospitalized, it's acute. Try to be compassionate. Ask the staff at the hospital for reading suggestions, and for help in dealing with her, your parents, and your own feelings.

Your parents probably feel awful, worried, financially pressured, exhausted, conflicted, and scared for your sister's well-being. Keep telling them: it's an illness, it's not something anyone chooses, they were good parents(assuming this is true). I know terrific parents with mentally ill kids, and really horrid parents whose kids were resilient and turned out mentally healthy. It really sucks that help for kids(and adults) with mental illness is hard to get, not always as good as it should be, and expensive. Your parents sound like they're doing their best, and need your support. I'll bet they mostly need you to listen.

Have you ever wanted to be a hero? to do something special to help someone? This is a chance to help your family. Visit your sister if you can, and just tell her you love her and want her to be happy and well. Listen to your folks as often as you can. Get help for yourself if you can. This is what it means to be a grownup; life's complicated and sometimes difficult, but you set priorities as best you can.
posted by theora55 at 9:03 AM on September 12, 2011 [1 favorite]


Disclaimer: I used to work at a residential treatment facility for teenagers. I worked in the female house.

I'm going to guess that one of the goals of your sister being in the group home is to learn coping skills in a supportive environment, as well as learning boundaries. It sounds like she is trying to comfort/distract herself from what's going on in her head by asking parents to visit at a moment's notice, asking them to buy her things, and bragging about her "status" among others in the home. That's part of what we call their "honeymoon" period...where they are in denial about why they are really there, wanting to avoid the really hard stuff, and thinking that this will be easy to overcome. The trick is to be supportive while also reminding her of the positive coping skills she has available to her and setting boundaries for yourself. For example, if she calls at an inopportune time and begs you to talk, it's perfectly fine to explain to her why you can't talk right then ("I have to go to class, to a meeting, etc") and remind her that there are staff members at the group home for her to talk to if she's having a rough time. Or she can talk to the other residents, or distract herself with games/activities they have available. By doing so, you are distancing yourself (and taking care of yourself) while reminding her that she has the power and the capability to handle her own stuff. Make a planned day to visit (if you want) and keep to that plan...don't jump to her last minute requests.

Usually after a couple of weeks (and a couple of really good meltdowns because the distractions they used to use aren't available to them anymore) residents start getting to the nitty gritty of what's going on and start learning to take care of themselves. We saw it as part of the therapeutic process, and we always stayed calm about it because as their anxiety ramped up they needed to see that the "adults" around them weren't going to lose control with them. It provided them a secure environment.

I know I haven't answered all of your questions, but I did want to point that part out to you that isn't always obvious. In short, you can set whatever boundaries you need in order to take care of yourself...as long as you are open about what those boundaries are and why you need them.

Your family should also have access to a therapist or caseworker from the group home that will help explain everything to you...it might be a good idea to have a family meeting with them if possible.
posted by MultiFaceted at 11:04 AM on September 12, 2011 [1 favorite]


If she's not really depressed? You are demonstrating what it is you believe your sister needs to learn - self-sufficiency. Continue setting a good example. When she comes around, you will be a stable source of moral support.

If she really is depressed? Depression is a mental disorder that benefits most from outside professional support and therapy. She's already getting that help and you're not a professional. So take care of yourself. Finish school, kick ass at your job, and be 100% supportive on your terms (calling and visiting her at times when it's comfortable for you, et cetera).

Either way, you can't be a good source of moral support if you're stressed, anxious, grudging or resentful. If you're living well, your parents' need for affirmation will take care of itself.

FWIW, I am in a similar situation (ages and all).
posted by theraflu at 11:52 AM on September 12, 2011


My 17-year-old son (kid1) is right now in inpatient treatment for depression/anxiety. As a result of his issues, I also see his outpatient therapist (1) to learn how to understand what he's going through/how it affects his behavior toward others/how I can support him and (2) to learn how to cope with the guilt/grief/anger/etc. I'm feeling. Mental illness affects everyone who comes into contact with it, and family therapy should be part of your sister's overall treatment plan.

This inpatient thing came on all of a sudden for us, so I'm not on top of things yet, but as soon as possible I'm going have my 15-year-old son (kid2) start talking with the therapist as well. He does not believe kid1 is mentally ill/doesn't believe depression is "real," just believes he is an attention whore who turned into kind of an asshole in recent months. On the other hand he is angry with me for giving up on his brother, and wants kid1 to be the way he used to be. Kid2's feelings are confused, ambivalent, and contradictory. And they're all legitimate.

My kid2 has been through (and will continue to go through) a lot as the sibling of a sick person. It doesn't matter that the illness is not physical in nature, and it makes it harder that the illness makes the sufferer behave in ways that make him more difficult to be around. As the parent, I need to do my best to make sure both my kids' needs are being met (at least to the extent that I can). If your parents are abdicating that responsibility, then you have every right to take it on yourself, for yourself. See if your university has a counseling center, find out if your sister's caregivers plan to include family counseling in her treatment plan, make sure you have and take advantage of whatever personal and professional support is available to you.

Good luck. To both you and your sister, and to my beloved boys too.
posted by headnsouth at 12:18 PM on September 12, 2011 [3 favorites]


Nthing that seeing a therapist could be very useful and helpful to you. When I was seeing my therapist, one of the most valuable things she did for me during our sessions was to ask questions I hadn't thought to ask. (The one that still sticks in my mind, years later, was "Could you ask your family for help?") The questions were generally worth considering, and what was even more useful and always a source of insight was for me to ask myself why I hadn't thought to ask the question myself.

Speaking as somebody who's spent 35+ years struggling with depression (sometimes suicidal), I do think your post displays a lack of knowledge, understanding, and empathy for what it's like to have severe depression. The thing is, that's perfectly understandable. When I'm not down in the Pit of Despair, I honestly cannot remember what it was like when I was down in the Pit. I remember asking my husband to remove all the medications from the household because I was afraid of what I might do if I had access to them; I do not remember what that fear felt like.

If you're interested in some reading that might help expand your understanding, there are a few books I recommend. It's been several years since I've read it, but Andrew Solomon's The Noonday Demon was the most accurate description I'd read of what it's like to live with depression. Peter Kramer's Against Depression gives an excellent roundup of the current (as of 2006) state of research and understanding about depression, and might help you have a bit more patience when it feels like your sister is being willfully nonfunctional. (For example: in one of the research studies Kramer describes, people with depression — intelligent people, many of them college graduates as I remember — were unable to correctly complete simple connect-the-dots diagrams.) And the book I recommend most often: The Depression Book: Depression as an Opportunity for Spiritual Growth by Zen teacher Cheri Huber, which I truly believe saved my life when my depression was at its worst and when I was the closest to suicide I've ever been.

Best wishes to your sister as she learns to live with this horrible disease. And very best wishes to you as well.
posted by Lexica at 2:30 PM on September 12, 2011


Lots of good advice, little to add... But. I was reading expecting to find a sister a generation removed -- years and years older -- and no, it's just a five-year gap. 22 will not be wildly removed from 17 in not so many years and you might blush a bit at seeing the two of you as being in dramatically different life stages.

You are not being unreasonable with wanting a bit of a break; I had to write off, at significant financial and academic cost, an entire year of university after a friend-turned-roommate's suicide. (Lots of ER visits, lots of late assignments and missed lectures; sympathy from only one out of five instructors -- too many people making that stuff up, I think -- so dodgy grades in all classes but one.) I would explain your need to focus on school to your sister, though, instead of wordlessly fading and thus, as you put it, 'being a puss about it.' She may not be thrilled but it beats not saying anything.

I was a suicidally unhappy teen-ager -- I'm fine now -- this isn't hopeless. Offer what support you are able to, ask yourself how you would want people to handle things if you were in any sort of bad way. Talk positively about her future and try to mentor; if you need to get out of the present, think about how you might be able to help her when she's in college, talk that up. +1 on finding your school's counselling services; depression/people dealing with people dealing with depression will not be anything new to them.
posted by kmennie at 3:49 PM on September 12, 2011


I personally think you should support her, but maybe if you can't be there physically you can put together a care package of books/DVDs she might like to help take the edge off any boredom? At least talk to her on the phone... you have to let her know that however you're feeling that you're there for her, emotionally.
posted by Lovecraft In Brooklyn at 5:22 PM on September 12, 2011


Yeah, you're being selfish. It's not selfish to feel uncomfortable about the situation or be mad about certain things or to be confused -- or even to want to disappear. But if you actually care about your sister at all, you can not just drop her. If you can't stand by her for this, what else won't you stand by her for down the road? Being a family is not simply about having nice Thanksgiving dinners and taking vacations to Disneyworld. It's also about sticking with each other through nasty times like these. The people in your family (and others) are going to challenge you in many ways and make life harder for you throughout the rest of your life -- now sounds like a good time to learn how to deal with those kinds of challenges.

I'm not saying you need to drop everything and make her the center of your life -- that would be enabling her. But please, make sure she knows that you care about her in whatever way seems most genuine and comfortable for you. I was your sister. When someone mentioned upthread the idea of even just going and playing board games with her, my heart sort of lifted. That's such a great idea. When I was in the hospital I would have loved that. It's perfectly ok to tell her that you don't understand what's going on with her, but that -- and this is key -- you want to understand, if she wants to tell you. Don't feel like you have to be a rock for her, or say the right thing or anything like that. Be honest. Tell her that this is hard for you, too. Tell her why. Some of the interactions that most helped me want to get better were the ones where people I cared about were honest (yet kind) about how my behavior and illness were affecting them.

To get down to the nitty-gritty: I would say at least weekly contact of some form (a letter, a call, a short note with cookies, etc). If you are 40 minutes away, I would think a visit every 2 weeks or so would be nice, if you can swing it with school. Though your sister is not me, I would have been (and was) perfectly happy with that amount of interaction with my brothers when I was in her situation. Can you visit her without your parents? It sounds like a lot of the stress for you involves the dynamic between all four of you. It might be good to get to know how your sister is doing without the parental presence around.

Good luck to you all.
posted by imalaowai at 10:42 PM on September 12, 2011 [1 favorite]


The first thing you need to realize is that depression is a real condition that many people suffer from. I can assure you that depression does exist in teenagers, and even children. That doesn't mean that everyone who is sad or moody has a mental illness, but it does happen with alarming frequency.

The second thing you need to do is understand that if your sister is mentally ill, she has no control over that. She can't wake up one morning and decide to stop putting people through this. She's going through something really hard herself. Sure, it sucks that you and your family are being dragged along, but... you are family.

You seem to think she's being selfish and unreasonable. I think you're being a little selfish, too. But hey, we're all entitled to that. You don't have to do anything you don't want to do, and you certainly have the right to put yourself first. But I do think you should at least make some attempt to understand depression because until you do this is only going to be more difficult for you to deal with. Pick up a book, talk to a counsellor, something.

As far as support, try writing her letters. That way you can be supportive without actually having to interact with her. Maybe you'll better understand what she's going through if you hear it from her directly.
posted by metaphorik at 12:19 PM on September 13, 2011


And if it is ok to feel like this, to distance myself, how can I explain that it's ok to my parents? Because they feel that I should be equally supportive/involved by calling her/visiting her/having long deep conversations with her about her problems/etc.

"Mom, Dad, I love Sis, but I'm not a mental health counselor and I'm not equipped to serve that role. I don't even really understand depression, though I'm trying to learn more -- I've been reading (X, Y, Z) -- have you read that? What resources are you using for yourselves? Gosh, you guys must be exhausted. Do you have a support group? I read about this group for parents of mentally ill teens that's close to you, maybe they have the advice and support you need?

Anyway, I'm planning to visit Sis on the 16th. We're just going to play games and stuff. I've picked out some little care-packages I'm going to send out periodically -- nothing big, just (clothing/books/games -- be careful about what she's allowed in the facility.)

I love you guys! I have to get back to my studies/job search."
posted by endless_forms at 12:21 PM on September 13, 2011 [1 favorite]


On a different note: I think it would be really great if you started some therapy yourself. While your sister's mental illness has only become visibly critical recently, from your post it sounds like she may have been struggling with it for a long time.

Depending on how long she's been sub-clinically ill, that may mean, for you, that you've actually been struggling with "healthy sibling" issues for a great deal of your adolescence and young adulthood, maybe even your childhood. There are many ways that can be hard, and talking them out with a good counselor would be good for everyone, including your parents and your sister.

Also don't be surprised if you educate yourself to the eyeballs about depression, come to what you really feel is a compassionate and loving place about it, and then you see your sister again and she still drives you bonkers. Take things one step at a time.
posted by endless_forms at 12:30 PM on September 13, 2011 [1 favorite]


tel3path: This is exactly what is happening I think and thank you for breaking that down for me because I definitely wouldn't have realized that on my own.

Know what tel3path did? How tel3path took what you wrote here, then helped you


... put a nice pretty bow on top of it.

That's what therapists can do.

Look, you're defining yourself by what you're not.

except when you're not

"I have also been known to be and consider myself to be not very emotional or sensitive or emotionally-sensitive"
"I am in such a different place at 22, trying to develop my personality into a positive, productive, happy adult interacting with her really throws me off, makes me angry/in a bad mood."

etc.

***

You don't have to talk to her/visit her if you really don't want to. it sounds like she already has enough "support", and i doubt that your visiting or not right now be the difference between her being able to get by as an adult or not. not to say you should cut off all communication forever but for now .. fuck her. you can choose who you associate with, and what other people think doesn't really matter (unless it does).

it seems like you think your parents are imposing upon you these obligations, which makes them "HUGE SELFISH ASSHOLE[s]".

if you were "a HUGE SELFISH ASSHOLE" the same behavior would be apparent in other aspects of your life. but that doesn't seem to be the case with you (is it?).

most people don't want to deal with other people like that, which is why dealing with people like that is a job, and not just a hobby.

what to tell the 'rents? "i don't want to deal w/ this shit, i have my own shit to deal with" unless you're dependent on them.
posted by cupcake1337 at 11:09 PM on September 13, 2011


There is a huge difference between being a counselor and being a supportive friend or family member. The first is a paid position that requires serious training, and the second is one of those reciprocal obligation deals that identifies you as a nice, caring person. Yes, of course, set limits. But cupcake1337, your answer sounds suspiciously like "cut this crazy nutcase off." Which is certainly the OP's right, but it's not the same thing as merely protecting one's self.

And I have evidence that quite a few people - as in every single person who knows my diagnosis in real life - are OK with "dealing with people like that [i.e., me.]" Total abandonment of another person, even on a temporary basis, just because they're facing difficulties with mental illness strikes me as needlessly cruel and actually pretty darned unusual.
posted by Fee Phi Faux Phumb I Smell t'Socks o' a Puppetman! at 3:15 PM on September 14, 2011 [4 favorites]


based on what the OP said, it sounds like her sister's situation is a little more severe than run of the mill "facing difficulties with mental illness".

i'm not advocating total abandonment. i'll edit some of what i said to make the meaning clearer.

most people don't want to deal with other people acting like that, which is why dealing with people acting like that is a job, and not just a hobby.


what to tell the 'rents? "i don't want to deal w/ this shit, i have my own shit to deal with" unless you're dependent on them.
posted by cupcake1337 at 6:16 PM on September 14, 2011


based on what the OP said, it sounds like her sister's situation is a little more severe than run of the mill "facing difficulties with mental illness".

No, its straight up 'facing difficulties with mental illness.


most people don't want to deal with other people acting like that, which is why dealing with people acting like that is a job, and not just a hobby.


Sometimes you don't have a choice. OP doesn't have to spend all her time with her sister, but she at least needs to show that she supports or cares. Call her, visit her sometime, let her know that whatever happens she is THERE FOR HER SISTER.

what to tell the 'rents? "i don't want to deal w/ this shit, i have my own shit to deal with" unless you're dependent on them.

That doesn't sound like a good idea.
posted by Lovecraft In Brooklyn at 7:01 PM on September 14, 2011 [1 favorite]


And I have evidence that quite a few people - as in every single person who knows my diagnosis in real life - are OK with "dealing with people like that [i.e., me.]" Total abandonment of another person, even on a temporary basis, just because they're facing difficulties with mental illness strikes me as needlessly cruel and actually pretty darned unusual.

There's a difference between, "I normally see my friend/family member, but I can't see them right now because they're in the hospital, so I should visit/call/mail them while they're in the hospital" and "I am going to drop what I'm doing on a regular basis to serve as a surrogate caretaker while this person is being professionally treated or as a substitute for professional treatment," which we see so, so often on AskMe.

If the OP normally keeps in touch with her sister, then she shouldn't abandon her because she's going through a tough time. But beware of families that try to convince siblings, "You all have to drop what you're doing right now to 'support' [other sibling] while they're going through this." This isn't just about setting boundaries between you and your sister, it's about setting boundaries between you and your parents, who may be looking for a reason to avoid having to set boundaries around their interactions with their ill daughter.
posted by deanc at 10:29 AM on September 15, 2011 [1 favorite]


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