At her worst was her high school and college years. Those were the years she had plans to end her life, an attempt which led to therapy and SSRIs that lasted for some time. Around her mid-20s, she kind of "evened out" and it's been pretty consistent ever since. One parent died in early childhood and the other parent died in early adulthood. It's been just the two of us for some time.

She is not a difficult person to be around, if anything, she's overly accommodating and I believe her when she says she's not planning on ending her life because she wouldn't do that to me, it sounds very much like her to not want to burden me. She's very funny and kind. But will slip into these zones where she's difficult to get a hold of, can't sleep and doesn't take care of herself. She has told me whenever she seems okay, it's because she's pretending and sometimes she just gets tired and needs a break from pretending.

It breaks my heart. I don't know how to help her. It seems this is all she knows.

Anonymous wrote:Unpopular opinion, but I fought for my sister even though she’s always been awful to me. Showed up at her house and dug her out of her hoarding multiple times despite her verbal abuse. It took a toll on me and she didn’t “deserve” it, but that’s what grace is all about. She pushed us all away because it would be so much easier to “leave” if no one would miss her. She is so strong and I regret the boundaries I set earlier. She just needed me to see her and love her. I’m making up for lost time.

This is an atypical case. Honestly sounds like you two are codependent as a means of coping with her depression.

Op you need to set boundaries, and work to get your sister Medicaid so she can find therapy. She may need SSI but that will be up to therapist if worn pursuing.

This severe I would guess personality disorder. Though with headaches and vision maybe it neurological. But she’s always been like this ? — like my experience with a sibling.

Was she better than parents were alive? Dependent personality disodse

Unpopular opinion, but I fought for my sister even though she’s always been awful to me. Showed up at her house and dug her out of her hoarding multiple times despite her verbal abuse. It took a toll on me and she didn’t “deserve” it, but that’s what grace is all about. She pushed us all away because it would be so much easier to “leave” if no one would miss her. She is so strong and I regret the boundaries I set earlier. She just needed me to see her and love her. I’m making up for lost time.

Anonymous wrote:What is the seasonal job? Maybe there is a related craft, group, job, something that can give her some meaning and happiness during the other months?

Without giving too much away, it's a large (and so far, consistent) Christmas event that she's hired on for every year. It's mostly the people in charge there are abnormally great and it's not work from home so she can't sit in her depression cave... and she doesn't need to deal with the public or strangers. Her social anxiety makes branching out very difficult, but I keep hoping she'll find something else either from this job or people from it...

For the other PP above, I'll mention trying ketamine sessions. I think I'll need to wait for her to be employed again or just off of her employment when she's in a better place to broach the topic. Hopefully she'll be more agreeable when she's not as bad as she currently is.

That kind of depression is very hard to treat as our severe headaches. If something was life threatening enough for me, I think I'd choose to pass as long as my kids were adults vs. fighting it. Living with chronic health issues sucks, don't want new ones.

Take her to one ketamine session that you pay for. It was life changing for me and worst case scenario is that she feels no better and you're out a few hundred bucks. Best case is the darkness lifts for a minute or a day or a week and she might feel a glimmer of hope.

My brother died from mental illness by suicide. I wish I had known about ketamine in time to try it with him.

What is the seasonal job? Maybe there is a related craft, group, job, something that can give her some meaning and happiness during the other months?

Cut off her internet and wait four months.

Anonymous wrote:Is the depression/social anxiety the reason she is unemployed?

Yes.

She has seasonal employment at one place that's been steady for the last 8 years or so, but it's only during Fall/Winter seasons. It pays her well but not enough to sustain her all year long, but does seem better when she's working. She's tried various jobs off season and dealing with the public and/or crappy coworkers makes her depression significantly worse than it already is.

Anonymous wrote:In I'm the same boat as your sister and in my experience my insurance only provides online therapy, which is horrible at best, so I don't bother. The alternative to pay out of pocket is too much for an unemployed person. I can tell myself to be less anxious, which is all they therapists have done but they charge for that piece of advice.

Quite frankly she's probably planning something and if she's like me she's picked a date and is slowly getting her ducks in a row. There is really nothing you can do except listen to her and not abandon her and hope for the best. My sister and parents cannot deal with my depression and just have silently stepped out of my life. I'm ok with that; it's what I expected.

I’m so sorry. I’m not okay with your family stepping out of your life. I don’t want you to give up.

Is the depression/social anxiety the reason she is unemployed?

Anonymous wrote:

Anonymous wrote:"She's starting showing symptoms of high blood pressure, but won't get checked out."

What signs?

Headaches and vision problems.

High blood pressure is usually asymptomatic, which is why they call it the “silent killer.” Symptoms really only arise in a hypertensive crisis (which necessitates a trip to the ER).

Is online therapy really useless? Better Help?

Anonymous wrote:

Anonymous wrote:Sounds like she needs antidepressants. Make an appointment with a psychiatrist and go with her.

She could definitely use some and I think they'd help take the edge off of the worst of it. She's been on them on and off since high school and she says they don't help. I've been trying to get her to try again.

Antidepressants don't work for everyone. Perhaps she would be a good candidate for microdosing psilocybin.

Anonymous wrote:

Anonymous wrote:In I'm the same boat as your sister and in my experience my insurance only provides online therapy, which is horrible at best, so I don't bother. The alternative to pay out of pocket is too much for an unemployed person. I can tell myself to be less anxious, which is all they therapists have done but they charge for that piece of advice.

Quite frankly she's probably planning something and if she's like me she's picked a date and is slowly getting her ducks in a row. There is really nothing you can do except listen to her and not abandon her and hope for the best. My sister and parents cannot deal with my depression and just have silently stepped out of my life. I'm ok with that; it's what I expected.

Please call 988 — please. They will help you through this.

Have you ever tried these thing?! We should cut funding to them, because they are totally useless. I suppose it makes some people feel good to have something to recommend when they don't have anything useful to say.