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My sister’s suicidal impulses are a knife to my heart

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I found a list of suicide instructions in my sister's room recently.

In careful handwriting in a pretty green spiral notebook with pink flowers, she listed the steps for death by pills (go to a doctor, request drug X; return and ask for drug Y; combine) and asphyxiation (bags without holes; elastics).

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Suicide is an awful word. It squeezes my gut and cuts off my breath. My heart drops, and I feel overheated. And yet, it seems to be a running theme in my family home sometimes.

My sister has been diagnosed with borderline personality disorder, a serious mental illness characterized by problems with regulating emotions and thoughts, impulsive behaviour and unstable relationships. She has had suicidal thoughts since at least the age of 11. Maybe earlier.

Too many know the road of mental illness and how it becomes a "family disease." In my family it has done so to the point that 10 years after my sister's emotional troubles surfaced, finding a list of suicide instructions is not that shocking.

You roll your eyes and think, "Here we go again."

Truthfully, I sometimes get angry and want to snap her out of it. Other times I want to cry. And I'm only her brother. I can't imagine how her parents feel.

My sister was born to my mom and her second husband, and almost immediately became the hub of our family circle. We doted on her, playing, laughing, enjoying her effervescent nature.

I am about 10 years older, so I helped take care of her. I remember her first steps, words, favourite toys. When she was upset and crying for someone to "take her," it wasn't just my parents she turned to. It was me, too. I admit I've sometimes felt paternal, wanting to protect her, support her into a productive adult life, and heal her pain.

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Because of BPD, her pain is a real and frequent visitor. But I can no longer pick her up and give her a hug or a toy to make it go away.

My earliest memory of trouble involved my sister bringing a bread knife from our kitchen to school and threatening to hurt herself. I was annoyed then, thinking it was a ploy for attention. But soon she became anorexic and then fell into bouts of despair and unshakeable unhappiness.

A brief stay in a psychiatric ward didn't seem to result in any progress. I hurt as much for my mother, who kept repeating, "I don't know how to cope."

As my sister grew, she loved dark themes in TV, books and movies. She watches Law & Order: SVU, and movies such as Girl, Interrupted. It seems old school, but I worry about the effects. She seems highly impressionable. Once, one of her outbursts included phrases recycled directly from a movie we'd recently watched.

Sometimes I wish my mom would parent harder: get angry, put her in an institution, pitch the depressing books and movies. But this experience has also made me reevaluate my mom. She's in pain too and can only do so much.

My sister's life still has a lot of happiness and productivity. She loves baking and helping out at family parties, particularly the baby showers. She was once a very good dancer and has recently begun singing and attending open-mic nights.

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But as part of her BPD, she will never admit to happiness. "I fake it when I'm happy," she says when we're feeling relieved that she seems to be doing well.

She has made a lot of progress recently. She graduated high school as an Ontario Scholar, completed two college certificates and spent her first year in residence. She came out of her shell to participate in group work and some college activities.

But still, when challenges arose, she called our mother threatening suicide and it was off to the crisis clinic. The cause? A tough lecture. When she did poorly on a lab assignment, she dropped the class. That is the borderline mind.

"Don't let your illness define you," my mom has wisely told her. I admit I haven't always been helpful. Sometimes I have no patience. I've caused fights.

I've read a few books on the illness now and learned that it is best to give support, but maintain boundaries. Don't let the person control you and take away your quality of life. I should leave my sister to her destiny and focus on mine.

"But what if she …," I think. It's not that easy, but I'm working on it.

So, what do you do when you find a suicide instruction list in your sister's room? The respectful thing is to leave her property in place. But brothers don't always do what you want. They can be annoying and take charge. It's not because they want to hurt you. It's because they truly love you and want to protect you. So, into the garbage it went.

Brian Bradley lives in Toronto.

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