Q. Dear Dr.:

My sister was recently diagnosed with a "anxiety/personality" disorder...My family and I have noticed changes in her behavior over the last several years. She keeps a lot of things to herself so I don't know if there was more to her diagnosis. We live in different states So I don't see her very often. We are about 1 year apart in age. I am 33 and she is 34. After reading your other emails and information on your website I am convinced that she has BPD.

She is extremely thin, very paranoid, a heavy drinker, hates to be confronted about anything, says "Ouch" when asked about things that she doesn't want to talk about. Goes from extremes of happiness (seems phony) and irritability-there's hardly anything in between...When telling happy stories she often dwells on the past...

She has had several bad relationships with men, becomes obsessed with each one, calling several times a day, writing letters to them-definitely unable to let go. She has had problems with overspending, resulting in huge financial problems and appears to be depressed.

Her psychologist that she no longer sees somehow gave her a prescription for Xanax, I'm told a very small dose. It seems like she takes them along with several beers to help her sleep-her mood changes almost instantly once she has beers/Xanax in her system.

I am very concerned about her. She has "reckless" sexual encounters-having intercourse with people she hardly even knows...etc. Her "appearance" and eye movements tend to change a lot.

What do you suggest I do? She does not like to be confronted at all. I want to help her. I can't be sure that she knows she has this either but I really feel strongly that she might. There's alot more to the story-Alcoholism in the family but no sexual abuse to my knowledge. Please help me help her!

A. Whether your assessment of the BPD is accurate or not is not clear, but from what you described she is in trouble and most likely in misery.

The best suggestion I can make is to send her a copy of my first book's cover "Life at the Border" - it can be downloaded from "books" section of the website. The back cover of my new book "Biological Unhappiness" may be very helpful as well.

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