My sister shares her struggles on social media but not with me. How can I help her?

My younger sister frequently uses social media to share her struggles with depression, her loneliness, her intensive drinking and her general self-hatred. More than 20 years ago she was a drug addict. She got herself clean – an achievement requiring incredible resilience and courage – but she continues to measure her worth by how she supported her addiction (which also obviously required courage and resilience). She cannot seem to forgive herself and it is painful to watch. It’s like she is denying herself the right to be a whole person. And she is an amazing person.

When I read on her social media that she is miserable and doesn’t want to go on, I contact her – but she denies anything is wrong and, if I press, she becomes defensive. I am deeply worried about her but I cannot think of anything I can do that will actually help. What would you do in my situation?

Eleanor says: Hope is the primary casualty of prolonged suffering. It sounds as though your sister has been in pain for decades – one of the cruellest effects of ambient pain like this is it trains us to stop hoping it will end. It makes us wish for ever less. Instead of hoping for joy, or the internal glow of contentment, we learn to hope for a life that is – technically – bearable.

Torture can mutate over time into a sort of muffled drumbeat of discontent. People with that drumbeat in their brain can dismiss it on the grounds that isn’t interrupting today and it won’t interrupt tomorrow – it is, technically, bearable.

As long as that’s a person’s relationship to their own version of that drumbeat, it’s difficult to persuade them to get help. You can frogmarch your sister to therapy or to group meetings but the problem is how that sets her up to deal with setbacks – and, very unfortunately, there will be setbacks. She could find a bad therapist, not connect with the group meeting near her, find her friends unsupportive – unless she is the source of her own willingness to get help, each one of those failures can get brought back to you, receipt style, as proof that effort is futile. “See?”

So you have to find a way to defibrillate some hope in her. Doing that will not be easy. It is astonishing how much we can ignore or push aside until things get to a crisis.

I think hope needs two thoughts to stay alive: that a better life is possible, and that it’s desirable. I don’t know which of those is the hardest for your sister, but it might be helpful just to try to find out. Before pushing her to do this or that, try with genuine curiosity to know more – ask what’s unappealing about talking to you more, or what she feels about the possibility that she will continue to feel bad. This will be uncomfortable. There is no way to have these conversations that doesn’t feel awkward. But you can do it in a way that feels like pushing at the problem, not pushing at her – be vocal with the esteem you so obviously have; stress that you’re revolting against her pain, not her choices; apologise for anything that might have made her feel hounded or judged in the past.

You asked what I would do. I’d enlist as much professional help as I possibly could – for both of you. Loving someone who lives with addiction or depression can feel high-stakes and hard, and it’s important – for both your sakes’ – that you don’t feel it’s your job to “fix” her. But tens of thousands of people have walked where you both are walking now. The most important thing either of you can do, for each other and yourselves, is to guard against hoping for less.