Q. All the stories I read sounded like soap operas ... abuse, neglect, addiction. Well I write about my sister who has been diagnosed with Borderline Personality Disorder, Obsessive Compulsive Disorder and Schizoaffective Disorder. Truthfully, none of us know what she has. Her symptoms seem to match with all of the above. But why she has them, no one knows.

Contrary to most of the letters, we grew up in an extremely warm and loving home. My parents treated us all equally showering us with love, overlooking our faults and praising us over the slightest accomplishment.

But even with this great environment, my sister was always different. A step behind everyone else socially. She is 1 year younger than me, but it seems more like 15. She drives me crazy, but I love her and feel for her pain. Sometimes I am her only friend, besides my parents and semi-absent younger brother. She loses jobs and friends at a rapid pace. It's always someone else's fault. And soon all these relationships turn sour.

One day she's O.K. the next she couldn't be lower. Her conversation is often irrational as she drones on and on about the tiniest detail. Most people will tune her out on the phone and anxiously look for an excuse to end the conversation. Her temper is often violent, especially with those who love her most. She can get physical and will throw a temper tantrum like a 5 year old.

Medication has been introduced several times through therapy, but she has had bad reactions and often stops prematurely. She also loses therapists as often as she loses friends and jobs. Always the other person's fault. She does not talk about her illness in scientific terms, only in terms of the pain and confusion she is suffering.

I wish we were in a movie. Then I could find a cure for her and life would be perfect.

Since I live very far from her, and she doesn't fly (a fear she developed 10 years back), I don't have to deal with her illness that often. But when I see her again, boom there it is - and it never seems to really get any better. My parents are very supportive and very involved in her life. However, their knowledge of her illness/s is marginal and any efforts to get them more plugged in seems futile. My dad seems more active than mom, who is often too "innocent" to deal with my sister's mental illness.

I pray to God that someone will invent a drug that can wipe out the pain, but alas I fear that's only a pipe dream! In the meantime, God give me patience to be there for her and put aside my frustrations with her oddities.

A. Truly sorry about your sister. She will do well if she gets on the right medications, and finds a good therapist. Doing therapy before you start meds is not very productive, and is better left until the medications work. There are plenty of medications, and they work for the vast majority of folks if used correctly. Your sister does have all the "illnesses" you listed, but they are really just symptom clusters (Behaviors) arising form the same chemistry. Get her on a SRI (Prozac at > 80 mg/day, Zoloft at > 200 mg/day, or Luvox > 300 mg/day) or SNRI (Effexor XR at > 300 mg/day) and she should do okay. All except the Luvox have been published. If she smokes, she will need more medication statistically.

It is gut wrenching to watch a family member suffer. I hate watching anyone suffer, which is what makes my job difficult. Nonetheless, we have the wherewithal to help the vast majority of individuals. No reason your sister cannot be one of them if she tries the meds.