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Elizabeth remembers a childhood where alcoholism was rampant. She and her two sisters bonded amid the dysfunction, with the oldest taking the lead as caregiver when their mother died. Things were fine until their 20s when her older sister turned to drugs. Elizabeth was the one to bail her out of trouble, give her money and drag her out of bars. Much of her life was marked by worry and waiting for the next crisis. She felt responsible and thought that trying to manage every calamity would keep things under control and save her sister. But it only got worse.

Her sister’s illness had made her ill. Elizabeth was hooked on trying to save her sister. What she came to realize is that she had to learn to save herself first.

Why Addiction Strikes One and Not the Other

Living through a sibling’s addiction can be devastating. People are often closer to (and more competitive with) their siblings than any other relative. Not only do they typically share DNA, upbringing and family culture, they share a relational bond unique to siblings. When addiction strikes, siblings may feel responsible for addressing the problem and overcompensate by accommodating dysfunctional behaviors to keep up the appearance that everything is fine. Others feel invisible and resent being overshadowed.

Many siblings who do not become addicted feel guilty for being the “lucky one” and may even suffer a form of survivor syndrome. They often ask: Why them and not me? There are many factors that influence addiction. Unresolved childhood trauma is at the top of the list. It can impact siblings differently and occur at different life stages. For example, an older sibling may have had more exposure to an abusive or addicted parent, or perhaps it was a younger sibling who had fewer coping mechanisms and thus was more traumatized. This may make one sibling more likely to use drugs or alcohol to deal with the pain of the trauma

There are also genetic roots of addiction. Studies have shown impulsivity is passed along through the genes, and sensation-seeking also runs in families. Recent research that looked at brain scans of cocaine addicts as well as their siblings, who had no history of chronic drug use, found that both had a propensity toward lack of self-control. So why does one get addicted and not the other? Researchers are still searching for answers, but it appears that the non-addicted sibling may be less likely to struggle with cravings and to have resilience factors not shared by their addicted loved ones. 

The Codependency Trap

It’s normal to want to help an addicted sibling. If a sibling had cancer, you wouldn’t think of deserting them, and the same is true with the disease of addiction. But the desire to help can morph into an inability to turn away from the chaos. In an effort to regain peace and order, you may end up enabling your sibling and becoming enmeshed in their constant life crises. Some of the signs of codependency include:

  • An overpowering need to take care of others
  • Desire to be in control
  • People-pleasing
  • Difficulty setting healthy boundaries
  • Dependence on others, including the addict
  • Overwhelming emotions such as sadness, anger, fear, nervousness and irritability
  • Low self-esteem

One of the biggest traps for anyone who loves an addict is constantly doing damage control. As Elizabeth discovered, making excuses for her sibling, calling her boss when she was too high to work and giving her financial support only enabled the disease to progress. Unless the addict has to deal with the consequences of their actions they will continue the same behavior. As much as you love your brother or sister, you have to give up the fantasy that you can control their situation and focus on what you can take charge of — your own life.

How to Practice Self-Preservation

Here are a few ways to make your health and well-being a priority even in the face of crisis:

  1. Just say no. Setting boundaries can help encourage the addict to make changes as well. In Elizabeth’s case this meant telling her sister, “I love you but I can no longer be there to bail you out,” and she stopped paying her bills, giving her cash and lying to cover for her. She offered her sister assistance getting into rehab but refused to be around her when she was high. She also set limits on returning phone calls and text messages to step off the emotional roller coaster.
     
  2. Your joy in life comes first. Overwhelming emotions can dominate your life. Whether it’s a call from police in the middle of the night or finding your credit card missing, every incident adds to your anxiety. Find ways to bring peace into your life in some measure, if even for short intervals — walks, movies, exercise, or a dinner out with friends — so your nervous system is not constantly in a state of high alert.
     
  3. Your grief is real. Own it. The life you expected with your sibling hasn’t panned out. And some of your own hopes and plans may have been dashed by their disease. Allowing yourself to grieve can help you accept the loss, release unhealthy attachments and move on. Only then can you create something new for yourself, and perhaps someday with your sibling.
     
  4. Put your own oxygen mask on first. You’ve spent a great deal of time worrying, monitoring and trying to help your sibling. Now it’s time to redirect some of that energy back to yourself. This might include attending a support group like Al-Anon, talking with a friend or meeting with a therapist. Some people find they must limit contact with their addicted loved one for a time while they focus on their own recovery. 
     
  5. Keep hope alive. It’s important to your own healing process to hold on to hope that someday you may be able to heal the rift that addiction caused between you and your brother or sister. Regardless of whether or not they get help, you can remain hopeful while at the same time making sure you’re as healthy as you can be. Elizabeth never stopped loving her sister, but she learned to make her own needs a priority. When her sister went to rehab, Elizabeth had the strength to participate and be supportive during and after treatment.

Your sibling may have broken your heart, and you have a right to feel angry, distrustful and all the other emotions you’re experiencing. It may take a while before you can get past the pain. Although you can encourage them to seek treatment, you can’t always stop their addiction from taking them on a downward spiral. But you can stop it from consuming you. And doing so puts you in the best position to create not only the life you want for yourself but also the relationship you’ve hoped for with your sibling. 

David Sack, MD, is board certified in psychiatry, addiction psychiatry and addiction medicine. As chief medical officer of Elements Behavioral Health, he oversees a network of addiction and mental health treatment centers that includes Promises Treatment Centers and The Right Step drug rehabs in Texas.

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