to ask for help with what I think may be depression in my sister?

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My sister is appearing to become increasingly stressed. I am not sure what is wrong but she quit her job a while ago and seems to have gone from exercise queen to house slob. She doesn't answer the phone. If I show up, she will answer the door after repeated knocks. The flat is a mess. She can converse animatedly about politics, but suggest a shower and she goes back into herself. She can go from animated to crying about her past within the same conversation. She doesn't lead the house and is not eating regular meals. Crisp packets and alcohol bottles are all that seems to be lying around. How can someone go from a happy healthy outgoing working person to a complete drinking recluse in 2 months?
She says she won't leave the house to go to the GP as she can't get on a bus and she can't afford a taxi.
She has missed medical appointments because she apparently forgets about them.

She seems happy when I'm with her, but she lives alone and I suspect when I walk out the door she just cries.

How can I help her?

And she is refusing to come to the family dinner for Christmas as she says nobody would want her. We would love to have her and I've told her that. She just seems to want to be left alone which is most unlike her. She is the life and soul usually. I strongly suspect depression. Something happened her 2 years ago where she was a victim of a crime, but she seemed to have let it wash over. I'm wondering is it all coming back to her now? Should I leave her alone, should I just visit her alone maybe on Christmas day with some dinner or what should I do?

My family would happily all visit her late Christmas Day, but I suspect she wouldn't let us in. She just seems so sad which is not who she is. I can't bear to see her so lost and sad.

Have you asked her, what does she want to happen? What would she be happy with you doing for her?

She just keeps saying 'I'm fine' over and over again. Then she'll turn her head away and ignore me until I change the subject.

I feel for you and you sound like a very caring sister.

This seems likely to be a mental health issue - maybe post it in mental health section here ?

Or see if you can get any professional advice from someone by phone? Would a call to a mental health charity be an idea?

Can you call her gp and try to get a home visit? You would probably have to beg but she needs a doctor.

I don't know who I could call. The specific crime she was a victim of (or a version of police in that area) helped her a little for a few weeks, and she seemed to have totally sailed through the crime as if nothing had happened. She was working, very much a gym bunny, home immaculate. In two months, she has become a complete recluse, her flat is a mess and she just seems broken a bit. She's not herself. I know this is maybe a shitty time of year, so maybe she is finding it extra hard because of the time of year. She has one card up from our Dad and wears and twists a bracelet her niece sent her like her life depends on this bracelet.

I know what she's told me about happening, but I'm wondering whether something else happened. That or she's getting flashbacks or something to the crime 2 years ago. And I can't help with that. I feel I should maybe spend the day with her on Christmas Day, even though she is adamant that she doesn't care and just wants to be left alone.

You can't fix this op, she needs to see the doctor. It may well be that your theory is correct that it's all related to the crime. I would go and see her on Christmas day, maybe take her some Christmas dinner. I don't think you need to be there all day if you think she will be OK other than lonely. Just keep being there for her, don't give up. She will thank you one day. You don't have to spend all day every day but just there enough that she knows you care.
I don't know what the crime was but is there any kind of support group or charity relating to it in your area? It might be a good starting point even if it is just advice for you and how to help her. Or you could try contacting victim support. They might be able to point you in the right direction.

Keep going! You’re a lovely sister. Definitely see her in some way in Xmas day while accepting she doesn’t want to join the family this time. She really needs you even when she is blocking and obstructing. And yes definitely talk to her GP and see what can be done there. You sound lovely!

The crime was rape and she attended 4 counselling sessions. She couldn't get time off work to attend any more so she quit them. As I said, she seemed totally unaffected. Now, she just appears to be someone I don't know. She is not herself. She is little miss prim with the house immaculate at all times and now it's a mess. She won't let me clean up she just says 'Leave it'. I think she is ashamed, or doesn't care or does care and I don't know what she's thinking. She's a lovely sister, always the life and soul and I don't know how to deal with this way she is being now because it's not her. I know it's her, I just don't recognise her.

Your poor sister.

You can’t fix this.

The best you can do is keep in touch in a low pressure way, try see her when you can or keep in touch via phone, let her know you’re not pressuring her to do anything but when/if she’s ready to speak to someone you know where she can go (you can google your local IAPT team and she can self refer for trauma therapy in most areas).

She’s already lost a lot of control in being raped, it’s really crucial you respect where she’s at and allow her to feel and act how works for her currently instead of trying to force her into anything, so if she says she wants to be alone on xmas day, let her. If she is happy to have you pop round, do that.

She’ll work through this in her own time and you can’t speed it up however much it hurts you to witness. Just be a frequent presence and make sure she knows you’re there, also when you see her try and take the heaviness off a bit sometimes and just chat to her about your own life, ask her advice on stuff, she’s probably dreading a host of concerned faces tiptoeing around her and just wants to be alone.

Could you afford a taxi and maybe accompany her to ge GP? Not the appointment but just to see her in and home again.

It's only our mother who knows what happened, so I suppose while there wouldn't be concerned faces, there would be questions. I will just pop in for a few hours in the evening with a dinner and stay. We have the best political arguments ever (her current bugbear is Jeremy Corbyn's suits).
I guess only she can pull herself out of this hole. I'm not a miracle worker but I can be a sister.

Unfortunately I work fulltime and I guess I probably could book a half day off now that you mention it. Neither of us are floating in money, but yes, that seems like something I could suggest.

Her GP won't be able to discuss her with you but you might be able to request a phone call or appointment and tell them what has happened and is now happening. Or request a house visit if she isn't leaving the house.

Not to internet diagnose at all but when I had PTSD I was exactly the same no motivation, house untidy and scared to leave the house. I developed it a year after the trauma occurred. Mental illness affects people differently with different symptoms she needs a professional to work with her and deal with it. It's unlikely to go away without help.

If you are worried she might hurt herself look up your local crisis team and ring them but be warned a lot of services are cut to the bone. I think your best bet would be explaining to her GP or even the admin staff and securing a home visit before everywhere starts closing over Christmas.

This video from the WHO gives some advice for partners and loved ones of people with depression.

She won't have dealt with the rape at the time. Believe it or not, it's in some ways better that she's (probably) dealing with it now. The only way out is through. I completely denied what had happened to me for more than a year and I went through a very shaky period of depression and PTSD when I finally started processing it. I came out the other side stronger but I needed counselling, meds and support.

I think you just need to keep being there for her and gently nudge her to get help.
Do you know why she left her work, is it possible something happened there that triggered a breakdown related to what happened two years about? I think she sounds in crisis right now.
Without being too overbearing when you go to hers can you tidy up as I know how much better a clear environment makes me feel, even if she protests it might help a bit, if only to get some clarity to make a docs appt.
Can you contact her friends and arrange a bit of a rota of checking in with her? I know she's pushing people away but it might be a safety net.
It sounds really tough, I hope she can get some help soon.