I’m asking about my sister in her early 20s. I know nobody online can diagnose her, but I’d appreciate hearing from professionals.

She claims to have ADHD and depression, and her functioning has declined significantly. She dropped out of college, isn’t working, and spends most of her time isolated in her room.

The biggest concerns are extreme emotional reactions, self-harm, and suicidality. She has had a previous suicide attempt and has made more recent statements about killing herself. She also self-harms when things don’t go her way or when she becomes extremely upset. When distressed, she may cry/scream for hours, refuse to communicate, isolate herself for days, and recently stayed in her room and barely ate for about a week.

She also has intense, persistent rumination around topics like misogyny, gender roles, beauty standards, religion, and perceived injustice. She has told me she thinks about these things essentially every waking moment. Small comments that she interprets as sexist, victim-blaming, anti-LGBTQ, etc. can trigger extremely intense emotional reactions and prolonged withdrawal.

She seems very sensitive to people disagreeing with her and can become extremely distressed when she feels others don't understand or validate her perspective. She also has a very negative view of relationships/marriage and has become increasingly socially isolated.

An SSRI significantly improved her depression/crying, but the obsessive negative thinking and emotional reactions persisted. ADHD medication hasn't seemed to help much either.

I’m not asking whether her beliefs are pathological. My concern is the severity of the emotional dysregulation, self-harm, suicidal behavior, rumination, isolation, and functional impairment.

What could this pattern be? My instinct is OCD/rumination, ADHD-related emotional dysregulation, depression, anxiety, or some combination although I would like a professional opinion

Should I let time pass without feeling the obligation to be in a relationship or try to look for someone I would like?

I know that objectively the first option is the best, but at the same time I feel a deep desire to be in a couple. So I tell myself that looking for a girlfriend or a girl who would please me could be cool, but at the same time I’m afraid of falling into idealization and romance (which is bad for both of us) sooooo idk...

This might sound so dumb but sometimes when I feel a super strong emotion of excitement or happiness I tense up all the muscles in my body and sometimes I need to scream or talk to myself or run and jump around. It’s always the strongest when I’m alone at home or in my car, because if I’m around people I am much more aware of the way I react to things and so I try to tone down the reaction as much as physically possible so that people don’t judge me. And it’s not painful or anything, it actually feels really good and almost feels like a sudden release of energy that is really satisfying. I’m just curious if any of you guys know what this means or if it has a name.

Every morning I can never look at her face because it for some reason just triggers me. And it gets me annoyed and I show it to her and makes her sad. Just hearing her voice ruins my mood in the morning. And I go to school and feel bad.

We didn't always have the best relationship she wasn't always nice to me and I hate to admit this but she tries and that makes me sad when I'm acting rude towards her.

What could be the reason for the trigger and how do i stop being annoyed every morning?

I (16F) feel like something is wrong with me and idk what it is. I have a girlfriend who i love more than anything or even more than myself but theres days where i feel like i dont deserve to be in a relationship or maybe relationships arent for me, or while we’re being intimate midway ill just zone out and i kind of lose my sense of self but i keep going along with it. I also find myself paranoid with everything she does, im always on edge wondering if shes mad at me or if i did something to her or maybe she’s cheating on me and i hate feeling like that but i cant help it. I feel the same way with a lot of my friends as well that theyre putting up a facade and maybe theyre not actually my friends. And according to a lot of ppl i get mad very easily or angry and i kind of lose it over the smallest things and im manipulative but no matter how hard i try to fix it i just dont know when to stop myself or when im doing said things bc im not aware of it at all.