I think my brother may be faking his illness, i dont know what to do.

I (18F) think my brother (22M) may be faking his illness, and it’s eating me up inside.

This might be a long post, so I apologize in advance, ill leave a TLDR at the end.

My brother has had a long history of mental health issues since childhood. depression, dissociation, age regression, Dissociative Identity Disorder, and hearing/seeing things that aren’t there. However, all of these were self-diagnosed, as we didn’t go to doctors much growing up, and my family didn’t believe in therapy. So please keep that in mind.

For most of our lives, he has needed a lot of emotional and physical support, much of which has fallen on me. I’ve always believed him and done everything I can to help. When he came out as trans, I helped cut his hair and bought gender-affirming clothes. When his depression was at its worst, I helped him bathe, detangled matted hair, cleaned his room weekly, and tried to make his life easier. I love my brother deeply and would do anything for him.

Recently things have escalated.

He started having episodes where he suddenly becomes extremely weak, lies down wherever he is, goes nonverbal, and is completely unresponsive. Sometimes his eyes are closed like he’s passed out. My family panics and repeatedly asks what’s wrong, which seems to agitate him, so I usually step in and try to calm things down.

I noticed that if I played media he was really into (like favorite shows), he would slowly “come out” of these episodes and be completely normal again within minutes. For example, once he became unresponsive, lay down, and wouldn’t react to anyone. I played Attack on Titan, which he was obsessed with at the time, and he gradually woke up and started laughing and watching with me like nothing had happened. This worked repeatedly until things started getting worse.

Eventually these episodes turned into him actually fainting. It became frequent enough that my family took him to the hospital, where he stayed for over a week. Doctors found nothing wrong and sent him home with plans for more testing. After that, the fainting stopped for about a month, then started again. He’s now on medication for fainting (Hydrocortisone I think?), but in my opinion it doesn’t help. he still passes out everyday, sometimes multiple times a day.

I never doubted him at first. I was the one pushing my family to take him to the doctor months before they actually started taking his issues seriously. But over time my doubts have grown and I feel like a horrible sister for even thinking this way.

Here are the main reasons I’m struggling right now:

• Before hospitalization, I could wake him up from these episodes by playing favorite shows or tickling him. This even worked once when we had called 911 and the EMTs were trying to get him into the ambulance. he briefly woke up and laughed. Is that even possible with real fainting??

• After the hospital stay, he privately told me he believed the fainting was psychological, possibly a trauma response to being in our home (which I think is plausible). Weeks later, after fainting again, he said he didn’t think it was psychological anymore. Later, during my grandfather's birthday he fainted immediately after smelling an old cologne our grandfather used to wear (my brother has trauma from dealing with our grandparents constantly screaming at each other) , after waking up later that day he told he was “90% sure” his passing out was physiological. Now, months later, he no longer believes it’s psychological at all. I’m very confused at this point.

• Doctors repeatedly say nothing is physically wrong. His doctors have told us to bring him to the ER if he passes out for too long. This has happened many times, and every single visit ends with doctors saying they find nothing wrong. My mom even took him to her personal doctor once to get a second opinion. During that appointment, my brother fainted. The doctor urgently sent us to the hospital for brain scans and called ahead. When we arrived, the ER doctor seemed angry, refused the scans, and said nothing was wrong with my brother and that we should consider therapy for him. My mom later spoke to her doctor again, who reiterated the same thing.

• He only faints when people are around. He passes out at least once a week. Every time I’ve seen it happen, it’s in front of someone or in a place where someone can catch him. I’ve never seen him faint when he’s alone. I check on him multiple times a night, and he’s either sleeping in a normal position where it is clear he went to sleep on his own and did not pass out, or he is awake playing video games. He stays up all night gaming with friends, laughing and yelling loudly so I can tell he is awake and he has never fainted during these sessions.

• and apparently he has a past history of this?? When I asked my mom why she didn't take my brother's issues seriously, she told me something similar happened when he was younger. Doctors ran tests, found nothing, and told her he just needed more attention at home.

There’s more I could say but this post is already really long.

I’m terrified for my brother. I don’t want to believe he’s faking. and honestly, part of me still doesn’t. I’ve supported him nonstop: bought a wheelchair when fainting got bad, bath aids, made meal plans and workout plans, introduced him to my friends after he had to leave school and became isolated. tried to get him into clubs and just overall tried by best to support him as much as I can. The idea that he might be faking is genuinely soul-crushing.

I’ve confided in friends, and several of them think the possibility that he’s faking is high, which scares me even more.

So my questions are:

• What can I do? Is there any way to bring this up to him without destroying our relationship?

• How can I tell if he’s telling the truth, especially when he’s extremely sensitive to being accused of faking?

Literally ANY advice would be deeply appreciated. I'm really stressed and struggling with this. And I honestly don't know what to do at this point

TL;DR: My brother has frequent fainting episodes, doctors find nothing wrong, and there are several signs that make me worry it may be psychological or even faked. I love him and support him, but the doubt is tearing me apart, and I don’t know how to address it.