Ultimately it's up to her to decide to change. You cannot make her change her behavior, be nicer, or stop shopping. Frankly, she might fall quite a bit further before she decides to take action, if she decides to do so. It is not your responsibility to rescue her. You can recommend she get help, even make calls for appointments, but that's about it. It sounds like she needs medication and therapy, but you cannot provide that. It's up to her.