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After performing at Italy's Sanremo music festival Feb. 16, Susan Boyle told an adoring audience, "Dreams have no expiry date. I'd like this to go on and on." But at what cost? Just hours before she received her latest standing ovation, Boyle, 48, had passed out in London's Heathrow Airport. The singer's rep brushed off the incident, blaming a "warm and stuffy" airport lounge: "Susan is fine." Boyle did sing with her usual grace and gusto that night in Italy, but now two of her brothers are voicing concerns for her well-being and speaking out about her ability to handle the pressure of global stardom. Brother Gerry Boyle tells PEOPLE, "The traveling and the whole [fame] thing is exhausting. She still has her anxieties and her loneliness." Her other brother, John Boyle, is even more blunt: "She needs 24-hour care. She needs to be looked after."

For a woman who'd barely left her small Scottish hometown before last year, the singer's meteoric rise was bound to create some burnout. Thanks to staggering sales of her debut album, I Dreamed a Dream–more than 8 million copies have flown off shelves worldwide–the Britain's Got Talent insta-star has been trotting all over the globe, singing for throngs of appreciative fans. Susan herself recently addressed her problems coping with fame on CBS Sunday Morning. "There was about 50 television stations outside my door. Stuff like that," she said. "And it's difficult . . . for someone who was [really] quiet to [come] to terms with that." However, she added, "I was like a scared child before, but I'm not the scared person I used to be."

But after the Heathrow incident, Gerry told a U.K. tabloid that Susan was lonely and tired, and that despite her success, "the one thing she wants above all everything else is love." (The Daily Mail then spun that forward to say the family feared another emotional breakdown due to her "crushing" loneliness.) Her brother John believes it's a bigger problem than Susan being a single lady. "She's got a disability," he says, adding that his sister has seen psychiatrists and doctors since childhood, but as far as he knows has never received a medical diagnosis or medication. "It's only manageable by having great patience with Susan. It's difficult to diagnose. One night she's okay. The next night she blows up. It's a difficult situation, multiplied by fame."

In fact, after placing second on Britain's Got Talent last spring, Boyle suffered a well-publicized breakdown that landed her in London's Priory clinic. She was further traumatized by finding an intruder in her Blackburn, West Lothian, home in January. Almost a year into her unlikely celebrity, these stumbles have many wondering if she can handle fame. "If Susan sat beside you, you would very quickly know that she had a wee problem. She has always had those problems," says John, who says his sister loves and is helped by singing. But he blames her management team for "not looking after Susan properly." Complicating matters is the fact that there is internal squabbling among Susan's relatives regarding what is best for her. Brother Gerry does approve of Andy Stephens, her day-to-day manager, who declined to comment on Boyle.

After a tough week, Boyle is getting a much-deserved rest from her grueling schedule–10 days off at home in Blackburn–before heading back out on the road to the Netherlands. Her family wants her to buy a new, more secure home with some of the estimated $9 million she is expected to earn from album sales, but for now she's still in her mother's humble town house. To ease her fears following the break-in, Boyle–who lived with her mother until she died in 2007–makes late-night calls to her family and friends, and her management installed 24-hour security outside her home. And when that's not comforting enough, "She knows she can come up to me anytime," says her longtime friend Lorraine Campbell. "If she's upset, she'll stay the night. Security would bring her up to my house. I take her home in the morning. Susan stayed with me a week ago. Nighttime is a lonely time for her."

"This is a totally different life than she is used to–I told her to hang in there," says Donny Osmond, one of Boyle's idols whom she met last year. "You go from one extreme to another: sheer adulation to a lonely hotel room."

Her most constant companion before she became famous, her cat Pebbles, is not at her side. Because of her frequent travel, Susan has temporarily left Pebbles in the care of an acquaintance. "She's always been a loner, always stayed in the background, which has made it harder for her to build up relationships," says Campbell.

The one man whom the famously single singer–who admitted on Britain's Got Talent that she'd never been kissed–does lean on is Stephens, who was with her when she fainted at Heathrow. Her brother Gerry acknowledges Stephens acts as "a tremendous support for her," but all rumors aside, there's nothing romantic about their relationship. Of course, Gerry says of his sister, "she would like to meet the right person. She's like any woman on earth." And while she's thrilled with her career success, "Susan would be the first to admit that sometimes she feels lonely," says Gerry. "When the lights switch off and the audience goes home, Susan is very much on her own."

  • Contributors:
  • With reporting by Simon Perry/London,
  • Helen I. Hwang/Glasgow.