The 26-year-old singer was just 10 years old when her mother Paula Yates died from an overdose, and she also lost her sister Peaches in similar circumstances two years ago.
And Pixie admits she will never "recover" from the tragedy, but does her best to live "as well" as she can.
She said: "How am I? I am... OK. There's no recovery from it. There's no therapy for it. I mean, there's no one day when it won't be bad."
"I have a very lovely life. Except there will always be something missing.
"You don't want to be the kind of person who knows how this feels, but unfortunately, I am.
"I realise now that everyone is just trying to live, as well as they can. And some people can't."
As she mourned her sister, Pixie was thankful to have her debut album, 'I'm Yours', to focus on and as an outlet for her grief.
She told the Observer magazine: "People put a lot of emphasis on the idea of music as therapy. It does help you explain how you're feeling.
"What it did, though, was give me something to focus on. It was the best thing for me. Not the music itself so much, but the doing something, something that wasn't sitting in my house staring in the corners."
Pixie and her family, including father Bob Geldof, were inundated with messages after Peaches died and the former model thinks it is "beautiful" her older sister had made such an "impact" on the world.
She said: "It's beautiful that someone can live a life so short and yet make such an impact.
"Things stop for a second with people like her. She changed worlds, both when she was alive and when she wasn't."
Pixie is in the process of having some of her tattoos removed because she is embarrassed by her inkings and even thinks the legal age to be allowed one should be increased.
She said: "[Removal] it's the worst pain in the world, like the sun has heated an elastic band and is whacking you with it, again and again.
"They should change the legal age of tattoos to 25. You don't know what you want on your body for life at 16! I'm a different person now."