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Borderline personality disorder patient addresses stigma

Sarah Coulthard-Evans was diagnosed with borderline personality disorder 10 years ago. (Supplied: Sarah Coulthard-Evans)
Sarah Coulthard-Evans was diagnosed with borderline personality disorder 10 years ago. (Supplied: Sarah Coulthard-Evans)

A woman with borderline personality disorder (BPD) is keen to dispel the misconception patients are a danger to others.

Sarah Coulthard-Evans, 36, was diagnosed 10 years ago after doctors repeatedly dismissed her symptoms as depression.

Having self-harmed and even attempted suicide several times, Coulthard-Evans was eventually sectioned.

Years of therapy allowed her to “heal massively and make sense of what happened in her life”.

Read more: Self-harm more common among teens who start puberty early

Coulthard-Evans, who lives in Northampton, moved into supported accommodation in the community on 18 March, just five days before lockdown.

Now in a better place, Coulthard-Evans manages her disorder with medication, monthly calls with a psychiatrist and plenty of sleep.

Coulthard-Evans hopes to raise awareness of BPD, stressing patients are “more dangerous to themselves than anyone else”.

Coulthard-Evans' symptoms led to her initially being told she had depression. (Supplied: Sarah Coulthard-Evans)
Coulthard-Evans’ symptoms led to her initially being told she had depression. (Supplied: Sarah Coulthard-Evans)

Project Air Strategy for Personality Disorders – a partnership between the University of Wollongong in Australia, the New South Wales (NSW) Ministry for Health and Local NSW Health Districts – has also produced work to dispel the “myth” BPD patients are dangerous.

“It is much more likely a person living with BPD will harm themselves, rather than harming someone else,” according to the strategy.

Coulthard-Evans struggled with low self-worth from an early age.

“My main problems were a very poor view of myself, instability – I struggled with relationships of any form, always really wanting to please but never feeling satisfied,” she told Yahoo UK.

“I self-harmed from a young age because of the pressure I put on myself.”

Parental neglect or abuse during childhood is a recognised cause of BPD.

“I experienced sexual abuse from a family member,” said Coulthard-Evans.

“It was a trusted relationship so straight away that messes you up.

“I was also not believed; I took that really hard.”

Read more: Two in five psychiatric ward patients had coronavirus at outbreak height

BPD can cause similar symptoms to depression, including prolonged low mood, self-harm and even suicidal thoughts in severe cases.

This led Coulthard-Evans’ GP to prescribe her antidepressants in her early twenties, which were ineffective at the time.

Several suicide attempts led to her being sectioned.

“I ended up in secure services, where there’s a lot more assessments done than in the community, where everything was with my GP,” said Coulthard-Evans.

These assessments resulted in her being diagnosed with BPD in 2010.

Watch: What is borderline personality disorder?

Coulthard-Evans spent four years at Rampton Hospital in Nottinghamshire, one of three high security hospitals in England and Wales.

“I had significant trauma therapy and intense CBT [cognitive behavioural therapy],” she said.

“Once my self-harm was under control, I could start tough trauma therapy, which allowed me to heal massively and make sense of what happened in my life.”

Coulthard-Evans was then transferred to a medium security unit via the charity St Andrew’s Healthcare, where

Trump’s attack on Hunter Biden underscores ‘harmful stigma’ of addiction

Remarks like these perpetuate “a harmful stigma,” said Mark Sutton, spokesman for the nonprofit Drug Policy Alliance, which advocates for the decriminalization of drug use.

“At a time when we have approximately 70,000 people in the United States dying per year from accidental overdose, it is unconscionable that someone vying for our highest elected office would be so willing to throw people struggling with substance-use disorder under the bus,” he added.

Federal data shows that roughly 1 in 10 American adults — or 23 million people — have struggled with a drug-use disorder at some point in their lives. Such a diagnosis is “based on a list of symptoms including craving, withdrawal, lack of control, and negative effects on personal and professional responsibilities,” according to the National Institutes of Health. Drug abuse is not necessarily illicit — many people addicted to opioids obtain them legally through a doctor’s prescription, for instance.

Drug and alcohol abuse often inflict suffering on the affected person’s family members. “By the time most families reach out for help and drug treatment, the disease of addiction has typically progressed to a crisis stage for the addict and family alike,” according to the Hazelden Betty Ford Foundation. The number of Americans with firsthand experience with addiction and dependency is probably much larger than official statistics show.

Drug and alcohol abuse are devastating disorders. Drug overdoses killed approximately 72,000 people in 2019, while excessive drinking is “responsible for more than 95,000 deaths in the United States each year, or 261 deaths per day,” according to the CDC, a figure that includes deaths from chronic alcohol-related illnesses, suicides, alcohol poisoning and drunken-driving crashes.

But according to many experts, the stigma surrounding drug and alcohol abuse is even more deadly.

“I think the biggest killer out there is stigma,” U.S. Surgeon General Jerome Adams said in 2019. “Stigma keeps people in the shadows. Stigma keeps people from coming forward and asking for help. Stigma keeps families from admitting that there is a problem.”

Writing this year in the New England Journal of Medicine, the director of the National Institute on Drug Abuse, Nora Volkow, said that stigmatizing people who use drugs “may be the equivalent of an electric shock in the cycle of drug addiction: it’s a powerful social penalty that spurs further drug taking … respect and compassion are essential.”

Hunter Biden has been open about his substance abuse, chronicling his history of alcohol and drug use — as well as his attempts to get those behaviors under control — for Adam Entous of the New Yorker in 2019. The Biden campaign did not respond to a request for comment.

For many people with a drug or alcohol problem, the support of family members is critical. At the debate, Biden’s response to Trump illustrated what that support looks like.

“My son, like a lot of people, like a lot of people you know at home, had a drug problem,” Biden said. “He’s overtaken it. He’s fixed it. He’s worked