Showing: 1 - 2 of 2 RESULTS

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

Troubling Sleep Disorder in Athletes a Sign of CTE?

Rapid eye movement sleep behavior disorder (RBD) is surprisingly common in athletes and may signal chronic traumatic encephalopathy (CTE) caused by brainstem tau and Lewy body pathologies, new research suggests.

CTE is a neurodegenerative disorder linked to years of repetitive head impacts from playing professional football and other contact sports.

“Repetitive head impacts may damage sleep-relevant brainstem nuclei and lead to REM sleep behavior disorder,” senior author Thor Stein, MD, PhD, neuropathologist at VA Boston Healthcare in Massachusetts, said in a webinar hosted by the Concussion Legacy Foundation.

“This is something both athletes and their doctors need to be aware of,” added Stein, who is an assistant professor of pathology and laboratory medicine at Boston University School of Medicine.

The findings were published online September 17 in Acta Neuropathologica.

Surprising Findings

In RBD, the paralysis that normally occurs during REM sleep is incomplete or absent, causing people to act out their dreams by talking, flailing their arms and legs, punching, kicking and other behaviors while asleep. 

“The disorder often comes to medical attention when there is an injury or potential for injury to the individual or the individual’s bed partner,” Stein noted.

To investigate ties between CTE and RBD, the researchers analyzed the brains of 247 deceased male athletes who played contact sports; the brains were donated to the Veterans Affairs-Boston University-Concussion Legacy Foundation (VA-BU-CLF) Brain Bank.

The athletes died at a mean age of 63 years. They all had a neuropathological diagnosis of CTE. Their relatives provided information on sleep.

Nearly one third of these athletes (n = 80, 32%) with CTE displayed symptoms characteristic of RBD when they were alive. “That really surprised us,” said Stein. “This is about 30 times more than what’s reported in the general population, where it has been estimated to be present in about 1% of people,” he noted.

In addition, there was a clear dose-response effect. Athletes with CTE and RBD had played contact sports for significantly more years than their peers without RBD (18.3 vs 15.1 years; P = .02). 

“The odds of reporting RBD symptoms increased about 4% per year of play,” first author Jason Adams, an MD/PhD student now at the University of California San Diego, said in a statement.

New Insight

The results also point to a potential cause for RBD.

Compared with athletes who had CTE and no RBD, those with CTE and RBD were four times more likely to have tau pathology within brainstem nuclei involved in REM sleep (odds ratio [OR], 3.96; 95% CI, 1.43 – 10.96; P = .008). Athletes with CTE and RBD were also more likely to have Lewy body pathology (OR, 2.36; 95% CI, 1.18 – 4.72; P = .02).

“Contrary to our expectations, tau pathology in the raphe nuclei was more strongly associated with RBD than Lewy body pathology, suggesting that tau pathology is more likely to lead to sleep dysfunction in CTE,” Stein said.

Christopher John Nowinski, PhD, cofounder and CEO of the Concussion Legacy Foundation, said this study