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”.
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 she had exposure therapy – in which a patient is exposed to the source or context of their anxiety without any danger.
Read more: Graduate who survived a suicide attempt went from ‘existing to living’
In October 2019, Coulthard-Evans moved to a rehabilitation unit.
“I came off section while there,” she said. “I moved out a week before lockdown.”
Coulthard-Evans now lives in a flat within supported accommodation.
Like most of us, the coronavirus outbreak means this year has not panned out as Coulthard-Evans expected.
“2020’s been a rubbish year for everyone, but I’ve been in services since 2009,” she said.
“I really thought it would be a great year doing things, but being in services so long you’re used to restrictions.
“I feel I’ve coped pretty well. It’s reinforced whatever is thrown at me I can manage it.”
Coulthard-Evans does not have regular therapy, but catches up with a psychiatrist over the phone once a month.
She also works hard to lead a healthy lifestyle.
“Sleep’s really important for me and it’s been a massive problem with the trauma causing nightmares,” said Coulthard-Evans, who tweets at @star_welsh.
“I’ve got a huge green across from me so I get fresh air.
“I do creative stuff. I’m always trying to learn new skills, like paint something. Those things keep me going.”
Coulthard-Evans is speaking out to raise awareness of BPD.
“Everybody struggles, but with us [BPD patients] we feel everything a lot more intensely,” she said.
“There’s so much stigma around us being dangerous people, but we’re more dangerous to ourselves than anyone else.
“People see us as attention seeking or manipulative. It’s not attention seeking to have BPD, it’s simply trying to get your needs met.”
Coulthard-Evans has secured a job in the mental health sector, which she hopes to start shortly.
“I will be working in a research role, looking at where services can be improved,” she said.
“I want to continue to campaign for the language to change in terms of mental health.
“I’m looking forward to the quiet life, in services your life is so hectic.”
What is borderline personality disorder?
BPD affects a patient’s mood and how they interact with others.
It is the most commonly recognised personality disorder, affecting an estimated 0.7% to 2% of people in the UK alone.
Lady Gaga has opened up about having dialectical behavioural therapy, a form of CBT that was originally developed to treat issues like BPD.
Symptoms typically include emotional instability, disturbed patterns of thinking, impulsive behaviour and intense but unstable relationships.
BPD’s exact cause is unclear, however, it is thought to be a combination of genetic and environmental factors. Experiencing traumatic events during childhood is linked to the disorder.
The condition can be serious, with many patients self-harming or attempting suicide.
Treatment is often psychological or medical, like therapy or antidepressants, which may last more than a year.
Over time, many patients overcome their symptoms and recover. Additional treatment may be required if symptoms return, however.
BPD is often linked with other mental health conditions or behavioural problems – like alcohol abuse, eating disorders or depression – which may need treating separately.
For confidential emotional support at times of distress, contact The Samaritans at any time by calling 116 123 or emailing [email protected]
Watch: Lady Gaga says fame made her suicidal