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Article about a University of Missouri swimmer who committed suicide. She had BPD. Sad, sad.
Missouri swimmer’s suicide might draw attention to disorder
By DAVID BRIGGS
Sunday, July 3, 2011
Sasha Menu Courey loved college life at Missouri.
She was a swimmer with Olympic ambitions but rarely missed a chance to set free a laugh so booming that it seemed to rattle the ceiling of teammates a floor below at Johnston Hall. The sophomore greeted friends — everybody counted as one — as if they were just the person she was hoping to see.
“It was always, ‘Heyyy!’ ” said MU swimmer Caitlin Connor, who met Menu Courey before a home football game their freshman year when she and her roommate from 233 Johnston searched out the source of the bursting cheer in Room 333. “She would talk to you like she had known you her whole life.”
In the classroom, Menu Courey earned a 4.0 GPA her first semester and was already planning for graduate school. The aspiring psychologist had lined up a prestigious internship this summer researching treatment for alcoholism.
“Everything she touched,” said her mother, Lynn Courey, “she was doing great.”
But this spring, Menu Courey fell into the grip of an illness she had kept hidden from the world.
Menu Courey committed suicide June 17 in a suburban Boston hospital. She was 20.
When a series of events one friend described as the “perfect storm” reached a crest, she slipped into a deep depression from which she would never escape.
Menu Courey left the team on March 21. She spent the next 10 days under watch and treatment at the MU Psychiatric Center, where her parents said she was diagnosed with borderline personality disorder, an illness characterized by extreme emotional instability.
Lynn flew in from the family’s Toronto home to be with her daughter when she was released. By then, however, she said she no longer recognized Sasha. Though Sasha often put on a cheerful front to keep friends and family from worrying, she bore an emotional pain too great to endure.
“We have difficulty understanding, as well, what happened,” Lynn said. “My daughter really had a great will to live, and suddenly she had a will to die.”
Now, Menu Courey’s family is celebrating a life that brought joy to so many while searching for answers and striving to raise awareness of a disorder they knew little about until it was too late. Continue reading Missouri swimmer’s suicide might draw attention to disorder →
In a recent article/review of Borderline Personality Disorder treatment options and management methodologies, the author quotes the Dr. John Gunderson in the New England Journal of Medicine May 26 issue:
“…BPD is present in about 6% of primary care patients and persons in community-based samples and in 15 to 20% of patients in psychiatric hospitals and outpatient clinics,” writes John G. Gunderson, MD, from the Psychosocial and Personality Research Program, McLean Hospital in Belmont, Massachusetts. “Patients with BPD usually enter treatment facilities after suicide attempts or after episodes of deliberate self-injury. Such episodes result in an average hospital stay of 6.3 days per year and nearly 1 emergency room visit every 2 years, rates that are 6 to 12 times those among patients with a major depressive disorder.”
As you can see BPD has a major financial impact on the health care system, not to mention the distress for the patients and their families.
When reviewing the various treatment options, the author says this about mentalization therapy:
Mentalization-based therapy is a cognitive or psychodynamic therapy including individual as well as group therapy. While assuming a “not-knowing” stance, the therapist insists that the patient “mentalize,” or examine and label his or her own experiences and those of others. This emphasis on thinking before reacting may be a process central to all effective therapies.
That “not-knowing” stance is what I tell the nons that I know: Be a detective, not a judge.
I’ve had conversations with several BPD “experts” about borderline behavior. There seems to be an assumption that many people with BPD are “silent” or “high-functioning” and do not engage in dangerous and/or ineffective behavior often attributed to the “typical” borderline.
In my group recently, a non-BPD was questioning his own “sanity” (I put it in quotes because I don’t believe that people with BPD are insane) and speculating that he was the one with BPD. One of our longer-time posters replied:
If you’re not throwing full-blown temper tantrums, freaking out because EVERYONE is out to get you, threatening to hurt or kill yourself, running away from those who love you because you’re afraid they’re going to leave you first, complaining that NOBODY loves or respects you AND popping pills and guzzling alcohol all at the same time… then, I think, you can go ahead and disqualify yourself.
Based on the polls that I have conducted over the past few months, I believe that she is right on the money. Here are the poll results from the last few polls about borderline behavior:
 Borderline Behavior Poll Results
As you can see by these polls results, more than 73% responded that their borderlines (or themselves if they have the disorder) indicated that they have engaged in self-injury, suicide attempts and/or substance abuse. While these polls are certainly not scientific and it’s pretty much impossible for me to understand the profile of a person that responded, they results are, for me, striking. If 7 out of 10 (or more) individuals engage in these “low functioning” or ineffective borderline behaviors at some point in their lives, what should that tell us?
I believe that it tells us that the “typical” profile of someone with BPD is the “low functioning” or “classic” borderline. While I am sure there are others out there that operate in pretend mode (and pretend everything is ok while they “white-knuckle” their way through life), the vast majority of people with BPD seem to be caught in a spiral of ineffective and often dangerous behavior. They seem to me to be sending the message that they are in a great deal of emotional pain and are suffering greatly – that they will do anything to stop the pain that they feel. It also indicates to me that it is vital for parents of child with borderline-like traits and feelings do their best to get the child into appropriate treatment before their teenage years.
Each day, I check my Amazon Associates account to see what has been purchased the previous day. Amazon is a day behind – it’s not “real-time” reporting – so I get the purchases of books, eBooks and other products that have been linked into my Recommended Reading List or by people who click out of the list and buy something else. Yesterday, one of the people who clicked through on my website bought a copy of Final Exit: The Practicalities of Self-Deliverance and Assisted Suicide for the Dying, which is a fairly well-known guide to suicide and how to make sure that suicide is successful. I suspect you all can see why this purchase disturbed me. As has been show in my poll conducted a few months ago, 70%+ of people with Borderline Personality Disorder (BPD) attempt suicide some time in their lives. Reports have shown that about 8-10% are successful in killing themselves. That is a rate 400% higher than the general population. What really disturbs me about this purchase is that many times a suicide attempt by a borderline will be impulsive and not planned. The purchase of Final Exit may indicate that a person out there is planning his/her suicide. If you’re the person who bought that book from a link on my site, please contact a mental health professional immediately or go to your nearest emergency room. You can also call the national suicide prevention hotline at: 1-800-273-TALK (8255)
How DBT saves lives and how to accept the label borderline. I stumbled upon this interview with Stacy Pershall, a woman recovered from Borderline Personality Disorder (BPD). The interview itself is fascinating and can be found here. She has also written a memoir entitled: Loud in the House of Myself: Memoir of a Strange Girl. Here are some highlights from the interview:
Stacy on the label Borderline Personality Disorder:
When I first heard of BPD, it was in a magazine article given to me by a college roommate. That was back in the early ’90s, and the article said BPD couldn’t be cured, so I either had to resign myself to being crazy forever or dismiss the diagnosis as a way of marginalizing women who refused to be meek and subservient.
My initial reservations about the diagnosis, with which I continued to struggle until I found DBT and, therefore, hope, centered around the question of whether you could diagnose any strange, artistic, outspoken girl with the disorder. I had a lot of legitimate anger over growing up marginalized, and I had a hard time separating that anger from the maladaptive rages that derailed my life for so many years.
Meeting my DBT therapist and reading Marsha Linehan’s work helped me make peace with the diagnosis and to see it as valid. When I read the DSM criteria and realized I was nine for nine, I had to admit there was some truth there. It really was like seeing an outline of my life. By that point, I wanted so desperately to get better, to build a life not punctuated by constant bingeing and purging and starving and suicide attempts, that I was willing to call my illness whatever I had to call it to get treatment.
As for what borderline means to me today, it is an accurate description of a disorder from which I feel mostly recovered. I encourage anyone who feels the diagnostic criteria ring true to pursue an official diagnosis and seek out the treatment for which they qualify.
Stacy on relationships as triggers (a study by Dr. Paul Links showed that relationship events are the #1 most important trigger for borderlines):
Relationships were my primary triggers. I wanted so desperately to be loved, validated and saved from my loneliness that I latched onto a string of partners who showed intense initial interest, and I promptly scared them off with the depth of my neediness.
I also had a propensity for seeking out emotionally abusive or withholding lovers. Relationship after relationship ended in emotional flameouts and trips to the emergency room for overdoses. When I entered DBT, I realized this was something I had in common with most of the other women in my treatment program, and I was able to let go of some of the shame I felt about it. Learning that this particular brand of self-destruction was a hallmark of my disorder gave me hope that I could use my DBT skills to avoid forming unhealthy attachments in the future.
Stacy on DBT (and mood stabilizers):
It’s a totally different world! Life before DBT seemed hopeless, and now it seems exciting and full of possibility. I trust myself to navigate the storms of day-to-day existence. Thanks to the DBT distress tolerance and emotion regulation skills, I even weathered a breakup without a suicide attempt, and know that if I ever see my ex again I can hold my head up and feel no shame or guilt over my behavior. I’m really proud of that.
The mood stabilizer Lamictal has also been a godsend. My moods now swing between happy and sad, not ECSTATIC and SUICIDAL. Needless to say, I’m a fan.
By (author) Stacy Pershall
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Article showing that teens with eating disorders have more suicidal thoughts:
Teens with eating disorders more likely to harbor thoughts of suicide, study finds
By Amina Khan, Los Angeles Times
7:21 AM PST, March 8, 2011
Teens suffering from anorexia, bulimia and other eating disorders are more likely to suffer from suicidal thoughts, anxiety disorders and substance abuse — but how much they suffer may depend on the type of eating disorder they have.
That’s according to an analysis published online Monday in the Archives of General Psychiatry that, with 10,123 adolescents surveyed, is the largest and most comprehensive study of eating disorders in teens in the United States.
About 0.3% of the teens surveyed reported suffering from anorexia nervosa, and 0.9% from bulimia nervosa. A full 1.6% suffered from binge-eating disorder. Ethnic minorities were more likely to report binge-eating disorder, and white teens tended more toward anorexia.
Those who had one of these three eating disorders often suffered from other issues as well. For example, those who were anorexic were 1.6 times more likely to have problems with alcohol – but bulimics were 3.1 times as likely, the study found.
As for phobias, people with anorexia were 1.8 times more likely to suffer from a social phobia. Those with bulimia were at 3.9 times the risk, but even that jump was dwarfed by those with binge-eating issues, who were 5.9 times as likely to suffer a social phobia.
Sound scary? It could be worse than we think: The researchers write in the paper that some of these numbers may actually be “a lower bound of the true prevalence of eating disorders.”
Follow me on Twitter @LAT_aminakhan.
Copyright © 2011, Los Angeles Times
I am closing the BPD and suicide attempts poll. The results were quite interesting. The last poll I ran was BPD and substance abuse. The basic results of the suicide poll were Yes 66%, No 25% and Don’t Know 9%. However, if I remove the “Don’t Know” group, the results are Yes 73% and No 27%. It is interesting to me that the substance abuse poll was Yes 76% and No 24%. The majority of people with BPD having substance abuse problems and having attempted suicide makes me wonder… are they generally the same group? If so, I think it indicates that people with BPD (generally) will do anything to stop the pain.
 Suicide Attempts Poll
Here are the results with the “Don’t Know” choice removed:
 Suicide Poll with Don't Know Removed
I found this article interesting… It reminded me of the book “Poisoned Love”.
Poisoned Love
I thought it was interesting that she was going to commit suicide with the pills and then impulsively used them to poison the man.
Stockton woman drugged boyfriend’s booze
Dec 14 2010 by Gareth Lightfoot, Evening Gazette
A VULNERABLE woman who spiked her older boyfriend’s drink with a potentially lethal dose of 16 sleeping tablets has been spared prison.
Lyndsey Cook poisoned her partner’s beer with 800g of amitriptylene, which is used as a sleeping tablet, at a mutual friend’s Stockton home after a day’s heavy drinking.
She later admitted slipping him the pills wanting to sever contact with him as he was “doing her head in”, Teesside Crown Court heard.
Prosecutor Anthony Dunne said her boyfriend Phillip Ross, 34, collapsed shortly after drinking a very fizzy can of lager on March 6.
Cook called the ambulance and Mr Ross was treated in hospital on the assumption of an opiate overdose.
The truth emerged the next day as 20-year-old Cook confessed to her church support worker then to police as she handed herself in.
Cook, of Grange Road, Stockton, said she stole the drugs from her gran to take them herself, but impulsively put them into Mr Ross’s drink.
With no previous convictions, she admitted a charge of administering poison or a noxious substance “with intent to injure, aggrieve or annoy”.
A forensic scientist said the dose was “of severe toxicity”, leaving amounts of the drug in Mr Ross’s bloodstream two days later.
A lower amount had been known to kill, the court was told yesterday.
Graham Brown, defending, said Cook was vulnerable, disadvantaged, severely emotionally damaged and of low intelligence with a borderline personality disorder.
He said it was an unplanned, “spur-of-the-moment act of stupidity” when she was depressed and thinking of using the tablets to kill herself.
He talked of a background of an “abusive relationship” with Mr Ross “from a time and an age when such a relationship was not appropriate”.
Now Cook had the support of people who had given her a controlled environment and her life had moved on.
Judge George Moorhouse said the crime justified an eight-month custodial sentence, but suspended it for two years with supervision.
He told Cook: “I accept that this was not a premeditated offence and I accept that you stole these pills from your grandma with the intention of taking your own life.
“You’ve had at times a horrible life through no fault of your own,” he added, expressing the hope that she could get her life back to normal with support.
Read More http://www.gazettelive.co.uk/news/teesside-news/2010/12/14/woman-drugged-boyfriend-s-booze-84229-27822538/#ixzz18Ib1n2I1
 Lindsay Lohan Breaks Down in Court
Well, it’s been some time since I have written anything about celebrities with possible borderline personality disorder. Personally, I wish some celeb would just come out and admit that they have the disorder and help others by showing that there’s effective evidence-based treatments for BPD. I guess the stigma is too great and they feel that it would hurt their careers. Of course, for some, their behavior is what is hurting their careers. Today, I am turning again to Lindsay Lohan (click here to see all posts about LiLo). Lately I have been receiving a ton of alerts with news stories that contain LiLo’s name and reference BPD. These are usually in the user comments. I can’t find a single legit magazine or news article that has speculated on BPD and LiLo. Recently, her behavior has accelerated, even as she is facing jail. Here are some recent articles that could indicate that (in combo) LiLo has BPD (remember, this is just speculation at this point):
Lindsay Lohan goes Doctor Shopping
http://entertainment.oneindia.in/hollywood/top-stories/scoop/2010/lilodoes-doctor-shopping-for-prescriptionmeds.html
Washington, July 12 (ANI): Lindsay Lohan apparently obtains her dangerous combination of prescription drugs through “doctor shopping” across the country.
According to a source, Lohan goes to six different doctors for prescriptions.
“When one doctor says no to refilling a prescription, she will go to the next. It’s a whole process to get what she needed, ” TMZ quoted the source as saying.
Lindsay who has prescriptions for- Zoloft (antidepressant), Trazodone (antidepressant), Adderall (stimulant to control ADHD), Nexium (acid reflux) and the extremely powerful painkiller Dilaudid, have doctors both in Los Angeles and New York.
In fact, one of her past rehab facilities still prescribes her meds.
The source even added that, Lohan “would get a large supply every time” she visited a doctor.
Lindsay Lohan and Suicidal Ideation
http://www.hollywoodlife.com/2010/07/14/lindsay-lohan-suicide-watch-kill-herself-jail-90-days/
Lindsay Lohan would rather kill herself than be locked away in jail. The 24-year-old actress is reportedly so upset over the 90 day jail sentence looming over her since July 6, that she’s threatening to take her own life.
“She just kept repeating, ‘I can’t go to jail,’ and, ‘I’ll kill myself first,’” a source tells Star magazine. “She’s mentally unstable and getting worse.”
After Lindsay’s discovered she’d be serving time at the Century Regional Detention Facility in Lynwood, Calif., Star reports she went home and broke everything in sight.
“She ran around breaking mirrors, cutting herself and rambling like a lunatic. She tore her house apart before she finally just broke down,” reveals a source. “Lindsay’s on a 24/7 suicide watch, it’s so bad. She isn’t doing well with this.”
Not only is Lindsay going around saying she wants to kill herself but she’s taking a lethal dose of prescription drugs.
“She has been doctor shopping across the country,” she says. “She is utterly unable to control her use of any mind-altering substance.”
Lindsay Lohan and Self-Injury
http://www.radaronline.com/exclusives/2009/11/exclusive-self-harm-sign-%E2%80%9Cseverely-disturbed-behavior%E2%80%9D
In shocking phone conversations exclusively obtained by RadarOnline.com Lindsay Lohan’s mom, Dina, is heard expressing her concern over her daughter’s self mutilation. And with good reason, as experts in the field tell RadarOnline.com that self harm is often just one factor of greater, underlying emotional issues.
Renown psychotherapist, and author of Cutting: Understanding and Overcoming Self-Mutilation, Dr. Steven Levenkron tells RadarOnline.com that Lindsay’s behavior is a sign of disturbed psychiatric behavior and that it will take time and energy to help her heal. “Whether (a given patient’s) condition is termed being ‘out of touch with reality,’ ‘psychotic,’ or ‘in a diagnosed state,’ the scene constitutes severely disturbed psychiatric behavior,” Levenkron says. “ This is the element that must be present in order to meet the criteria for self-injury. ‘Severely disturbed behavior’ does not mean hopeless, but it does mean that it will take a long time, lots of focused attention, and an intense emotional bond between helper and sufferer in order to repair the damage.”
And Dr. Wendy Lader, PHD, President and Clinical Director of the S.A.F.E ALTERNATIVES program, a nationally recognized treatment approach, professional network and resource base, and an international speaker on self-injury elaborates, telling RadarOnline.com, “The main reason for self injury is to deal with emotional regulation. For whatever reason it helps them to calm down.
“People who self harm have the inability to communicate the depth of their feelings.
Continue reading Lindsay Lohan and possible BPD (more detail this time) →
Here’s a NY Times Article about a man charged with assisted (or encouraging) suicide. He allegedly did so over the Internet. It is one to watch to see if free speech on the Internet will be regulated. I NEVER advocate suicide (obviously). I wonder however how this case (or if) will impact the back-and-forth dialog in chat rooms and online groups, such as ATSTP.
May 13, 2010
Online Talk, Suicides and a Thorny Court Case
The seemingly empathetic nurse struck up conversations over the Internet with people who were pondering suicide. She told them what methods worked best. She told some that it was all right to let go, that they would be better in heaven, and entered into suicide pacts with others.
But the police say the nurse, who sometimes called herself Cami and described herself as a young woman, was actually William F. Melchert-Dinkel, a 47-year-old husband and father from Faribault, Minn., who now stands charged with two counts of aiding suicide.
Mr. Melchert-Dinkel, whose lawyer declined an interview request on his behalf, told investigators that his interest in “death and suicide could be considered an obsession,” court documents say, and that he sought the “thrill of the chase.” While the charges stem from two deaths — one in Britain in 2005 and one in Canada in 2008 — Mr. Melchert-Dinkel, who was indeed a licensed practical nurse, told investigators that he had most likely encouraged dozens of people to kill themselves, court documents said. He said he could not be sure how many had succeeded.
The case, chilling and ghoulish, raises thorny issues in the Internet age, both legal and otherwise. For instance, many states have laws barring assisting suicide, but rarely have cases involved people not in the same room (much less the same country) or the sharing of only words (not guns or pills).
The case also brings up questions about the limits of speech on the Internet: How does one assign levels of culpability to someone who shares thoughts with people who say they are already considering suicide? And for some who counsel against suicide, it points to a growing area for worry, an online world where the most isolated and vulnerable might be touched in a way that they would not have in the past.
Groups that work to prevent suicide compare suicide chat rooms to “pro-ana” sites, Internet sites that portray anorexia as a lifestyle as opposed to a disease. Anti-suicide advocates say that there has been more than one instance recently where a person killed himself on a Webcam as others watched. Papyrus, a charity in Britain that works to stop young people from killing themselves, says it has tracked 39 cases in that country alone where young people committed suicide after visits to “pro-suicide” chat rooms.
It was the untrained, unpaid Internet sleuthing by Celia Blay, a 65-year-old from a tiny community in Britain, that helped lead to charges in April against Mr. Melchert-Dinkel. “He was practically invisible,” she said. “I tried to talk to any police I could, and most of them would have nothing to do with it. The first one I talked to told me, ‘If it bothers you, look the other way.’ And that really bothered me, because by then I was pretty sure people had died.”
About four years ago, Ms. Blay, who describes herself as a “computer illiterate,” became friends online with a young, depressed woman who had entered into a suicide pact. Ms. Blay persuaded her not to proceed, but the incident sent Ms. Blay searching for the other member of the pact. It was someone who called herself Li Dao, another screen name that the police later said Mr. Melchert-Dinkel used.
Making inquiries on a Web site aimed at people talking about suicide, Ms. Blay said she found at least half a dozen people who had similar pacts with Li Dao, a name that popped up on all sorts of suicide Web sites. She and a friend uncovered Mr. Melchert-Dinkel’s name and e-mail address after setting up a sting in which her friend posed as someone preparing for suicide and was, she said, approached by Mr. Melchert-Dinkel.
By then, the police in Minnesota say, Mr. Melchert-Dinkel had already aided the suicide of Mark Drybrough, 32, of Coventry, England. A coroner’s report found that Mr. Drybrough, who was suffering from a psychiatric illness, hanged himself from a ladder in his home in July 2005. His computer showed that he had posted a question in a suicide chat room about how to hang oneself without access to something high to tie a rope to, and that Li Dao — Mr. Melchert-Dinkel, the police say — had offered details on how to use a door.
In March 2008, Nadia Kajouji, 18, disappeared from her college in Ottawa. The Canadian authorities investigating her disappearance searched her laptop and discovered that she had been talking online with a person who used the screen name Cami. In e-mail messages, the authorities say, the pair agreed to a pact in which Ms. Kajouji would jump from a bridge into a river (to avoid, at Cami’s suggestion, the police say, creating a mess) and Cami would hang herself a day later. In April 2008, Ms. Kajouji’s body was found in the Rideau River.
Around the same time, Ms. Blay contacted the St. Paul Police Department through an acquaintance in Minnesota. By then, she said, she had grown frustrated with what she described as the authorities’ unwillingness to study the huge file she had amassed with the stories of 20 to 30 people who had been approached online. Over time, she said, she had tried to tell the story to a police department near her home, a member of parliament and even law enforcement in the United States.
Since at least the 1970s, many states have barred assisted suicide, though criminal charges are rarely filed. Physician-assisted suicide is allowed under certain conditions in Oregon and Washington.
In Minnesota, 12 charges of aiding suicide have been brought since 1994, when the state began keeping track, and about half of those have resulted in convictions. That state’s law, a felony, applies to “whoever intentionally advises, encourages or assists” another in taking his or her own life; convictions carry sentences of up to 15 years in prison.
Barbara Coombs Lee, the president of Compassion and Choices, who has advocated for laws like the one in Oregon, said she found it “perfectly appropriate” that Mr. Melchert-Dinkel faces such charges. “This is so egregious, so clearly wrong, that I’ll be very disappointed if assisted-suicide statutes do not reach this,” she said. “There is a bright line between aid in dying and assisting in suicide like this.”
Still, legal experts suggested that there may be room for challenges. The Minnesota law itself, some suggested, could be seen as too ambiguous or too broad to include protected speech that falls short of actually leading someone to suicide. The deaths occurred in other jurisdictions, posing potential issues, other lawyers said.
Terry A. Watkins, a lawyer for Mr. Melchert-Dinkel, said it was premature to describe what defense he intends to present but made it clear that he had questions about the law itself, as well as the dissection of causes that lead to any suicide. “As a society, we need to be careful when we start putting together laws that prohibit things like ‘encouragement’ without a really clear definition of what in God’s name you’re talking about,” he said.
Mr. Melchert-Dinkel, who is scheduled to be arraigned on May 25 in Rice County District Court, has had his nursing license revoked. He had held it since 1991, despite a record that included repeated discipline for complaints of leaving a nursing home patient unattended, being too rough, sleeping on duty, failing to take vital signs and failing to track a patient’s medications.
But Mr. Watkins said his client was basically a good person. “This is not a monster,” he said.
Shortly after the police interviewed Mr. Melchert-Dinkel last year, he checked into a local emergency room, state records show, saying that he was dealing with an addiction to suicide Internet sites and feeling guilty over advice he had given to people to end their lives.
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