MU swimmer Sasha Menu Courey’s parents have committed themselves to using her story to make waves for borderline personality disorder awareness.
“To give me peace, I want to make a difference,” Menu Courey’s mother Lynn Courey said. “I want to make sure that I’m saving other families from the pain we are going through. Borderline personality disorder is very treatable. So treatable that if it’s caught early, you don’t even need medicine.”
**Sasha’s story**
Menu Courey’s condition might have been diagnosed earlier, her mother said, had a psychiatrist been better informed of the effects of borderline personality disorder. When Menu Courey was 16, she had her first suicide attempt, but the psychiatrist was reluctant to label her with any type of disorder because she was “too young.”
Increased knowledge of and awareness for BPD would have helped Menu Courey better manage her emotions and ultimately could have saved her life, her mother said.
“If you look at this, you say, ‘Oh my goodness, if they had just given her the treatment, it would have made a huge difference in her life,’” Lynn Courey said.
Menu Courey returned home to Toronto with her parents following the diagnosis. She returned to her one true love, the pool, and eventually landed at MU. Although paperwork issues sidelined her during the season her first year, her coach Patrick Rowan said she was still excited and happy to be a part of the team.
Her sophomore year, however, things began to go downhill. She was sidelined from the team in January after a back injury hindered her ability to perform to her fullest potential. She had troubles with a roommate and eventually moved from one couch to the next.
On March 21, her boyfriend, her pillar of support, broke up with her. That evening around 11 p.m., Menu Courey phoned her parents to say she was going to seek help at the hospital.
“We told her, ‘Sasha, we’re really proud of you. You’re not feeling good, and you’re going to seek some help,’” Lynn Courey said. “We were very, very proud of her.”
After a few days of limited contact, Lynn Courey found out her daughter had been transferred to the psych ward. At this point, Menu Courey was speaking to her parents almost daily. She was held in the ward for 10 days, but near the end of her stay, things weren’t looking as they had at the beginning of her stay.
She became acquainted with several other tenants of the ward who steered her back on the path toward suicide, her mother said.
“Once she met these people, they encouraged her to kill herself,” Courey said.
At this point, Courey traveled to the United States to visit her daughter and immediately knew something was up.
“Something is wrong,” Lynn Courey said she told her husband, Mike Menu, shortly after her arrival. She encouraged him to come join her, and he arrived a few days later.
The parents found their daughter sitting on a bed with another released psych ward patient after returning to their hotel room one evening. The run-in rubbed both parents the wrong way, and that night, Lynn Courey said she had the worst dream of her life.
“I dreamt that my daughter was making a suicide pact with the girl,” she said.
She woke up and immediately phoned 911 at about 1:30 a.m. to eventually learn from the police a half hour later that Menu Courey had indeed attempted suicide with the girl. Her parents brought her back to Canada, away from the ward that they said spurred her demise.
Unable to find immediate inpatient treatment for BPD in Canada, Menu Courey went to McLean Hospital 3East in Boston at the end of April for specialized residential treatment.
In Canada, the Center for Addiction and Mental Health is free for all citizens, but the wait time is lengthy. In situations such as Menu Courey’s, having immediate treatment is integral.
High costs hampered the family from keeping Menu Courey undergoing the treatment in Boston. The only way for Menu Courey to afford treatment was to go back to Canada and begin outpatient services there.
For Menu Courey, the idea of transitioning back to Canada, away from her Boston care team proved too difficult. She committed suicide in Boston and died June 17 at Beth Israel Hospital.
**The disorder**
Psychologist Christine Sloss said borderline personality disorder is a mental disorder characterized by a dysfunctional emotional regulation system.
“People who have BPD tend to be very sensitive emotionally and highly reactive when things go wrong,” she said. “They experience intense emotions, and it’s really hard for them to come back to a baseline level.”
The extremely variant and rapidly changing emotions in people who have BPD tend to make them display deregulated behavior, have conflictual interpersonal relationships and negative, unstable perceptions of themselves.
Their strong emotions affect their thoughts, behavior and relations toward others, Sloss said. Many people with BPD engage in extreme impulsive behavior in response to their extreme emotions, such as self-harm, disordered eating, suicide attempts and drug or alcohol abuse.
Ten percent of people diagnosed with BPD die by suicide, and 80 percent display suicidal behaviors. A study from the National Institute of Mental Health states that about 85 percent of people with BPD have comorbid mental illnesses, including major depression, anxiety disorders and post-traumatic stress disorder.
Menu Courey could have been diagnosed with BPD when she was younger, but the disorder is traditionally not diagnosed until the afflicted is an adult. But this doesn’t mean only adults display traits associated with BPD, Sloss said.
“We often think that teenagers’ behavior anyway is quite emotion and impulse-driven, and after time, they get used to that and learn to manage that behavior,” she said. “But for a minority of individuals, that behavior doesn’t become more manageable and they need treatment to manage those strong emotions and to be healthier.”
According to the American Psychiatric Association, BPD affects about 5.8 million Americans, which is about as common as schizophrenia. Among the psychiatric population, prevalence is as high as 20 percent.
Sloss said there are widespread perceptions that BPD is far more common in females, but larger studies show the prevalence among genders is about equal. She credits the misconception to the fact that women are more likely to seek help for a mental illness and male inpatients are more likely to be hospitalized for non-BPD related symptoms.
BPD can be treated in several ways, one of which is dialectical behavior therapy. Sloss said in the first stage of DBT, treatment focuses on helping patients to become more mindful and more tolerant of their strong emotions and to cope with crises without engaging in unhealthy, problematic behavior.
It is hard for individuals who have BPD to find adequate treatment, and if they do, they might not be able to afford it. Even when individuals obtain treatment such as DBT, they often obtain only partial, short-term service and might only complete Stage I DBT.
Sloss stressed the importance of responding to BPD with the correct treatment.
“In the past, there were a lot of stigmas attached to a BPD diagnosis,” she said. “What often happens is that people get treated for depression, anxiety, eating disorders, substance abuse or whatever, but they’re not really getting treated for the underlying personality and emotional difficulties, so they don’t fully get better.”
Lynn Courey said she is aware of the pain her daughter went through the last few months of her life.
“They say with BDP, you’re so low that you just cannot bear the pain,” she said. “They say it’s worse than having a child or for a man having kidney stones. You don’t see the light at the end of the tunnel.”
She said she doesn’t want anyone to have to go through the same thing.
“Sasha wanted to live,” Lynn Courey said.
Read more about Menu Courey [here](https://www.themaneater.com/stories/2011/7/21/sasha-menu-coureys-life-revolved-around-swimming-f/).
