**To whom this may concern,**

**To whom this may concern,**

Audio by Paper 2 Audio

**To whom this may concern,**

I am writing this letter to provide a detailed, first-hand account of my observations of Ellie's behaviour, wellbeing, and life events since we became friends in July 2021.

My aim is to give you a full, accurate picture of her experiences, as I strongly believe she has underlying mental health conditions that have not yet been properly identified or diagnosed. I believe her symptoms align closely with characteristics of Borderline Personality Disorder and A.D.H.D, and I hope this account will help you understand the full extent of her struggles and support her in getting the right diagnosis and treatment.

I have known Ellie since July 2021. When we first met, she was initially quite quiet, but once you got to know her, she was warm, incredibly funny, and very talkative — she would “chat for England” and was always the first person to offer help or support to anyone who needed it. She was fun to be around, and at that time, I did not see obvious signs of poor mental health. The most noticeable trait back then was that she was very hyperactive; she had high energy levels, was always busy, and had clear focus and purpose in her life. During this early period, she did not disclose any past trauma or difficult experiences, and she appeared to cope well with daily life.

However, looking back, I can see she was already different from others in how intense her energy and emotions were, and she has told me she felt different from other children even when she was young.

From around February 2022, I began to see a significant shift in Ellie's behaviour that concerned me greatly. The most obvious change was her reliance on alcohol. Whenever we spent time together — regardless of whether others were drinking or not — Ellie would regularly consume between half a bottle and a full bottle of gin on her own during a single visit. This became a consistent pattern and was clearly a way she was coping with things she was not yet speaking about.

Tragically, while she was drinking heavily at this time, Ellie was sexually assaulted by someone she trusted. This event escalated everything massively, and her mental health took a severe turn for the worse. After this, she continued drinking and entered a deep depressive state. She began avoiding people entirely, would miss work without even calling in sick, and would shut herself away indoors for days at a time. She would stay in bed or sleep for long periods, would not answer phone calls or messages, and even refused to let her own mother into her bedroom.

During this time, her self-care and hygiene deteriorated badly — she would go several days without showering, and struggled to manage basic daily tasks such as eating or looking after herself. She became extremely unsociable and withdrew from everyone. Over time, she appeared to improve slightly: she reduced her drinking and only drank occasionally in social settings, and tried to hide how low she still felt. However, this was not a real recovery; she was simply masking her pain and trying to appear “normal” to everyone around her.

**Severe Decline From October 2025**

From October 2025 onwards, Ellie's mental health declined drastically again, and this is where her symptoms became much more severe, unstable, and alarming. Her mood is now incredibly unpredictable — it feels as though everyone around her is constantly “walking on eggshells”, never knowing what we might say or do that could trigger her into a crisis, a severe low, or an outburst.

She had to stop working completely because she can no longer cope with the demands of a job or daily routine. She became so anxious and fearful of being around people that she could not leave the house unless someone was with her — even to go to the shop right next door. She was terrified of supermarkets or crowded places, especially if alone.

However, her behaviour is very inconsistent and extreme, which I believe shows how unstable her emotions and thoughts are. For example, on one occasion, she became very agitated with her boyfriend, made him get out of the car, and then drove away erratically. She ended up at a stranger's house, and has no memory or understanding of how she got there or what her plan was.

She knocked loudly on a stranger's door crying and asking for help — luckily the person was kind and helped her contact the crisis team, but she did not see any danger in this action at the time. This was completely out of character and showed how disoriented and impulsive she can become when distressed.

Since then, she has remained unable to work. She has tried several different types of medication, but none have made any meaningful difference to her condition. At one point, she was told her symptoms were caused by her contraceptive pill — but Ellie, her family, and I completely disagree with this. We have seen her struggles develop long before she was on this medication, and we know her difficulties stem from trauma and underlying conditions, not medication. We also know she was different from other children from a young age, and these patterns have been with her her whole life, even if they have worsened over time.

I accompanied Ellie to her Work Capability Assessment for Universal Credit, and the assessor herself agreed that there was clearly something underlying that needed to be addressed. Even without a formal diagnosis yet, they deemed her unfit to work, as her struggles are so severe.

Over the last six months, Ellie's condition has become even more severe. Her moods swing constantly between the “highest of highs” and the “lowest of lows”, though in the last 3 to 4 weeks, I have barely seen any highs at all — she is mostly in a state of emotional numbness or deep distress.

She is extremely sensitive to what is said or done around her. Even a small comment or a situation she is unhappy with can trigger an extreme reaction. She describes feeling like she “explodes” inside, and when this happens, she often gets into her car and drives away dangerously and erratically. She tells me she often has no memory of getting into the car, or how she arrives where she ends up. At these times, she admits she sometimes wishes she would crash the car, and she does not care if she survives or not. These episodes are terrifying for everyone who loves her, as we never know if she will harm herself or others, or put herself in danger.

One very important thing I have noticed is that Ellie masks her true feelings and behaviour very well. When she attends appointments or speaks to professionals, she tries her hardest to appear calm, reasonable, and “okay”. She deliberately tones down her distress, hides her symptoms, and tries to act in a way she thinks is expected. This means that doctors and specialists often do not see the real Ellie — the one we see at home or when she is not putting on a brave face. I believe this is why her condition has been missed or misdiagnosed for so long.

Since her last appointment with a psychiatrist, Ellie has finally opened up about extensive, long-term abuse she suffered as a child. She disclosed that she experienced severe physical, emotional, and sexual abuse at the hands of her brother throughout her childhood. This trauma has affected her every day of her life, but she suppressed these memories and feelings until recently. Now that these memories are coming back, her distress is at an all-time high. She is currently involved in an ongoing court case regarding this abuse, which is causing her immense stress and pain.

Sadly, because of her unpredictable moods, her “hot and cold” behaviour, and the strain of her condition, her mother has reached a point where she can no longer cope, and Ellie has had to leave the family home. She is currently sofa-surfing — staying in her car, at her boyfriend's house, or with friends — with no permanent or safe place to live. This instability is making every part of her mental health worse, and she has no safe base to recover or heal.

I have also noticed that Ellie often changes her personality, likes, dislikes, and interests depending on who she is with. She tends to copy or imitate others' traits, opinions, and behaviours, almost as if she does not know who she really is, or is trying to fit in and be liked. This is a very clear pattern that I have seen over a long time, and it fits with the other difficulties she has with identity and emotions.

From everything I have observed — the hyperactivity and intensity from childhood and early adulthood, the emotional instability, the extreme mood swings, impulsive and dangerous behaviour, dissociation or memory gaps during distress, difficulty with relationships, masking, identity issues, and the severe impact of long-term trauma — I strongly believe Ellie is living with conditions including Borderline Personality Disorder and A.D.H.D. These are not lifestyle choices or reactions to medication; they are lifelong conditions that have been worsened by trauma and abuse.

Ellie is in crisis, she is unsafe, and she is suffering every single day. She has tried to help herself, she has tried medication, and she has tried to cope alone, but she cannot do this without the right diagnosis and the right support.

I am writing this to ensure you see the full picture — not just the calm, polite person she tries to be in appointments, but the person we see every day who is struggling to survive. I fully support Ellie in getting a formal diagnosis, and I urge you to take every part of this account into consideration when assessing her.

I am happy to speak with you further, answer questions, or provide more details if needed.

**Yours sincerely,**

**Mrs Chloe Shanks**

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