STEVE HELBER/POOL/AFP/Getty Amber Heard
On day nine of Johnny Depp's defamation trial against ex-wife Amber Heard, a clinical and forensic psychologist — hired by Depp's lawyers — testified that Heard showed signs of borderline personality disorder.
Dr. Shannon Curry, who said that she is not board-certified, told the court that she was asked to "provide a psychological evaluation" of Heard, 36, in Oct. 2021. Curry said she reviewed "all the case documents," Heard's medical records, audio and video recordings, photos and "multiple witness statements," and met with the Aquaman actress on two separate dates in Dec. 2021 for a total of around 12 hours.
"The results of Ms. Heard's evaluation supported two diagnoses: borderline personality disorder and histrionic personality disorder," Curry said.
Borderline personality disorder is a type of mental disorder that impacts how a person thinks and feels about themselves, Dr. Ziv Cohen, the founder and medical director of Principium Psychiatry and a board-certified forensic and clinical psychiatrist, who has not treated Heard, tells PEOPLE.
Cohen says he is "not in a position to say" if he agrees with the diagnosis, not having examined her, but in general, patients feel "chronic symptoms of emptiness," he explains. "They have identity diffusion, which means they feel like they don't know who they are, and it can be so extreme that they try to join a cult or take on a persona that will give them some sense that they are real and that they have an identity. They tend to have a very extreme fear of abandonment, and they tend to have extreme mood swings, so they can suddenly be triggered to anger or sadness."
The condition is one that doctors have been aware of since the sixties and seventies, Cohen says, but it's only in the last 20 or so years that there's "been a huge increase in awareness," with more mental health providers learning about and diagnosing people with the disorder. Because of the gaps in knowledge, though, along with stigma around borderline personality disorder, it tends to go underdiagnosed, or confused with bipolar disorder.
The difference between the two "goes down to a debate in the mental health community about what are the roots of mental illness," Cohen says. "So bipolar disorder is a disease, it's a brain disease. Whereas borderline personality is a much more complex condition that has a strong psychological component."
"I certainly believe, as most psychiatrists do, that this is a distinct diagnosis from bipolar. Bipolar people can have manic depression where sometimes they're flying high and they feel like they're on top of the world, and then they're in a depressive phase where they can't get out of bed."
Borderline patients can appear to have similar mood swings, but "personality disorders are not things that come and go if you have it," Cohen says. "Depression can happen for a week and then go away. Borderline personality disorder is a stable trait."
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For people with the condition, medication can "help blunt some of the symptoms," such as the anxiety and mood swings. "It's not going to eliminate it completely, but it can really take the edge off for the patient. And that's really positive because even a 10 or 20 or 30% reduction of those symptoms can really make a difference," he says. The best treatment, though, is psychotherapy.
"In psychotherapy, we're going educate the patient about their condition. We're going help them identify the symptoms and behaviors. And then finally we're going help them modify how they react to certain situations so that they can react more adaptive way," Cohen says. "But that process is a laborious one, and it generally takes years."
What is important to note about people with borderline personality disorder, Cohen says, particularly in light of Curry's claims about Heard, is that just because someone has the condition it does not discount their beliefs and thoughts.
"Patients with borderline personality do cry wolf a lot. That is true. But of course, even someone who cries wolf can be a victim," he says. "So we have to be very, very careful that we take very seriously any allegations, and not just dismiss them because the person has borderline personality. Even if she has it, that doesn't mean that she's not abused."