Despite profound professional success, Garland struggled in her personal life from an early age. The pressures of early stardom affected her physical and mental health from the time she was a teenager; her self-image was influenced and constantly criticized by film executives who believed that she was physically unattractive. Those same executives manipulated her onscreen physical appearance. Into her adulthood, she was plagued by alcohol and substance abuse, as well as financial instability; she often owed hundreds of thousands of dollars in back taxes. Her lifelong addiction to drugs and alcohol ultimately led to her death in London from a barbiturate overdose at age 47.