Parents and caregivers are increasingly becoming aware of borderline personality disorder (BPD) and its confusing symptoms. BPD is a form of biosocial disorder that begins with temperamental inclination. The degree of BPD a person may suffer is largely determined by the social environment. People suffering from the condition are often weighed down by extreme anger as well as intense shame, self-harming behaviors, and feelings of emptiness.
The other challenge is difficulty connecting with other people. Due to the high proclivity to interpret things negatively, individuals who are hypersensitive to social cues stand a high risk of experiencing heightened symptoms.
The signs of BPD may include:
• Intense emotional reaction, which is often inappropriate and disproportionate to the situation
• Dysfunctional self-image that may lead to serious consequences such as damaged identity
• Constant fear of abandonment and rejection
• Feelings of hopelessness, emptiness, or excessive boredom
• Acting out sexually
• Self-injury
• Suicidal thinking and planning
• Desire to engage in impulsive and risky behaviors as informed by self-destructive patterns
• Turning to substance use as a way to cope with thoughts or emotions
• Engulfing sense of anxiety and worry that creates urges that push the affected person beyond the existential risks
The intense emotional reaction felt by teens with BPD may mean mood swings from a happy expression to a despondent mood in a short time. Fear of abandonment is common among BPD sufferers. This feeling is often exacerbated by the thought of being left alone and can happen if a loved one or caregiver arrives home late or goes away for some time. The self-injury behavior exhibited by BPD sufferers can easily lead to suicidal behavior.
Research suggests that individuals with a diagnosis of BPD are at a greater risk of dying by suicide. The suicidal tendency is normally expressed through attempted suicide and suicidal gestures. The desire to engage in impulsive or risky behaviors may be heightened when the affected person is upset. This is often expressed through reckless driving, engaging in risky sex, binge eating, or using alcohol and drugs to help avoid thoughts or emotions.
While it may be tempting to imagine that a child or teen is threatening suicide as a way to seek attention, suicidal threats or attempts should always be taken seriously. If your teen is threatening to harm themselves or others, please contact your local emergency services.
Can you diagnose a teen with borderline personality disorder?
Yes! There is nothing to prevent a licensed healthcare professional from diagnosing a teen or child with BPD. In fact, most adults with BPD will recognize that their symptoms often began in childhood or when they were teens.
A licensed mental health professional can diagnose a teen with BPD after an in-depth interview and assessment—including family history. Often it takes several appointments to make an accurate diagnosis.
According to article written by researcher Marie-Pier Larrivée, clinicians often find it difficult to diagnose BPD among adolescents because this is the stage when adolescents experience natural life transition, which is often marked by turbulence. A lot of these changes do not qualify as a personality disorder. For instance, adolescents typically experience moodiness and a certain degree of risk-taking and impulsive behaviors as they grow. This can happen without the teen falling into any serious personal or health problem.
Teens may be compelled to try out sex or alcohol out of individual or peer impulses. Although BPD is largely misunderstood, evidence-based treatment can help diagnose the condition more accurately. To achieve a better outcome, the treatment team constitutes professionals with experience in diagnosing and treating BPD.
The following therapeutic interventions can help achieve sustainable healing:
• Cognitive Behavior Therapy (CBT) – This form of therapeutic intervention helps bring valuable insights to the suffering teen by identifying the emotional issues causing a sense of isolation. CBT can also help the teen overcome self-defeating thoughts.
• Mentalization Based Treatment (MBT) – This is a form of psychotherapy developed by Anthony Bateman and Peter Fonagy in the United Kingdom. It’s designed to help the teen recognize and understand their emotions.
• Dialectical Behavioral Therapy (DBT) – This approach involves the application of mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation skills. Therapist are also available in between sessions to help the client and their family.
• Mindfulness and Self-Compassion Therapy – Several behavioral studies show that a focus on mindfulness and self-compassion training can help people with BPD overcome feelings of insecurities and improve coping skills.
• Experiential Therapies – Although music, art, and adventure therapy are not an evidence-based treatment for BPD, they may be very beneficial. These interventions are often helpful at building self-worth.
When considering therapeutic intervention, it is important to find the right therapist—someone who is experienced in working with teens with BPD. The healing process often involves breaking down the dysfunctional patterns that control the thought or emotional process and cause the teen distress. Family-based approaches are also highly recommended because teens are an integral part of the family. With love and support, family intervention can help facilitate the much-needed, long term healing.
The Role of Medications in Treating BPD
Prescription medication can also be used as part of the overall intervention but is often not necessary. In the United States, the Federal Drug Administration (FDA) is yet to approve any medication to help treat BPD. As a DBT therapist, I often encourage my clients and their families to think about lifestyle and nutritional changes as a potential alternative to medications.
Medications may help but some teens but parents and caregivers should not imagine that a pharmaceutical approach can replace evidence-based therapy, strong family support, and a lot of patience.
Conclusion
Teens can be diagnosed with borderline personality disorder. The diagnosis should not be delayed until after the teen turns 18 or 21. Moreover, families of suicidal or self-harming teens should not be encouraged to postpone treatment and wait to see if the adolescent outgrows the behavior.
Parents and guardians may find it challenging to get the right treatment and will benefit from educating themselves about this diagnosis.
If you are looking for additional information on helping children and adolescents with borderline personality disorder, please check out these books.
• The BPD Wellness Planner for Families by Amanda L. Smith
• BPD in Adolescents: What to Do When Your Teen Has BPD by Blaise Aguirre
• Parenting a Teen Who Has Intense Emotions by Pat Harvey
• The Highly-Sensitive Child: Helping Our Children Thrive When the World Overwhelms Them by Elaine Aron