Borderline Personality Disorder in Teens

Table of ContentsView AllTable of ContentsWhat Is Borderline Personality Disorder?SymptomsDiagnosisPrognosisPrevalenceRisk FactorsPreventionTreatmentNext in Borderline Personality Disorder GuideWhat Is Borderline Personality Disorder (BPD)?

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Table of Contents

What Is Borderline Personality Disorder?

Symptoms

Diagnosis

Prognosis

Prevalence

Risk Factors

Prevention

Treatment

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Borderline personality disorder symptoms are confusing, frustrating, and hard for loved ones to understand. This is particularly the case for parents or caregivers dealing with teens who haveborderline personality disorder(BPD).

While we know a great deal about howborderline personality symptomslook in adults, we know much less about how the disorder presents in teens. In fact, there is still controversy over whether it is appropriate to diagnose teens with BPD.Many experts argue that teens can have BPD, and adolescent BPD is now recognized as an official diagnosis.

At a GlanceParents often have questions about borderline personality in adolescents. Some are worried that their teen is exhibiting the signs of borderline personality disorder (BPD), such as intense andfrequent mood swings,impulsive behaviors,self-harm, or difficulties in relationships.Others have BPD themselves and are worried that their kids will also have the disorder. Keep reading to learn more about how BPD in teens, including the symptoms, prevalence, and treatments.

At a Glance

Parents often have questions about borderline personality in adolescents. Some are worried that their teen is exhibiting the signs of borderline personality disorder (BPD), such as intense andfrequent mood swings,impulsive behaviors,self-harm, or difficulties in relationships.Others have BPD themselves and are worried that their kids will also have the disorder. Keep reading to learn more about how BPD in teens, including the symptoms, prevalence, and treatments.

Many experts have argued that borderline personality should not be diagnosed in anyone younger than 18 since, technically, their personality is not yet fully formed. In the most recent edition of the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5), though, there is a provision that allows for the diagnosis of borderline personality before the age of 18.

While the provision technically allows forthe diagnosis of BPDin children under 13, this is very rare.

Symptoms of BPD in Teenagers

While the symptoms of BPD as listed in the official DSM-5 diagnostic criteria are no different for teens and adults, some experts have suggested that there are differences in adolescent BPD symptoms.

Symptoms of borderline personality disorder include:

Symptoms, such as instability in interpersonal relationships, impulsive behavior, chronic emptiness, and unstable sense of self, may look different in teens.It may also sometimes be difficult to distinguish between symptoms of BPD and normal teenage challenges.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see ourNational Helpline Database.

Diagnosis of BPD in Teenagers

In order to diagnose BPD in teens, doctors and psychiatrists will look not just at the individual’s behavior but also their motivations for those behaviors. For example, engaging in substance use is not necessarily a sign that a person has BPD. However, if they engage in such behavior in order to avoid problems or feelings, or to manage emotions, that might be considered a sign of the condition.

Research suggests that children as young as 11 are able to describe their behaviors and motivations enough for an accurate diagnosis.

McLean Screening Instrument for Borderline Personality Disorder

Prognosis of BPD in Teenagers

For adults with BPD, the symptoms of the condition typicallygradually decline with age, particularly past the age of 40.The progression and outlook for teens with the condition are less clear, although appropriate treatment can significantly improve the management of symptoms.

According to a review published in 2015, theremissionrate for adolescents could range from 50% to 65%. However, it’s also possible that some symptoms could remain even though some teens no longer met the diagnostic criteria for BPD.

How to Be a Good Friend to Someone With BPD

Prevalence of BPD in Teenagers

A study published in 2014 suggested that rates of borderline personality in teens are slightly higher than in adults.This may be related to the fact that some teenagers display BPD in reaction to stressful events, but many are more likely to recover.

Some studies suggest that the prevalence among teens is around 3%.

Prevalence rates are higher in psychiatric populations. Research has found that 11% of adolescents receiving treatment in outpatient clinics have BPD. This number climbs to 78% of teens admitted to the ER for suicidal behavior or attempts.

Risk Factors of BPD in Teenagers

The risk factors for borderline personality in adolescents are very similar to the risk factors in adults. In fact, many of the environmental risk factors for BPD occur during childhood. Some of the factors that may increase the risk of BPD include:

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Prevention of BPD in Teenagers

If you are worried that your adolescent may be at risk for developing BPD based on either environmental risk factors (e.g.,trauma exposure) or biological risk factors (e.g., a first-degree relative with the disorder), some experts believe that there are ways to modify the course of the condition.

Kids who experienceexternalizingdisorders such asoppositional defiant disorder(ODD) andattention-deficit hyperactivity disorder(ADHD) appear to be more likely to develop BPD symptoms in adolescence. The presence of depression in adolescence appears to predict BPD during adulthood.

This suggests that early detection and the use of specific therapeutic interventions to address those symptoms may help change the course of the disorder.Thus, if you have concerns about your child’s mental health, seek advice from a physician or mental health professional.

Treatment for BPD

While BPD is a serious and complex condition, there are effective treatments available that can help manage and reduce symptoms. Getting an accurate diagnosis and the use of appropriate treatments is important.

Psychotherapy

Several types of psychotherapy includingcognitive-behavioral therapy(CBT) anddialectical behavior therapy(DBT) may be effective with teens with borderline personality.

DBT has also been adapted for use specifically with adolescents. Dialectical-behavioral therapy for adolescents (DBT-A) involves individual psychotherapy and family skills training.

One randomized control trial comparing DBT-A to psychodynamic therapy and CBT found that DBT-A was associated with increased reductions in depressive symptoms, borderline symptoms, self-harming behaviors, and suicidal ideation over the other treatments.

Medications

While there are no FDA-approved medications for BPD, there are medications that have been shown to reduce some of the symptoms.

Keep in Mind

Finding good treatment for an adult with BPD is hard, but given some of the controversial issues in diagnosing borderline personality in adolescents, finding a therapist for a teen with BPD is even harder. Fortunately, more and moretherapistsare being trained to treat teens with borderline personality. With treatment, remission and relief from symptoms is possible.

5 Keys to Living With Borderline Personality Disorder

9 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kaess M, Brunner R, Chanen A.Borderline personality disorder in adolescence.Pediatrics. 2014;134(4):782-93. doi:10.1542/peds.2013-3677Biskin RS.The lifetime course of borderline personality disorder.Can J Psychiatry. 2015;60(7):303–308. doi:10.1177/070674371506000702American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th edition. 2013.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Guilé JM, Boissel L, Alaux-Cantin S, de La Rivière SG.Borderline personality disorder in adolescents: prevalence, diagnosis, and treatment strategies.Adolesc Health Med Ther. 2018;9:199-210. doi:10.2147/AHMT.S156565Videler AC, Hutsebaut J, Schulkens JEM, Sobczak S, van Alphen SPJ.A life span perspective on borderline personality disorder.Curr Psychiatry Rep. 2019;21(7):51. doi:10.1007/s11920-019-1040-1National Institute of Mental Health.Personality disorders.Kothgassner OD, Goreis A, Robinson K, Huscsava MM, Schmahl C, Plener PL.Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis.Psychol Med. 2021;51(7):1057-1067. doi:10.1017/S0033291721001355Mehlum L, Ramberg M, Tørmoen AJ, et al.Dialectical behavior therapy compared with enhanced usual care for adolescents with repeated suicidal and self-harming behavior: Outcomes over a one-year follow-up.J Am Acad Child Adolesc Psychiatry. 2016;55(4):295-300. doi:10.1016/j.jaac.2016.01.005

9 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Kaess M, Brunner R, Chanen A.Borderline personality disorder in adolescence.Pediatrics. 2014;134(4):782-93. doi:10.1542/peds.2013-3677Biskin RS.The lifetime course of borderline personality disorder.Can J Psychiatry. 2015;60(7):303–308. doi:10.1177/070674371506000702American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th edition. 2013.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Guilé JM, Boissel L, Alaux-Cantin S, de La Rivière SG.Borderline personality disorder in adolescents: prevalence, diagnosis, and treatment strategies.Adolesc Health Med Ther. 2018;9:199-210. doi:10.2147/AHMT.S156565Videler AC, Hutsebaut J, Schulkens JEM, Sobczak S, van Alphen SPJ.A life span perspective on borderline personality disorder.Curr Psychiatry Rep. 2019;21(7):51. doi:10.1007/s11920-019-1040-1National Institute of Mental Health.Personality disorders.Kothgassner OD, Goreis A, Robinson K, Huscsava MM, Schmahl C, Plener PL.Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis.Psychol Med. 2021;51(7):1057-1067. doi:10.1017/S0033291721001355Mehlum L, Ramberg M, Tørmoen AJ, et al.Dialectical behavior therapy compared with enhanced usual care for adolescents with repeated suicidal and self-harming behavior: Outcomes over a one-year follow-up.J Am Acad Child Adolesc Psychiatry. 2016;55(4):295-300. doi:10.1016/j.jaac.2016.01.005

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Kaess M, Brunner R, Chanen A.Borderline personality disorder in adolescence.Pediatrics. 2014;134(4):782-93. doi:10.1542/peds.2013-3677Biskin RS.The lifetime course of borderline personality disorder.Can J Psychiatry. 2015;60(7):303–308. doi:10.1177/070674371506000702American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th edition. 2013.American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.Guilé JM, Boissel L, Alaux-Cantin S, de La Rivière SG.Borderline personality disorder in adolescents: prevalence, diagnosis, and treatment strategies.Adolesc Health Med Ther. 2018;9:199-210. doi:10.2147/AHMT.S156565Videler AC, Hutsebaut J, Schulkens JEM, Sobczak S, van Alphen SPJ.A life span perspective on borderline personality disorder.Curr Psychiatry Rep. 2019;21(7):51. doi:10.1007/s11920-019-1040-1National Institute of Mental Health.Personality disorders.Kothgassner OD, Goreis A, Robinson K, Huscsava MM, Schmahl C, Plener PL.Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis.Psychol Med. 2021;51(7):1057-1067. doi:10.1017/S0033291721001355Mehlum L, Ramberg M, Tørmoen AJ, et al.Dialectical behavior therapy compared with enhanced usual care for adolescents with repeated suicidal and self-harming behavior: Outcomes over a one-year follow-up.J Am Acad Child Adolesc Psychiatry. 2016;55(4):295-300. doi:10.1016/j.jaac.2016.01.005

Kaess M, Brunner R, Chanen A.Borderline personality disorder in adolescence.Pediatrics. 2014;134(4):782-93. doi:10.1542/peds.2013-3677

Biskin RS.The lifetime course of borderline personality disorder.Can J Psychiatry. 2015;60(7):303–308. doi:10.1177/070674371506000702

American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders.5th edition. 2013.

American Psychiatric Association (APA).Diagnostic and Statistical Manual of Mental Disorders. 5th ed, text revision. Washington, D.C.; 2022.

Guilé JM, Boissel L, Alaux-Cantin S, de La Rivière SG.Borderline personality disorder in adolescents: prevalence, diagnosis, and treatment strategies.Adolesc Health Med Ther. 2018;9:199-210. doi:10.2147/AHMT.S156565

Videler AC, Hutsebaut J, Schulkens JEM, Sobczak S, van Alphen SPJ.A life span perspective on borderline personality disorder.Curr Psychiatry Rep. 2019;21(7):51. doi:10.1007/s11920-019-1040-1

National Institute of Mental Health.Personality disorders.

Kothgassner OD, Goreis A, Robinson K, Huscsava MM, Schmahl C, Plener PL.Efficacy of dialectical behavior therapy for adolescent self-harm and suicidal ideation: a systematic review and meta-analysis.Psychol Med. 2021;51(7):1057-1067. doi:10.1017/S0033291721001355

Mehlum L, Ramberg M, Tørmoen AJ, et al.Dialectical behavior therapy compared with enhanced usual care for adolescents with repeated suicidal and self-harming behavior: Outcomes over a one-year follow-up.J Am Acad Child Adolesc Psychiatry. 2016;55(4):295-300. doi:10.1016/j.jaac.2016.01.005

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