Borderline personality disorder (BPD) in teens is marked by a more intense experience of typical teenage feelings as well as unstable relationships, an unclear sense of self, intense mood swings, and explosive anger. Experiences during this time influence how we feel, act, and relate to others, making it especially difficult for a teen struggling with BPD.
What Is Borderline Personality Disorder?
BPD is a mental health condition that involves mood swings, abandonment concerns, low self-esteem, low self-worth, poor boundaries, and impulse issues. In general, teenagers have a reputation for being moody and full of angst; however, BPD in teens presents with more extreme emotional reactions.
17 Symptoms of Borderline Personality Disorder In Adolescents
The symptoms or signs of BPD in teens are varied, but they include impulse control issues, fear of rejection, paranoia, substance use, and poor boundaries.
17 symptoms of borderline personality disorder in adolescents are:
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- Unstable friendships
- Unstable family relationships
- Poor performance in school
- Extreme mood swings
- Low self-esteem and self-worth
- Anger and/or extreme rage
- Self-harm behaviors and thoughts
- Impulse control issues
- Severe depression
- Fear of abandonment
- Fear of rejection
- Poor boundaries
- Anxiety
- Sleep disturbances
- Weight disturbances
- Paranoia
- Substance use
Looking For Signs of Self-Harm & Suicidal Ideation
Self-harm behaviors and suicidal ideation are major indicators of BPD in teens. Note that self-harm can manifest in many different behaviors, so as a parent, teacher, or caregiver, it’s important to be on the lookout for lesser known or more concealed forms of it teen suicide and self-harm.
Forms of self-harm include:
- Cutting
- Punching walls or other hard, inanimate objects
- Using drugs or alcohol
- Talking about harming themselves with a plan
- Playing with fire or sharp objects
- Engaging in unsafe sexual behavior
- Burning their skin, nails, or hair1
9 Risk Factors & Causes of BPD In Teenagers
There are many risk factors and causes of borderline personality disorder in adolescents, including abuse, sexual trauma, and mental health conditions like anxiety, depression, and anti-social personality disorder (ASPD).
Here are nine risk factors and causes of BPD in teens:
- Child abuse and neglect
- Sexual trauma
- Existing mental health conditions (anxiety, depression, ASPD, etc.)
- Separation or loss of parent/caregiver
- Unstable home environment
- Family history, or genetic predisposition of BPD or other mental health conditions
- Chronic invalidation of a child’s emotions
- Physical differences in the brain (impacting emotions and impulses)
- Genetic/hereditary factors2
How Is BPD In Teens Diagnosed?
BPD must be diagnosed by a licensed healthcare professional (e.g., a psychiatrist). Usually, these physicians work with a team of therapists and other therapeutic support staff members who are trained in various types of interventions and behavioral analysis. Over the course of a few one-on-one sessions with the client, they can make a proper recommendation.
When it comes to diagnosing teenagers with BPD, therapists have to figure out the context of certain behaviors. Many teens engage in risky acts or the kind of behavior that mirrors BPD symptoms in an effort to “fit in.” They’re also going through puberty and other hormonal changes.3 For this reason, it takes more time (and trust) to uncover teenagers’ reasons for engaging in certain behaviors.
Treatments Options For Teenage BPD
There are a number of ways to treat borderline personality disorder in adolescents, including dialectical behavioral therapy (DBT), cognitive behavioral therapy (CBT), mentalization-based therapy (MBT), and different forms of medication.
Here are four treatment options for teens with BPD:
1. Therapy
Dialectical behavioral therapy for BPD helps to reduce self-harm behaviors, including suicide. These sessions focus on mindfulness, distress tolerance, regulation of emotions, and interpersonal skills. Teens learn how to accept themselves without judgment, acknowledge their emotions, learn how to better manage those emotions, improve communication, recognize when they have no power, and manage that situation accordingly.4
Cognitive behavioral therapy for BPD can be helpful in conjunction with DBT or as a stand-alone modality. It aims to help teens identify patterns of negative thoughts and recognize how thoughts lead to actions. The goal is to challenge them to identify their thoughts and feelings and replace negative ones with positive ones in order to heal and move forward.5
MBT helps people with BPD improve their understanding of themselves and others, which can be helpful in forming or maintaining their relationships with others.
2. Medication
While there is no known medication to treat BPD, there are medications that can help treat certain symptoms. Because some symptoms of BPD overlap with depression, anxiety, psychosis, and bipolar disorder, it’s common to take medications related to those diagnoses. It’s considered best practice to use pharmacological intervention in conjunction with talk therapy like CBT.6
3. Support Systems
It’s important for teens to have a strong support system in place, especially if they’re struggling with BPD. BPD treatment can be challenging, so they’re encouraged to include family and close friends to help them throughout their journey. Teens who have involved parents/caregivers are more optimistic and tend to have better outcomes as well as better family cohesion.
Attending therapy sessions can also help parents/caregivers learn how to be better supports for their teen. When the family is involved with the teen’s care plan, the overall prognosis improves greatly.
How to Get Help For a Teen With BPD
To support a teen with BPD, parents should provide consistency and stability and avoid shaming. Due to their own fears and anxieties about what BPD is and what the future holds, it’s common for parents to struggle. That means they should prioritize self-care and have their own support system and/or therapist as well.
Consistent boundaries and consequences are critical for teens. Adhering strictly to the boundaries and guidelines set in place makes it clear that they won’t get “special treatment” or be able to bend the rules. This kind of consistency is also important for their healing.
If your teen has siblings, consider therapy for them, too, and pay attention to how they’re coping. Siblings with a good relationship may want to try and fix the problem, which could backfire. Siblings who don’t get along may struggle to understand or show compassion. Family counseling provides a collective outlet, a means to connect, and an opportunity to get on the same page.
How to Find a Therapist
Find a therapist by searching an online therapist directory and reviewing providers based on your preferences and insurance. Start by researching clinician profiles online and selecting a few to contact for initial conversations. Many therapists offer a free phone consultation to give families an opportunity to evaluate whether they’re the right fit.
Cost typically depends on your insurance and length of treatment. Therapy can last anywhere from 12-15 weekly sessions. Each one-hour session can range from approximately $60-$200 depending on your insurance, co-pays, and whether your provider is “in-network.”
Final Thoughts On BPD In Teens
What you’re struggling with may be unique to you, but you’re not alone. Talking to a therapist or reaching out to a trusted friend or family member can make a big difference in how you feel.
