Borderline personality disorder is a serious mental health disorder that can cause long-term harm to a person’s mental health and well-being. While most people receive a BPD diagnosis after the age of eighteen, BPD is also common in adolescents. But many young people who develop BPD during their teens don’t receive an accurate diagnosis or appropriate support for several years.
The early diagnosis of BPD is critical. Timely intervention can prevent BPD traits from developing and intensifying and lead to earlier recovery. It also prevents much of the social and psychological harm that can result from BPD, such as the development of other mental health disorders or patterns of unstable and damaging relationships.
Why Diagnoses of BPD in Adolescence Still Uncommon?
Many clinicians are still reluctant to diagnose personality disorders like BPD in under-18s. Some clinicians may think that because a teenager’s personality is still developing, it isn’t possible to identify stable personality traits that might fit the criteria for a BPD diagnosis, or that BPD traits and symptoms are transient and likely to change without interventions and support.
Others may believe that adolescence, as a developmental stage, is characterised by impulsivity and emotional reactivity, and that experiencing BPD traits at this time could even be considered ‘normal’.
However, we now know that these ideas are based on misconceptions and misunderstandings about the disorder. Research shows that BPD diagnoses are as reliable and prevalent among adolescents as among adults, and many adolescents with BPD continue to experience BPD traits as adults. Moreover, BPD traits and symptoms are well outside what can be considered a normal trajectory for adolescent development.
Clinicians’ reluctance to diagnose adolescents with BPD may be partly explained by stigma surrounding the disorder. Some clinicians still falsely believe that BPD isn’t treatable or that recovery is very difficult. They may also be concerned about how a BPD diagnosis would affect a young person’s opportunities in the future.
But in reality, there are several treatment approaches available that effectively treat BPD. Rather than improving a young person’s future opportunities, delaying diagnosis instead allows BPD traits to continue and intensify, causing harm to a young person’s social life, education, and work.
What Are the Benefits of an Early BPD Diagnosis?
Adolescence is a time of particular mental health vulnerability, and the peak onset of major mental health disorders. Mental health support during adolescence is crucial to prevent mental health symptoms from continuing into adulthood and prevent disruption to important social and emotional developmental processes, including the acquisition of essential skills.
For mental health support to be effective, it needs to reflect the actual experience of a young person. Different mental health disorders require different kinds of treatment and care. This means that young people with borderline personality disorder require treatment specifically designed for adolescents with BPD. The earlier a young person receives a BPD diagnosis, the sooner they can access the right kind of care.
Health and Well-Being
Among young people, BPD or subthreshold BPD is linked to a lower health-related quality of life and psychopathological distress. Both diagnoses are also associated with co-occurring mental health disorders and worse overall functioning.
This means that early diagnoses of BPD and BPD treatment can help protect young people’s well-being and prevent damage to their future prospects. Diagnosis and intervention are important even if BPD is in its earlier stages, before the development of full-threshold BPD.
Education and Employment
Young people with BPD may face challenges as they move into adulthood. BPD is associated with disruption to the completion of education, transition to employment, and independent functioning in society. Research has found that young people with subthreshold BPD, meeting only 1–4 DSM-IV criteria, have worse occupational outcomes than those with no personality disorder features.
Early diagnosis and intervention can support young people to recover from BPD and avoid these harmful consequences. It helps them stay in education, find employment, and live independently as they move into adulthood.
Relationships and Social Life
BPD also impacts young people’s relationships, including romantic partnerships and friendships. They may find it hard to form stable and meaningful connections with others, instead experiencing patterns of intense and unstable relationships. Research shows that young people with BPD tend to have less enduring friendships and take part in fewer social activities than those without the disorder.
Trusting relationships are essential for the well-being and development of young people. In addition to offering support and companionship, they’re also a key means by which young people acquire knowledge and learn and practice skills.
Early diagnoses of BPD pave the way for interventions that support young people to build trusting relationships, stable and continue their socio-emotional development.
Preventing BPD in Adulthood
Many children and adolescents with BPD traits or a BPD diagnosis continue to show the same traits as adults. Studies show that personality disorder symptoms in childhood or adolescence are the strongest predictors of personality disorders in adulthood. A community study also found that young people with a BPD diagnosis were at a much higher risk than others of having the same diagnosis two years later.
This means that diagnosing BPD early and offering effective treatment is one of the most effective ways to protect against adult BPD. In the years between the onset of BPD in adolescence and adulthood, young people may experience a range of harmful consequences that impact their relationships, education, opportunities, and well-being. Early diagnosis and intervention can help prevent much of this harm.
Treatment for Borderline Personality Disorder Among Adolescents
Due to the stigma and misconceptions that surround BPD, some young people may think – or even be told – that BPD isn’t treatable. But in reality, there are several different treatment approaches that can effectively treat BPD among adolescents. Studies have consistently shown that structured psychological interventions lead to significant improvements among young people with borderline features of BPD.
Some treatment approaches for adolescent BPD include:
- Dialectical behavioural therapy -A
- Adolescent identity therapy
- Emotional regulation therapy
- Cognitive analytic therapy
- Mentalisation-based treatment
Recent research also suggests that it isn’t therapy alone that supports young people to recover from BPD. Young people also require social networks to build – and learn from -trusting relationships with others. This means that BPD treatment should adopt a whole-person approach that involves a young person’s family, community, and other social environments.
The Wave Clinic – Transformative Mental Health Support for Young People
The Wave Clinic provides residential and outpatient mental health support for young people living with eating disorders, borderline personality disorder, and other mental health concerns.
Our approach emphasises the role of past traumas and social environments in shaping young people’s present experiences and behaviours. We fully involve families in our treatment programs through family therapy interventions and collaborative decision-making.
If you’re interested in our programs, get in touch today to find out more.
