The Complexities of Emotionally Unstable Personality Disorder in Teens

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For loved ones, borderline personality traits can be frustrating and puzzling. This is especially true for parents or adults caring for teenagers with borderline personality disorder (BPD), also known as emotionally unstable personality disorder (EUPD).

Concerns about borderline personalities in teenagers are common among parents. Some are worried that their child may develop extreme and frequent mood swings, impulsive actions, self-harm, or relationship issues. 

Although the signs of borderline personality disorder in adults are well known, how it manifests in adolescents is less understood.

What Is Borderline Personality Disorder?

Borderline personality disorder is a mental health condition affecting how people progress through life and form relationships. As with most mental illnesses, it involves difficulty managing emotions and can cause intense and unstable relationships.

Since a person’s personality is not technically fully formed until adulthood, many experts have maintained that borderline personality should not be diagnosed in anyone under 18. While the appropriateness of diagnosing adolescents with BPD remains contentious, it is acknowledged as an official diagnosis in the most recent version of the “Diagnostic and Statistical Manual of Mental Disorders” (DSM-5).

Symptoms of BPD in Teenagers

Although there is no distinction between teenage and adult borderline personality disorder symptoms according to the official DSM-5 diagnostic criteria, some mental health professionals contest this notion.

Borderline personality disorder signs and symptoms include:

  • Depression
  • Wide-ranging mood swings
  • Paranoia
  • Self-harm
  • Drug misuse/substance abuse
  • Intense fear of rejection
  • Unstable relationships
  • Impulsive behaviour
  • Rapid changes in self-identity and self-image
  • Intense emotions/emotional instability
  • Eating disorders
  • Hearing voices
  • Suicidal thoughts

Teenagers present a diverse range of symptoms which can sometimes make it challenging to distinguish between borderline personality disorder symptoms and typical teenage struggles.

Diagnosis of BPD in Teenagers

According to research, children as young as 11 can adequately articulate their actions and motivations for the disorder to be diagnosed. However, while it is not prohibited to diagnose borderline personality disorder before age 18, most doctors are reluctant to do so. Although symptoms may appear during the teenage years, borderline personality disorder is often diagnosed in early adulthood.

Mental health services will consider the person’s goals as well as their motives when diagnosing a personality disorder in adolescents. For instance, taking drugs or alcohol is not always a sign that a person has BPD, but it could be if they do so to suppress negative emotions. 

Prognosis of BPD in Teenagers

Adults with borderline personality disorder often have a steady drop in their symptoms as they get older, especially beyond the age of 40. Although the course and prognosis for teenagers with the condition are less clear, the management of symptoms can be considerably improved with the right medication.

The remission rate for adolescents ranges between 50% and 65%, according to a 2015 review. However, it’s also possible that some symptoms persisted even in teens who no longer fit the diagnostic criteria.

Prevalence of BPD in Teenagers

Mental Health UK estimates that around 1 in 100 people have borderline personality disorder in the UK, affecting both men and women equally. Moreover, the disorder among adolescents is estimated at 3% – approximately one child in every classroom.

A 2014 study also showed that borderline personality disorder was slightly more common among teenagers than adults. This may be because some teenagers develop the condition in response to stressful situations.

Risk Factors of BPD in Teenagers

The risk factors for borderline personality disorder in teenagers and adults are very similar. Some of the variables that could raise the risk of developing BPD include:

• Brain Differences – According to research, patients with BPD frequently experience abnormalities in the brain regions linked to impulse control and the regulation of emotions.

• Environmental Factors – In teenagers with a personality disorder, childhood maltreatment, neglect, parental divorce, or death have all been connected.

• Family History – Children with parents who have a severe mental illness (such as depression, substance addiction, or antisocial personality disorder) are more likely to develop BPD.

Prevention of BPD in Teenagers

Some specialists believe there are ways to alter the course of the disorder if you are concerned that your child has been affected by environmental risk factors, such as trauma, or biological risk factors, like a first-degree relative with the disorder.

Oppositional defiant disorder (ODD) and attention-deficit hyperactivity disorder (ADHD) are conditions that affect how people outwardly relate to their environment. Children impacted by these externalising disorders may be more susceptible to having personality disorder symptoms as they enter adolescence. Depression, anxiety disorder, and post-traumatic stress disorder among teenagers have also been found to increase the likelihood of developing borderline personality disorder during adulthood. In fact, in many cases, these illnesses co-occur.

Treatment for BPD at The Wave

Despite the seriousness and complexity of borderline personality disorder, there are effective treatments that can help control and lessen symptoms. It’s crucial to receive a proper diagnosis and apply the necessary treatments.

At The Wave, we understand that everyone faces problems growing up. For young people, having borderline personality disorder adds a lot of complexities and challenges. Our goal is to help individuals get through their toughest moments and lead them to a better point in their lives.

With a holistic approach to treatment, we assist our young people in acquiring the skills and resilience required to overcome their mental health struggles. Additionally, we adopt a multifaceted strategy for recovery, integrating medical care with compassion and the development of life skills. This gives our young people a strong foundation of coping mechanisms and the tools they need to begin their recovery journey.

During treatment, there are seven main components that we focus on to ensure young people develop and grow throughout their time with us. These include:

  • Clinical 
  • Destination future 
  • Education 
  • Experiences 
  • Global citizenship 
  • Medical
  • Outside-inside

We know that young people and their families can better manage the disorder being treated if they understand it. As a result, we offer mental health education to assist each individual in understanding the primary symptoms of borderline personality disorder and practical methods for managing them.

Along with various information about the symptoms, we also want to assist our young people in taking back control of their life. People in our care see a significant change in their daily life due to our efforts to boost confidence and facilitate progress.

Treatment Approaches

Psychotherapy

Every young person who completes a treatment programme at The Wave participates in a large number of talk therapy sessions. Two types of psychotherapy that may be effective with adolescents with borderline personality disorder include dialectical behaviour therapy (DBT) and cognitive-behavioural therapy (CBT). The former helps individuals address negative habits, learn new skills, and discover coping mechanisms for intense negative emotions, while CBT can be helpful in teaching people to recognise and alter destructive thought patterns.

Medication

At The Wave, a mental health professional will carefully evaluate each individual’s condition upon arrival at our facility. Throughout their stay, we regularly assess their condition to make sure the treatment is appropriate and efficient. In some circumstances, medication can complement the other treatments we provide.

GROUP THERAPY

Group therapy is integrated into each young person’s recovery programme at The Wave. This treatment approach allows each individual to share, listen, offer support, find acceptance, and reflect. During these sessions, young people often discover a sense of community that helps them advance in their recovery.

We discuss a variety of general psychotherapy issues in group therapy. Although every session is unique, recurring topics include:

  • Challenging unhelpful self-talk
  • Taking control and care of the body
  • Communication with others
  • Relapse prevention

Reach Out Today

At The Wave, we understand that the needs of young people are unique and complex. Our mental health team is extensively trained in teenage personality disorders to deliver the highest standard of medical treatment. We include family members in the treatment process, ensuring loved ones are involved in the journey.

If your child is living with BPD and you have questions regarding our treatment options, please contact us today to find out how we can help.

Further reading can be found via our blog The Effects of Divorce on Children.

Fiona - The Wave Clinic

Fiona Yassin is the founder and clinical director at The Wave Clinic. She is a U.K. and International registered Psychotherapist and Accredited Clinical Supervisor (U.K. and UNCG).

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