Borderline personality disorder (BPD) is a mental health condition surrounded by debate. Although practitioners know a lot about BPD in adults, a question remains around whether it is appropriate to diagnose teenagers and young adults with BPD.
Teenagers and Borderline Personality Disorder
In the past, practitioners have been hesitant to diagnose teenagers with BPD as their personalities are still growing and developing. Personalities do not stabilise until a person is in their 20’s or 30’s; therefore, the thinking was that teenagers could not be diagnosed with a personality disorder until they were older.
However, adolescent borderline personality disorder is now recognised as an official diagnosis.[1] In some rare cases, practitioners can also diagnose a borderline personality disorder in children under 13.
Symptoms of BPD in teenagers are no different to those seen in adults. These can include:
- Extreme emotional reactions
- A persistent fear of abandonment
- Difficulty maintaining relationships
- Distorted self-image
- Impulsive and risky behaviours
- Dissociation
In some cases, it can be difficult to distinguish these symptoms from everyday teenage challenges. For those with BPD, it can be incredibly challenging and lead to many unhealthy behaviours.
Early diagnosis for BPD can help the future outlook for teenagers and young adults with the condition. As those with BPD can struggle with emotional regulation, early intervention can help them manage their behaviour before negative patterns become entrenched in their minds.
Risk-Taking
One of the symptoms of BPD in teenagers and young adults is impulsive and risky behaviour. It is normal for teenagers to take risks, but those with BPD can do so to cope with or hide their mental health struggles. Risky behaviour that those with BPD may undertake can include:
- Experimenting with drugs and alcohol
- Risky sexual behaviour
- Skipping school or work to party
Borderline Personality Disorder and Suicide
There is a strong link between BPD and suicidal ideation. Many teenagers struggling with BPD can often turn to self-harm to cope with their thoughts and feelings.
Statistics also show that around 10% of people with BPD die by suicide.[2] Therefore, it is essential to ensure that teenagers with BPD are diagnosed and have a safe environment where they can receive treatment.
Co-Occurring Disorders
Some young adults with BPD may be dealing with multiple mental health conditions alongside it. This may include:
- Post-traumatic stress disorder (PTSD) – One study found that more than 53% of people with BPD also had diagnosable PTSD.[3]
- Major depressive disorder (MDD) – People struggling with major depressive disorder can struggle with long periods of low mood, fatigue, and sleep issues which can also be symptoms of BPD.
- Anxiety – Young adults with BPD may face prolonged periods of anxiety alongside their condition.
It can also be common for young people showing symptoms of BPD to be misdiagnosed with another mental health condition or personality disorder. This is because the symptoms of BPD can overlap with the symptoms of other conditions such as bipolar disorder and major depressive disorder. This, in turn, can make it difficult for young people to receive the correct diagnosis and treatment.
If you feel that a diagnosis is wrong for yourself or your loved one, contact a mental health professional for a reassessment. A professional will consider symptoms and current treatment approaches and make recommendations to change treatment for the diagnosis if appropriate.
Causes of Borderline Personality Disorder
There is no one defined cause of BPD, but there are several factors that can influence whether a teen or young adult may be at risk of developing it:
- Genetics – studies have examined the links between BPD and family and found that children whose parents have a mental health condition including BPD, depression, and substance abuse, have a higher chance of developing BPD.[4]
- Trauma – young adults who struggle with BPD may have experienced some form of trauma in their childhood, such as abuse, neglect, or abandonment.
- Brain differences – abnormalities in the brain can cause BPD. One study found that those with BPD often have changes in areas of the brain associated with inhibiting negative emotions.
Treating BPD
The prognosis for young adults and teenagers with BPD is primarily favourable. Symptoms gradually decline with age, and in teens, the remission rate could be as high as 65%. However, it is vital that young adults receive treatment for BPD, as without it, they may be at risk of self-harm and suicidal tendencies. Therapy for young adults with BPD include:
- Cognitive-behavioural Therapy (CBT) – CBT can help those with BPD to recognise their negative thoughts and provide them with the tools to change them.
- Dialectical-behavioural Therapy (DBT) – One of the primary uses of DBT is to help those with BPD address their destructive and impulsive behaviours and find new ways to deal with them. DBT has also been adapted especially for adolescents (DBT-A).
- Art Therapy – Incorporating art therapy into treatment for BPD can help relieve psychological distress and works well in conjunction with psychotherapy such as CBT or DBT.
- Medication – Although there is no medication primarily for BPD, anti-anxiety medicines, second-generation antipsychotics, and antidepressants can effectively treat specific symptoms.
There is no generic treatment for BPD. Each young adult will respond differently to treatment, and a personalised approach should be taken for each individual. At The Wave, we tailor all of our treatment plans for borderline personality disorder to meet the needs of every young adult who comes to us. Our twenty-four-hour onsite nursing team is on hand to provide treatment that matches exactly what our clients require at any given time.
Conclusion
Teenagers and young adults can be diagnosed with borderline personality disorder before turning 18. Many practitioners now believe that the earlier BPD can be diagnosed, the better the outcomes for treatment are, as early intervention can prevent unhealthy habits from forming.
Treatment for BPD can help young adults manage their symptoms and live a happy, healthy life. At The Wave, we provide comprehensive treatment for BPD at our luxurious treatment centre situated in stunning Malaysia. For more information about our treatment plans and approaches, contact our team of specialists today.
Sources:
[1] Biskin RS. The lifetime course of borderline personality disorder. Can J Psychiatry. 2015;60(7):303–308. doi:10.1177/070674371506000702
[2] Paris, Joel. “Suicidality in Borderline Personality Disorder.” Medicina (Kaunas, Lithuania) vol. 55,6 223. 28 May. 2019, doi:10.3390/medicina55060223
[3] Scheiderer, Emily M et al. “The comorbidity of borderline personality disorder and posttraumatic stress disorder: revisiting the prevalence and associations in a general population sample.” Borderline personality disorder and emotion dysregulation vol. 2 11. 24 Jul. 2015, doi:10.1186/s40479-015-0032-y
[4] 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
Fiona Yassin is the International Clinical Director of The Wave Clinic. Fiona is a UK Registered Adolescent and Family Psychotherapist and Clinical Supervisor (Licence number #361609 NCP/ICP), further trained in the specialty of Eating Disorders and Borderline Personality Disorder Treatment. Fiona is trained in FBT (Family Based Therapy), CBTE for eating disorders, FREED (King’s College, London), EMDR for eating disorders (EMDRIA) and has a Post-Graduate Diploma in Neuroscience and Trauma from the University of Tennessee, Knoxville.
Fiona works with international families and family offices from the UK, Dubai, Kuwait, Singapore and Malaysia. Fiona can be contacted by email on fiona@thewaveclinic.com.
