Borderline Personality Disorder in Young People
No. 127; Updated October 2019
Young people may be moody and irritable at times. They may also feel sensitive to being left out. Learning how to regulate emotions is a normal part of growing up. For some teens these emotions can be more extreme and a sign of serious problems. If your teen is experiencing intense and frequent mood swings, impulsive behaviors, self-harm or difficulties in relationships, it could be due to a psychiatric condition called Borderline Personality Disorder (BPD).
Common signs of BPD include:
- Problems managing thoughts and feelings such as:
- Frequent dramatic mood swings
- Episodes of rage
- Feeling “empty” or “numb”
- Frequent changes in self image
- Suicidal thoughts
- Dangerous and Impulsive behaviors such as:
- Self-harm (e.g. cutting or burning oneself)
- Suicidal behaviors
- Unsafe sexual encounters
- Illegal drug use
- Problems in relationships such as:
- Poor boundaries
- Intense and unstable relationships
- Frantic efforts to avoid rejection or abandonment
- Feeling misunderstood
The exact causes of BPD are not known. Genetics and life experiences can contribute to the development of BPD. Some people with BPD have experienced abuse or trauma.
Research has demonstrated that the following psychotherapies are effective treatments for young people with BPD or traits of BPD:
- Dialectical Behavior Therapy (DBT) which teaches skills to manage symptoms
- Mentalization Based Treatment (MBT) which works on building trust and curiosity
A comprehensive treatment plan also may include:
- Parent and family treatment
- Peer and family support groups online or in-person
- Creation of a Crisis Plan that decreases the need to go to the emergency room or psychiatric hospital
- Medications to treat associated symptoms such as anxiety, depression and impulsivity
BPD can be challenging for young people and their families. With appropriate assessment and effective treatment, studies show that BPD can get much better over time.
If you think your teen has BPD, it is important to have a comprehensive assessment by a qualified mental health professional to determine if these thoughts and behaviors are due to typical teen development, BPD, or another psychiatric illness.
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