Borderline Personality Disorder in Teens: What You Need to Know

What is Borderline Personality Disorder?

Teens with borderline personality disorder (BPD) have particularly negative and distorted views of themselves, including a lack of self-worth.  This contributes to feelings of inadequacy, and makes it difficult to create and maintain relationships with other people. Borderline personality disorder also contributes to the likelihood a person will experience mood swings, emotional outbursts, or other unpredictable behaviors.

Symptoms of Teens with Borderline Personality Disorder

Teenagers with borderline personality disorder tend to behave in these ways in a compulsive manner, meaning while they may be aware of (and even feel guilty about) their behaviors, it feels impossible to behave differently.  Symptoms include feelings of guilt and/or shame, coupled with the inability to change behavior often results in increased self-loathing, and thus a vicious cycle ensues.

Additionally, borderline personality disorder can create more pervasive challenges for teens due their still-evolving personal identity.  It is common for the adolescent and teen years to be a time of self-discovery and identity exploration.  But for youth with BPD, the lack of a firm identity can create an over-dependence on other people.  Essentially, these teenagers can seem almost chameleon-esque, in that they attempt to take on (often subconsciously) behaviors, likes, dislikes, etc. of those around them.

Symptoms

Although borderline personality disorder affects every person differently, there are some very common symptoms when it comes to this psychiatric disorder in teenagers.

• Distorted self-image or identity – “identity disturbance,” or an unstable sense of self is listed as a diagnostic criterion for borderline personality disorder. Teenagers with BPD often describe having no idea who they are.  This is sometimes referred to as identity diffusion.
• Emotional outbursts – clinically referred to as emotional dysregulation, teens with BPD suffer from impaired emotional control and regularly experience excessive emotional responses, especially anger.
• Ongoing fear of abandonment and/or rejection – abandonment issues is one of the most widely experienced symptoms of borderline personality disorder in teenagers. With BPD comes a deep-seated and intense fear of being abandoned by those closest to the person.
• Difficulty experiencing empathy – research shows individuals with BPD have less activity in the areas of the brain that produce feelings of empathy. This is why teens with borderline have a difficult time understanding and/or predicting how those around them are feeling.
• Substance use/abuse – the relationship between borderline personality disorder and substance use is a dangerous one. Drugs and alcohol aggravate some of the most difficult BPD symptoms, like anger, rage, and depression.
• Unstable moods – teenagers with borderline personality disorder often experience volatile and intense mood swings. These tend to be long lasting and, many times come without any evident cause.
• Impulsive or risky behaviors – this includes behaviors that are harmful to self and/or others. Examples of impulsive or risky behavior are spending sprees, drug or alcohol use, self-injurious behaviors, physical aggression and impulsive sexual acts.
• Self-harm, suicidal thoughts and/or attempts – borderline personality disorder is the only psychiatric condition that includes self-injurious or suicidal behavior as part of the diagnostic criteria. This is because it is so common; 70% of people with BPD will make at least one suicide attempt, and unfortunately, 10% of those people will succeed.

Causes

The cause(s) of borderline personality disorder in teenagers is not fully understood, but experts indicate a combination of genetic and environmental factors.

Genetic factors

Many twin studies have been conducted in relation to borderline personality disorder, and result in the findings of a strong hereditary link.  Thus, there is no doubt a genetic link to BPD.  Adolescents and teenagers are five times more likely to have borderline personality disorder if there was a previous diagnosis in the family.

Neurological factors

Individuals with borderline personality disorder lack the brain capacity to inhibit negative or difficult emotions.  This means the part of the brain responsible for regulating and controlling emotions and impulses is often damaged in those with BPD.

Trauma

Teenagers who are diagnosed with borderline personality disorder frequently also have experienced a traumatic event, or have a history of childhood trauma.  The trauma is often related to physical or sexual abuse, neglect or abandonment, or extreme stress.  Yet, it is important to distinguish that while many teens with BPD report a traumatic past, most young people with a history of trauma are not diagnosed with BPD.             

Statistics

Borderline personality disorder affects approximately 1-3% of adolescents and teenagers.  BPD is more common in girls and women; about 75% of teenagers diagnosed with borderline are female.  It is important to note that, while adolescents and teenagers are diagnosed with borderline personality disorder, many mental health professionals are hesitant to assign the diagnosis to individuals under the age of 18.  Because of the reluctance to diagnose young people with BPD, it is under-recognized and under-diagnosed in this population.  Thus, statistics may not reflect the actual numbers regarding teenagers with borderline personality disorder.

Signs

If you suspect your teenager may have borderline personality disorder, there are certain indicators to look out for. 

Unstable relationships

teens with borderline personality disorder tend to have relationships with peers, friends, and family members that are very “up and down.”  This means that one day your child may describe his or her closest friend as the most wonderful person in the world, and the next day as his or her worst enemy.  This pattern of instability goes hand-in-hand with the very common all-or-nothing (black or white thinking) typical in BPD.

Expressing feeling empty

often experienced as loneliness and/or boredom, teens with borderline personality disorder often describe feeling “empty” or devoid of feeling.  This “emptiness” tends to spur young people to engage in impulsive or dangerous behavior, which can trigger intense feelings and emotions. 

Defensiveness

teenagers with borderline frequently feel a sense everyone is “against” them or thinks they are to blame.  This belief can cause defensive reactions and disdain toward others around them.

Distrust

a teen with an emerging personality disorder, such as BPD, regularly questions the motives of others.  This distrust, or suspicion of others generates a lot of stress, which can exacerbate other symptoms.

Anger outbursts

borderline personality disorder makes it hard for anyone to regulate their emotions.  And for teenagers with BPD, emotion regulation can feel impossible.  Anger is an emotion that goes from zero to ten very quickly, especially for those with BPD.  Thus, it is not uncommon to see these individuals fight with and lash out at those close to them.  Of course, anger is not the only emotion that is difficult to regulate for teens with BPD.

Dissociation with reality

because many adolescents and teens with BPD have a history of trauma, they may display signs of dissociation.  Dissociation is described as emotional “numbing,” and is a way people with borderline personality disorder establish emotional safety in their experience of life.  Without dissociating, many with BPD feel the emotions experienced are too big or overwhelming to cope with.

Although each of these early warning signs of borderline personality disorder can be associated with other emotional issues or psychiatric disorders, noticing several of them might indicate the presence of BPD.  It is vital these signs and symptoms are not ignored, or not just assumed to be part of a teenage “phase.”  Seek a professional opinion and have your teen properly assessed.

If you see signs of borderline personality disorder in your child, contact Polaris Teen at (844) 836-0222 to find out more about residential treatment options, programs and services.

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Polaris Teen Center is a residential treatment facility for teens and adolescents suffering from severe mental health disorders. Our highly accredited facility is fully licensed and certified in Trauma Informed Care and is a part of the Behavioral Health Association of Providers (formerly AATA).

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