Teenagers and Borderline Personality Disorder

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Along with depression, anxiety and bipolar disorder, borderline personality disorder (BPD) is one of the most common (and most serious) mental health issues facing teenagers in the United States.

The symptoms of the BPD are wildly erratic, causing its victims to alternately jump from extreme emotion to extreme emotion, usually without warning and little provocation.

According to the Diagnostic and Statistic Manual of Mental Disorders IV (DSM-IV), borderline personality disorder is defined as a persistent pattern of instability in a patient’s life in relation to interpersonal relationships and self-image and characterized by impulsive responses to minor events. The signs of the disorder can begin to show during the teen years in a number of different ways, creating problems for teenagers at school, home, work and out in the community. Some of the most common signs include:

  • Unstable sense of self
  • Focus on real or imagined abandonment, separation or rejection
  • Sensitive to environmental circumstances
  • Inappropriate anger when confronted with reasonable, finite separation periods or unavoidable changes to schedule or circumstance
  • Belief that changes indicate abandonment or that they have failed in some way
  • Intolerant of being alone
  • Self-mutilation or suicidal tendencies
  • Feelings of emptiness
  • Impulsive in relation to at least two of the following: shopping, drugs and alcohol, sex, driving or binge eating
  • Pattern of volatile and intense interpersonal relationships defined first by idealization then devaluation

Do these issues plague your teenager? If you believe that your teen is struggling with borderline personality disorder, it’s important to take the necessary steps to get your child the help that he or she needs to learn how to live a balanced and functional life despite the disorder. Medication, Cognitive Behavioral Therapy (CBT), family counseling and more are available to treat teens on an inpatient or outpatient basis. Contact us at Newport Academy today to learn more.

Borderline Personality Disorder Statistics

According to the Borderline Personality Disorder Center, BPD affects between six and 10 million Americans or between two and six percent of the population. About 10 percent of those who are in outpatient mental health care and 20 percent of inpatient psychiatric patients are in treatment for borderline personality disorder. About 75 to 90 percent of those living with borderline personality disorder are women, which may mean that more women than men suffer from the disorder or that women more often seek treatment for the issue than do men.

Treatment has been proven to be effective for those living with BPD. A number of different types of therapies, support groups and educational classes have worked for a number of patients in addition to medication.

A good prognosis is indicated when the patient receives early intervention and treatment then follows through on their care.

Identifying Borderline Personality Disorder in Teens

Teenage girls are the demographic considered to have the highest risk for developing borderline personality disorder, although the condition does strike a small percentage of boys as well. The characteristics of the disorder as defined by the DSM-IV above are not always easy to spot in teens. However, parents who suspect that their child may have borderline personality disorder should watch for the following signs and symptoms of the condition:

  • Reckless behavior, such as driving too fast or having unsafe sex with multiple partners
  • Suicidal thoughts
  • Self-harming behavior
  • Intense bursts of anxiety or depression
  • An inability to control one’s emotions
  • An inability to maintain personal relationships

See Related: Symptoms of Teen Drug Abuse


The Connection Between Childhood ADHD and Teenage Borderline Personality Disorder

ADHD and Personality DisordersDifferent types of childhood or persistent ADHD have been linked to the development of a number of personality and social disorders in teenage years and adulthood. According to a number of studies including one published in the Journal of Clinical Psychiatry, 2008 September; 69(9):1477-1484, there is an abiding connection between the diagnosis of childhood ADHD between the ages of 7 and 11 and a diagnosis during the teen years of borderline personality disorder. About 13 percent of those in the 2008 study with a childhood diagnosis of ADHD were later diagnosed with BPD in adolescence. In some cases, symptoms of borderline personality disorder, like instability and impulsivity in mood, behavior and relationships, are evidenced in teens who had a diagnosis for ADHD in childhood but without a formal BPD diagnosis.

At what age symptoms of BPD begin to develop in those who will develop the disorder, the prognosis and effective treatments are still being studied when ADHD is or was an issue for the patient.

Self-Mutilation and Suicidal Tendencies Among Teens With BPD

The Borderline Personality Disorder Center reports that one in 10 patients living with borderline personality disorder will commit suicide, and about 33 percent of teenagers who commit suicide exhibit symptoms of the disorder. When compared to the general population, this number is about 400 percent higher, and teenage girls and young women diagnosed with BPD are 800 times more likely to commit suicide. Self-mutilation, too, is a significant issue among borderline personality disorder patients; many teens cut themselves with razors or knives, leaving behind serious scars and risking death.

The good news is that both self-mutilation and suicidal tendencies are treatable at teen borderline personality disorder rehab centers. According to the National Institute of Mental Health, dialectical behavior therapy has been shown to cut the number of suicide attempts among patients diagnosed with BPD in half when compared to the results of other treatments and therapies.

Currently, clinical trials are underway to determine the best course of treatment for those struggling with borderline personality disorder.

Prozac, guanficine, selective serotonin reuptake inhibitors (SSRIs), Seroquel, topiramate, omega-3 fatty acids and Oxytocin are all being explored as options – both alone and in combination with dialectical behavior therapy.

Sexual Activity Among Teens Diagnosed With BPD

Sexual Activity and Personality DisorderImpulsivity in word and action is one of the hallmarks of teen borderline personality disorder. Impulsive choices in relation to driving, shopping, and drug and alcohol abuse are common among teens with BPD. Additionally, choices in relation to sexual behaviors are also an indicator of the disorder, according to a study published in Innovative Clinical Neuroscience, 2011 February; 8(2):14-18. Some of the signs of sexual impulsivity that can characterize BPD among teens include:

  • Preoccupation with sex and sexual behavior
  • Early sexual experiences
  • Casual relationships that are based primarily upon sexual attraction
  • Multiple sexual partners
  • Promiscuity

Teens who are diagnosed with BPD are more likely to engage in high-risk sexual activities including unprotected sex, to be the victims of sexual abuse, to contract sexually transmitted diseases, and/or to be coerced into sexual activities.

If your teen exhibits these behaviors, it is important to share them with your child’s medical team when they begin treatment for borderline personality disorder.

There may be health issues that will require immediate treatment and it can indicate the potential for the development of issues along this same line during inpatient treatment, which will require extra monitoring and care.

Diagnosing Borderline Personality Disorder Among Teens

The difficulty in diagnosing a teenager with BPD is that some of the symptoms can be construed as normal teen growing pains and experimental behaviors. It is important to take your child to a psychiatric professional trained in the diagnosis of mood and behavior disorders to determine if a BPD diagnosis is present in your teen. According to a paper on practical differential diagnosis among those with bipolar disorder, depression, ADHD and BPD by Kernberg and Yeomans, identifying borderline personality disorder among teens means looking for:

  • Symptoms of depression
  • Suicidal tendencies or cutting
  • Cognitive ability and function
  • Manic or hypomanic episodes
  • Quality of relationships with friends and family members
  • Drug and alcohol abuse
  • Sexual activity and proclivities

The more thorough the diagnostic and evaluation process, the more likely it is that your teen will receive the comprehensive treatment that he or she needs to make real progress in BPD treatment.

How Parents Can Prepare Their Teen for Treatment

Once it has been determined that your teenager does indeed have borderline personality disorder, parents should consider taking the following steps to help their child adapt and cope:

  • Improve communication. Parents of a BPD child must set aside their fears and preoccupation with the sometimes intimidating symptoms of the illness, and reach out to the child with greater caring and communication.
  • Help them defend against self-destructive behaviors. Watching out for some of the more physically endangering signs of BPD can help you identify areas of concern for your child and potentially help them to limit these behaviors and protect themselves.
  • Learn about the teen’s stressors. Once a line of communication has been opened, parents can begin to learn more about the sources of stress and anxiety in their child’s life that may be worsening BPD.
  • Call 911 if necessary. If your teen attempts suicide or cuts himself dangerously, call 911 for medical treatment immediately.
  • Seek professional treatment. Teenagers with BPD can be a danger to themselves and others. It is therefore important to get the child into treatment as soon as possible. Communication shows that you love them and helps you learn about the root causes of their condition but it is professional treatment that will really turn things around.

Treatment Options for Teens

The first step in treatment for teens diagnosed with borderline personality disorder after a full and comprehensive diagnosis is outpatient treatment.

Multiple group therapy and one-on-one therapy sessions are the first step, but if this therapy is interrupted for any reason or if suicide attempts or physical self-harm becomes or remains an issue, then it may be necessary to enroll in an inpatient borderline personality disorder treatment program where treatment is comprehensive and round-the-clock monitoring is available to ensure the safety of patients.
The prognosis for BPD patients is good in most cases. According to a study of patients done at Columbia Psychiatric Institute, about 75 percent of patients treated were supporting themselves and doing well after recovery and 40 percent were considered clinically recovered. The ones who were the most successful after treatment engaged in extended psychotherapy for many years.

Therapy and Teen BPD Treatment

There are a number of different therapies that have been proven effective in the treatment of teens diagnosed with BPD. Group sessions and personal psychotherapy sessions have both been shown to be beneficial to a limited extent, especially when repeated two to three times per week. Learning about how the disorder works in the body, how to handle the impulses, and deciphering the symptoms of paranoia from reality can help the patient to better manage anger, frustration and loneliness. Some other therapies that have been proven effective in the care of teens with BPD include:

Medication and Teen BPD

Depending upon the symptoms that your teen exhibits, different medications may be more or less appropriate.

Medication is often a part of both inpatient and outpatient teen BPD treatment and can be an effective choice for comprehensive care. According to BPD Resource Center, antidepressant medications or mood stabilizers can help when a major issue is depression or mood swings. Antipsychotics may help mitigate the issues of mistaken perceptions and/or anxiety when prescribed in low doses. Low doses of neuroleptic drugs most often prescribed to schizophrenics may help BPD patients fight stress associated with their symptoms. Certain tranquilizers and sedatives are rarely used because they are highly addictive and can create the new issue of drug addiction.

A thorough medical evaluation will help your teen’s medical team determine which, if any, medications are appropriate for treatment.

Borderline Personality Disorder Treatment for Teens at Newport Academy

Newport Academy offers treatment and care for young people suffering from borderline personality disorder. Left untreated, BPD can be a debilitating disease for the individual and his or her family. At Newport Academy, we provide more than just advanced treatment methods, we offer real hope for families who want nothing more than to get their lives back. Contact Newport Academy today for more information about teen borderline personality disorder treatment and the next best step for your family.