The Prejudice Against Teen Borderline Personality Disorder

Parents and caregivers should know that some clinicians may be resistant to diagnose a teen with Borderline Personality Disorder. A personality disorder is an illness that contains psychological patterns that have become woven into a person’s personality, and therefore are hard to change. On the whole, when a person has a personality disorder, treatment often feels ineffective.

Ineffective treatment may be one reason why mental health providers might want to stay away from this psychological disorder. However, another primary reason why clinicians are resistant to diagnosing teens with Borderline Personality Disorder (BPD), or other personality disorders, is because a teen’s personality is still developing. Clinicians might feel that it’s too early to diagnose BPD and that it may be worthwhile for a teen to continue to develop.

However, more recent studies indicate that adults who have BPD report that they began to experience their symptoms in adolescence. Typical symptoms of BPD can be severe and impact almost every aspect of a teen’s life. Here are some common experiences that BPD teens have:

  • extreme reactions, such as panic, rage, or frantic behavior
  • swinging from idealization to devaluation of others.
  • avoiding real or imagined abandonment
  • an inability to maintain a stable sense of self
  • dangerous and impulsive behavior
  • self-harming behavior
  • mood instability
  • chronically feeling empty
  • inability to regulate overwhelming feelings
  • signs of dissociation with reality
  • paranoia
  • frequent suicidal behavior
  • profound sense of hopelessness
  • self‐hatred
  • difficulty in consistently performing at school despite cognitive ability
  • often feel misunderstood or that they don’t feel they deserve to be understood
  • highly attuned to non‐verbal communication
  • highly susceptible to others emotions

Because adults with BPD say that they began experiencing symptoms as teens, this could be an indication that adolescence may be the precise stage in which to begin treatment. In fact, there are effective treatment methods if parents, caregivers, and teens are willing to be patient and accepting of where a teen is in their life. Over time, teens can learn to manage their symptoms.

Today, experts have learned that BPD usually emerges during adolescence and is estimated to affect 0.9% to 3% of teens and up to 3.5% of young adults. Of those teens who are hospitalized or who become patients of a residential treatment center, the occurrence rises to 49% in adolescents and 42% in young adults.

If a parent can find the right mental health provider, a teen can indeed benefit from treatment. In fact, sometimes waiting to treat BPD can prove to be a problem. For instance, waiting until a teen is an adult to see if any symptoms change can actually contribute to functional impairment and complications that have become entrenched in a teen’s life.

Because clinicians often consider it controversial to diagnose personality disorders (PDs) in adolescents, a parent might have a hard time finding the right therapist, psychologist, or psychiatrist. Furthermore, the prejudice against BPD teens also exists because treating adolescents with BPD can cause considerable stress and strong emotions in clinicians.

Sadly, adolescents with BPD often struggle with interpersonal relationships – including with therapists –and may find it difficult to engage in therapy. However, for those clinicians who are willing to hang in there, there can be success.  And if teens and parents are willing to do whatever they can to stay engaged in treatment, symptoms may change over time.