Sarah has a reputation among her friends as being very impulsive. Her emotions are erratic and she can get easy to anger. She tends to flirt with the males in her class, often exhibiting promiscuity. She tends to believe that that having sex with men is the only way that she finds her sense of self-worth. Her relationships with some of these men have been abusive. But Sarah accepts this because of her belief in being a terrible person who deserves such treatment.
Sarah is only 17 years old. Although it is unusual to diagnose teens with a personality disorder, early signs of such disorders do exist in teens. For a long time, teens were seen as having personalities that were not yet stable and still developing. Therefore diagnosing a personality disorder for a teen was considered early, and instead other diagnoses were considered. However, when seeing these signs of personality disturbance, some clinicians today might diagnose an adolescent with the appropriate personality disorder, while other clinicians might keep the disorder in mind while watching his or her client over time.
Borderline Personality Disorder
Personality Disorders are those mental illnesses that include deep-seated and long-lasting character traits that cause distress or lead to harm of oneself or another. They are those that might impair a teen’s functioning in school, at home, or within relationships. Borderline Personality Disorder, specifically, is characterized with certain behaviors that are significantly harmful and is worthy of examination.
Teen Borderline Personality Disorder patients, like Sarah, will display the following patterns:
Avoiding real or imagined abandonment
One of the beliefs that a teen with BPD possesses is that he or she is worthy of abandonment. Or that he or she is worthy of rejection. At the same time, avoiding abandonment at all costs becomes necessary for survival. If the possibility of abandonment is present, a teen might make attempts at suicide, engage in self-harming behavior such as cutting, or manipulate the person whom they feel abandoned by in order to feel in control.
Having relationships that are unstable with significant idealization or devaluing
One of the defining traits of BPD is all or nothing thinking. A teen might see his or her best friend as being the most wonderful person in the world one day and then his or her worst enemy the next.
An inability to maintain a stable sense of self
This might be difficult to assess for an adolescent because this stage of life is defined as the time in life to discover a sense of self. However, a teen with BPD tendencies will exhibit signs of self-loathing, self-hatred, and an inability to be who they are among friends. For instance, they might act as “chameleons” taking on the traits of friends or peers they are with at the time. Although this might be seen as a way to work through this particular life stage, those with BPD have a difficult time recognizing who they are.
Dangerous and impulsive behavior
For an adolescent, the impulsivity that is common with BDP might be drug use, frequent experiences of unsafe sex, or running away from home. These behaviors are a way of managing challenging and unbearable emotions. For this reason, teens with BPD also commonly get a diagnoses of an eating disorder.
Adolescents with BPD might cut themselves as a way to manage anxiety or other overwhelming feelings. Although caregivers often see cutting and other self-harming behavior as a suicide attempt, clinicians know it’s a way of managing difficult feelings.
What characterizes Borderline Personality Disorder is the frequency of mood swings from depressive symptoms to those of mania.
Chronically feeling empty
a BPD teen often experiences this as loneliness or boredom. And with their impulsivity and dangerous behavior, which tends to arouse strong and intense feelings.
Inability to regulate feelings of anger
Fights are common with those who have BPD, especially with those close to them. However, anger is not the only emotion that becomes difficult to manage; any strong emotion can be overwhelming and challenging to regulate.
Signs of dissociation with reality
Many teens with BPD have experienced trauma and as a result have signs of dissociation. That is, they tend to divorce themselves from their emotional experience and/or an aspect of reality in order to find safety in the experience of life.
If you see these signs in someone you know, treatment is available. Both medication and psychotherapy combine to facilitate better functioning in adolescents with Borderline Personality Disorder.