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Written by:Bisma Anwar, MA, MSc, LMHC

Published On: June 27, 2022

Medically reviewed by: Minkyung Chung, MS, LMHC

Reviewed On: June 27, 2022

Updated On: July 5, 2023


Borderline personality disorder (BPD) in teens is a mental health condition that impacts how teenagers see themselves and others. It’s often associated with mood swings and low self-esteem and can result in self-harm. Disturbingly, BPD also has a higher-than-average risk of suicide.

Because of teens’ already consistent tendency towards mood swings and hormonal imbalance, it’s imperative to recognize the difference between “average” teen moods and behaviors, and the extreme emotional dysfunction that’s associated with borderline personality disorder in teens. We’re sharing everything you need to know to determine exactly that.

Signs and Symptoms of Teens with BPD

Borderline personality disorder can cause teens to see themselves in a distorted, negative light. The condition can make it difficult for them to develop a personality, which can leave teens overly reliant on others.

Common symptoms of BPD in teenage groups may include:

  • Unstable self-image: Teenagers with BPD may experience sudden shifts in values, goals, and identity. Low self-esteem is one of the more common BPD symptoms in teens. Many teenagers will feel as though they don’t have an identity at all.
  • Fear of rejection and abandonment: BPD can leave teens with a constant fear that they’ll be abandoned by others. They may go to extreme lengths to try to avoid rejection or abandonment.
  • Emotional dysregulation: It can be difficult for teenagers with BPD to control their emotions. This can lead to damaging outbursts and mood swings. They’ll often have extreme emotional responses to events and are particularly likely to struggle with anger.
  • Difficulties with personal relationships: Teens with BPD might develop intense personal relationships that are marked by instability. The way teens with BPD see others can shift rapidly, causing them to idolize someone in one moment and then see them negatively the next.
  • Compulsive behaviors: Borderline personality disorder can cause teens to engage in self-destructive or impulsive behaviors. They can feel a compulsion to take certain actions, even if they’re aware that their behaviors are negative. This can then cause intense feelings of guilt and shame.
  • Suicidal ideation and self-harming behavior: BPD puts teens at high risk for self-injury, thoughts of suicide, and suicide attempts. Repeated suicidal behavior is part of the diagnostic criteria for BPD.

“Symptoms of BPD in teens include fear of abandonment, self-harming behaviors, unstable moods, and substance use. Some signs that a teen may meet criteria for a BPD diagnosis are unstable relationships, angry outbursts, and defensiveness.”

Licensed Mental Health Counselor (LMHC), MA, MSc Bisma Anwar

What Causes BPD in Teens?

While we don’t fully understand what causes borderline personality disorder, research suggests that borderline personality disorder can be caused by multiple factors. Studies indicate that the condition has a heritability above 50%. Some research suggests that BPD is up to 5 times more likely to be diagnosed in someone who has a previous family member with the condition. Experts also believe that environmental and epigenetic factors may predispose teens to BDP, and neurological factors and brain structure abnormalities seem to be a potential cause as well.

Borderline personality in teens is also strongly linked to childhood trauma. While trauma doesn’t directly cause BPD, many teens with the condition have had a history of trauma. The trauma frequently involves physical and sexual abuse or emotional neglect.

“It’s hard to know the exact cause of BPD in teens, but there’s usually a combination of genetic and environmental factors. When teens report having an unstable childhood or trauma, then that can also contribute to having a BPD diagnosis.”

Licensed Mental Health Counselor (LMHC), MA, MSc Bisma Anwar

Symptoms of BPD in teenage patients often emerge during adolescence. Early intervention and treatment can be a determining factor in the success of helping teens learn to manage their symptoms, leading to more positive BPD treatment outcomes.

Statistics of BPD

Experts believe that between 0.9% and 3% of teenagers are affected by BPD. This is similar to the prevalence of BPD in the adult population. While BPD is more commonly diagnosed in women (up to 75% of diagnosed cases), the condition can impact both genders.

BPD often coexists with other mental health conditions (known as comorbidity), such as depression or anxiety. Approximately 20% of people with BPD also have bipolar disorder. These comorbidities can make BPD diagnosis challenging, which is why teens with BPD may initially be misdiagnosed when seeking treatment.

Borderline personality disorder in teens puts this age group at a substantially increased risk for suicidal behavior and self-harm. An estimated 70% of people with BPD will make at least one suicide attempt in their life, and 10% of those attempts will be successful. The risk of suicide increases with age, which makes early treatment even more important.

The prognosis for BPD is fairly positive, especially for teens who are diagnosed and begin treatment early on. A follow-up with people who were treated for BPD in adolescence found that more than 50% of subjects no longer met the diagnostic criteria for the condition after 2 years of successful treatment.

Treatment Options for Teens with BPD

BPD therapy options like dialectical behavioral therapy (DBT), cognitive behavioral therapy, mentalization-based treatment, and some self-help, holistic BPD treatment options like yoga and mindfulness have all been found effective to treat borderline personality disorder in teens, especially in conjunction with BPD medication.

DBT is designed to help teens break down patterns and behaviors and develop essential skills. With DBT, teens can gain more control over their emotions and avoid self-harming behaviors. The skill sets focused on in DBT include:

  • Emotion regulation
  • Mindfulness
  • Distress tolerance
  • Personal effectiveness

A family-based approach is increasingly becoming recommended to achieve the best outcome for dealing with BPD in teens. Not only can families help the young adult in their life, but many find that either in-person or online therapy is useful for them personally, too.

Dealing with borderline personality disorder can be taxing. It can create an extremely stressful home life environment. When families work together and participate in the healing process, everyone can benefit.

Support has long been acknowledged as an efficient and effective way to help somebody learn to manage symptoms of BPD. With an entire family behind them, teens can overcome their BPD traits and symptoms and manage their condition in incredibly healthy and positive ways. When it comes to how to help someone with BPD, simply just being there for them can go a long way.

While borderline personality disorder presents many challenges for teens, the right treatment can allow them to gain control over their emotions and behaviors. Teens with BPD often report feeling empty or hopeless in the beginning stages of their condition, but treatment therapy can help them lead a full, rich, and satisfying life.

See References

Bisma Anwar, MA, MSc, LMHC

Bisma Anwar is the Team Lead for the Talkspace Council of Mental Health Experts. A major focus in her work has been anxiety management and helping her clients develop healthy coping skills, reduce stress and prevent burnout. She serves on the board of a non-profit organization based in NYC called The Heal Collective which promotes advocacy and awareness of mental health issues in BIPOC communities.

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