Symptoms Of Borderline Personality Disorder in Teenagers

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Borderline personality disorder or BPD in teens is a serious mental illness that may result in unhealthy relationships. It is characterized by moody, irritable, and unstable behaviors. This disorder may affect a teen’s overall well-being by causing low self-esteem, self-doubt, self-image issues, difficulty controlling emotions, and fear of abandonment.

Teens who experience BPD are also at a higher risk of falling prey to substance abuse, anxiety disorders, depression, and eating disorders. Read on to know the causes, risk factors, treatment, complications, and prognosis of BPD in teens.

Causes And Risk Factors For Borderline Personality Disorder In Teens

While the definite causes of BPD are not known, experts believe that a combination of the following factors can cause or increase the risk for BPD in teens.

  • Genetic factors: Although there is no concrete evidence that proves that a specific gene causes BPD, preliminary research done on twins suggests that the genes inherited from parents may make a child more vulnerable to developing BPD.
  • Neurological factors: Studies have shown that teens suffering from BPD have abnormities and damages in the structure of the brain area that regulates emotions and impulses.
  • Traumatic history: Most teenagers with BPD have a history of some form of major trauma. Usually, when children face physical or sexual abuse or experience trauma in the form of abandonment or adversities in their childhood, they tend to develop symptoms of BPD as they enter their teens.

Symptoms Of Borderline Personality Disorder In Teens

The following are some signs and symptoms encapsulated in the Diagnostic And Statistical Manual Of Mental Disorders (DSM IV). If your teen experiences at least five of the symptoms given below, it could indicate BPD.

  • Feelings of emptiness or boredom
  • Inability to comprehend an unusual feeling of void
  • Intense fear of being abandoned
  • Impulsive and dangerous behaviors such as harsh driving, extravagant spending, binge drinking, and substance abuse
  • Self-harming behavior, such as cutting, burning, or punching themselves
  • Suicidal tendencies
  • Going through intense mood swings and displaying highly emotional and dramatic behavior
  • Low self-worth and low self-esteem at a level that even the smallest challenges that come their way overwhelm them
  • Severe temper tantrums and uncontrollable anger issues.

Complications Of BPD

BPD is a complex mental condition that can cause the following complications.

  • Inefficiency towards education
  • Getting involved in illegal matters
  • Stressful relationships
  • Indulging in self-harm
  • Getting into unnecessary fights due to impulsive behavior
  • Getting involved in accidents
  • Suicidal thoughts and attempts
  • Substance abuse
  • Eating disorders

Besides these complications, teens may also have other mental disorders such as depression, attention-deficit/hyperactivity disorder, bipolar disorder, post-traumatic stress disorder, and other personality disorders.

Diagnosis Of Borderline Personality Disorder

The diagnosis of BPD can be challenging as the symptoms may be similar to those of other mood disorders. However, a psychologist or psychiatrist can help you with the diagnosis based on the following.

  • A detailed one-on-one session where the doctor is given the opportunity to interview the child
  • An in-depth psychological evaluation through questionnaires
  • An evaluation of the child’s medical history followed by an examination

Treatment For Borderline Personality Disorder In Teens

Although there is no definitive cure for BPD, it is treatable. These treatment methods could help reduce the severity of the symptoms of BPD in teens.


Different types of psychotherapy, including cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), may be effective in treating teenagers going through BPD.

  • CBT: Cognitive behavioral therapy can help a child understand the need to recognize and change their pessimistic thoughts that add to the symptoms of BPD. CBT treatment usually involves strategies that include
  • Recognizing one’s thinking process and identifying the thoughts that cause problems.
  • Making an effort to gain a deeper understanding of others.
  • Coping with difficult situations with the use of effective problem-solving skills.
  • Learning how to appreciate themselves and believe in their abilities.
  • DBT: Dialectical behavioral therapy helps children find new ways of coping with distress and unpleasant emotions. It is a comprehensive treatment that can help the child manage self-destructive behavior, regulate their emotions, and improve relationships and self-esteem.


A few medications may help treat specific symptoms such as mood swings and depression.

  • Second-generation antipsychotics come in handy while managing suicide risk.
  • Anti-anxiety medications are prescribed on a short-term basis to manage some symptoms such as intense anxiety and agitation associated with BPD.

In the case of severe symptoms, the child may require hospitalization to prevent them from causing self-injury.

Is Bipolar Disorder Preventable?

Since there is no definite cause of BPD, a structured formula to prevent the mental condition does not exist. Some of the steps that you can follow to decrease risk factors and triggers include validating their emotions, organizing a stable routine, being available for your child, promoting positive behavior, giving them the support they need, and being patient.

Since there is no one way to prevent BPD, early detection of co-occurring mental illnesses, such as depression, may help diagnose and treat BPD at the earliest possible stage. This may be of immense help in changing the course of the disorder.

Prognosis Of BPD In Teenagers

Based on a review published in The Canadian Journal of Psychiatry, the remission rate of BPD in teenagers varies from 50% to 65%. With proper care and treatment, most teenagers with BPD can learn to manage their symptoms.

Although the etiology of BPD in teens is unknown, genetic factors, neurological issues, and traumatic experiences may play a role in its development. Your teen may experience emptiness or boredom, have temper tantrums, or be unable to explain their feelings. Teens with BPD usually respond well to psychotherapy and medication, and early diagnosis can help in improving the child’s quality of life. Hence, instead of ignoring your child’s symptoms, schedule an appointment with a psychologist or psychiatrist. Along with the assistance of professionals, they need your love and care to manage and control their symptoms.

Key Pointers

  • BPD in children is a complex psychiatric condition with unknown etiology.
  • Traumatic history and neurological and genetic factors can cause or raise its risk.
  • The Diagnostic And Statistical Manual Of Mental Disorders (DSM IV) lists several symptoms, out of which if a child exhibits any five, it could indicate BPD.
  • Although there’s no definite cure for the condition, prompt diagnosis and treatment are vital to avert complications, such as depression.
  • BPD can’t be prevented, but controlling triggers and risk factors could improve symptoms and avoid complications.


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Dr. Supriya Mahajan

Dr. Supriya Mahajan is a pediatrician and pediatric hepatologist with nine years of experience. She completed her MBBS from Shyam Shah Medical College and diploma from the National Board of Education, New Delhi. She went on to gain specialization in the gut and liver-related diseases in children from the Institute of Liver and Biliary Sciences and MRCPCH 1, 2 from... more

Manjari Srivastava

Manjari Srivastava is a graduate of psychology. She also holds certificates in Basics In Clinical Psychology and Identifying Early Signs Of Psychosis In Adolescents And Young Adults.  Previously, she volunteered with an NGO specializing in positive psychology, where she took up individual counseling sessions for students. She also taught English to underprivileged children and helped them with their studies. At MomJunction,... more