Signs Of Borderline Personality Disorder In Child, And Tips

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Children experience emotional outbursts and impulsiveness occasionally. But if that happens too often, it may be due to a borderline personality disorder (BPD). Borderline personality disorder in children is a mental health problem characterized by extreme emotions, impulsive behavior, emotional dysregulation, and severe problems with self-worth, which makes maintaining long, stable, and strong relations with others difficult (1). Most often, the signs and symptoms of BPD appear in childhood, but the condition becomes prominent only during teenage or adulthood.

Read on as we tell you about the signs, causes, diagnosis, and treatment of BPD in children.

Causes And Risk Factors Of BPD

The exact cause of BPD is unknown. Problems with chemicals in the brain responsible for mood regulation might trigger the development of BPD (1).

The following factors may put a child at a higher risk of developing BPD (2).

• It may run in the family.
• It is more common in children with a natural tendency to get upset easily.
• Growing in a household where children do not receive enough support and training to handle their big emotions.

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• It might be more common in children who might have experienced childhood trauma such as physical, emotional, or sexual abuse, neglect, or loss of a parent or had attachment difficulties with parents.

Research finds

A small study on 500 college students found that BPD symptoms were related to internet addiction severity (8).

Symptoms Of BPD

Some mood swings and behavior changes are normal and happen with everyone. But for people with BPD, these problems are severe, repetitive, and may cause a disturbance with routine life. Some common symptoms of BPD include (1) (2).

• Intense emotions and mood swings
• Substance use
• Binge eating

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• Spending a lot of money
• Trouble maintaining relationships
• Risky sexual behavior
• Behavioral issues
• Rash driving
• Low self-worth
• A severe feeling of being left alone
• Aggressive behavior
• May judge other people as only ‘good’ or ‘bad’ and no in-between. May also shift from one viewpoint to the other suddenly.

The following symptoms may also be seen-

• Feeling empty inside
• Anger issues
• Violent tantrums
• Self-harm
• Suicidal thoughts or attempts
• Episodes of paranoia
• Episodes of psychosis (inability to distinguish between real and imaginary)
• Brief but intense episodes of anxiety and depression

Complications Of BPD

People with BPD may also have other mental illnesses, such as depression, bipolar disorder, and attention-deficit hyperactivity disorder (ADHD), substance use disorder, or eating disorders. The children might have repeated emotional crises. They may develop promiscuous behavior as adolescents. Children with BPD may also have suicidal tendencies (2) (3).

Trishna Saikia, a blogger, shares about her Border Personality Disorder (BPD) and the complications it causes. She writes, “Being diagnosed with Borderline Personality Disorder has suddenly pushed me into a pool of déjà vu… I was scared. I cried for days. I asked my parents if they would abandon me too. And slowly as I learnt about the disorder all my actions started making sense for me… I am often surprised by how easily I get overwhelmed by the slightest of trigger. I do not have a handle on how I might react to a certain incident. Sorrow, anger, irritation and frustration are my best buddies. Something as simple as a taunt activates something painful inside. I never seem to forget that incident or forgive that person. I do not understand moderation, so any emotional expression is extremely intense and painful (i).”

Diagnosis Of BPD In Children

There are no specific blood tests or brain scans to diagnose bipolar disorder in children. However, the healthcare provider may advise these tests to rule out other conditions. A pediatrician and child psychologist will thoroughly analyze your child’s symptoms to arrive at a BPD diagnosis. To be diagnosed with BPD, the child must exhibit at least five of the symptoms mentioned above before reaching adolescence (2).

Quick fact

Studies suggest that the prevalence of BPD in adolescents is around three percent (9).

Treatment Of BPD In Children

The treatment of BPD can be a little difficult, and it is not uncommon for the symptoms to return. Moreover, children with this psychological condition may also have disturbed relationships with their counselors and doctors. However, the treatment is long and eventually helps reduce the symptoms, avoid harmful behaviors, and help your children manage their emotions better. The treatment may include one or a combination of the following (1).

• Counseling and therapy

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A counselor plays a vital role in treating BPD in children. However, children with BPD may like their counselor one day and may hate them the other day. The children may develop more hatred for them, especially when the counselor asks them to change their behavior. A counselor specializing in dialectical behavior therapy (DBT) can be instrumental in treating this condition.

• Medications

Antidepressants, anti-anxiety medicines, mood stabilizers, and low-dose antipsychotics in combination with counseling and therapy can help treat BPD in children.

• Healthy habits

Sufficient sleep, healthy diet, regular exercise, and abstinence from drugs and alcohol can help reduce stress and anxiety. It reduces the frequency and intensity of symptoms of BPD in children.

Point to consider

DBT emphasizes skill sets, such as mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance (10)

Ways That Help A Child Cope With BPD

The following tips may help you support your child with BPD.

• Be patient and non-judgmental.
• Promote a calm environment at home.

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• Design strategies to control impulsivity.
• Help your child develop better interpersonal skills.
• Encourage your child to indulge in activities such as meditation, deep breathing, yoga, and relaxation techniques. You can do it with your child as a team.

• Exhibit and demonstrate love and support.
• Educate yourself about BPD.
• Lower your expectations and set realistic goals.
• Validate their emotions.
• Speak to the child honestly.
• It is difficult, but try not to lose your calm.
• Talk to them in clear, straightforward language. Also, be mindful of your nonverbal communication such as gestures, facial expressions, body language, etc.
• Be alert and aware of any signs of suicidal behavior.
• Make a daily schedule and stick to it.
• Encourage a healthy lifestyle and diet.

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• Be consistent with their appointments with the therapist.
• Ensure regular consumption of the prescribed medicines and no dose is missed.
• The school, teachers, coaches, and other caregivers should be informed and kept in the loop about the treatment. All of you should be on the same page regarding the child’s care.
• Talk about the child’s condition to their siblings and explain how they can help in empowering the child.
• If there are any other accompanying medical conditions such as a mental disorder, cardiac conditions, and learning disabilities, ensure they are monitored well and take all their medications properly.
• Keep an eye on any new and sudden changes in their dressing style, behavior, choice of friends, routine, etc.

Infographic: Managing Borderline Personality Disorder

A child with borderline personality disorder may experience overwhelming emotions. Teaching them to manage their emotions will make them more aware of their condition and develop better coping skills. This infographic enlists some self-help techniques for children with borderline personality disorder.

Illustration: Momjunction Design Team

Image: Stable Diffusion/MomJunction Design Team

Watch this video through a mother’s eyes, offering a firsthand perspective on coping with a child diagnosed with Borderline Personality Disorder. Grasp insights into navigating emotions and fostering acceptance in the face of this mental health challenge.

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Dr. Neha Bhave SalankarMD

Dr. Neha Bhave Salankar is a consultant psychiatrist at Bhave Institute of Mental Health based in Nagpur and has around 11 years of experience in the field. Having been a meritorious student throughout, she bagged the prestigious gold medal for medicine in MBBS and MD psychiatry. She also took training in Child and Adolescent Psychiatry at National Institute of Mental...more

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Rebecca MalachiBSc

Rebecca is a pregnancy writer and editor with a passion for delivering research-based and engaging content in areas of fertility, pregnancy, birth, and post-pregnancy. She did her graduation in Biotechnology and Genetics from Loyola Academy, Osmania University and obtained a certification in ‘Nutrition and Lifestyle in Pregnancy’ from Ludwig Maximilian University of Munich (LMU). She has been into health and...more

Apoorva KMSc (Counseling Psychology)

Apoorva is a certified psychological counselor and NLP practitioner. The assistant professor-turned-writer believes that her experience as a teacher, psychologist, and researcher enables her to guide MomJunction readers on child development and mental health. Apoorva did her post-graduation in Counseling Psychology from Madras School of Social Work, India. She also holds certifications in Psychological Counselling and Therapeutic Techniques and as...more