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 that features extreme emotions, impulsive behavior, 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.
A risk factor for borderline personality disorder in children

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  • Children who might have experienced childhood trauma such as physical, emotional, or sexual abuse, neglect, or loss of a parent.

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
A symptom of borderline personality disorder in children is binge eating

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  • Spending a lot of money
  • Trouble maintaining relationships
  • Risky sexual behavior
  • 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 health disorders such as depression, bipolar disorder, 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).

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).

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 BPD 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
Counselor plays a vital role in treating BPD in kids

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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.

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.
Give children a pleasant 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.
A healthy lifestyle can help manage BPD

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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.

Frequently Asked Questions

1. At what age does BPD develop?

According to experts, BPD can be diagnosed as early as 12 years if the child displays specific symptoms of BPD and the symptoms last for at least a year (4). However, in most cases, doctors don’t diagnose individuals under 18 years of age with BPD (5).

2. Does BPD ever go away?

BPD isn’t completely curable but is treatable. Research shows that symptoms of BPD reduce or reduce in intensity with age, and with proper treatment, several people see a marked improvement in their condition (6).

3. Are people with BPD aware of their behavior?

Yes. People with BPD are aware of their behavior and its consequences (7). Yet, they behave erratically due to their fluctuating mood and emotions.

Borderline personality disorder in children may alter their routine and impact their social interactions and quality of life to a considerable extent. Although the condition can be treated, it may take time to spot noticeable improvement in your child. Therefore, it is essential to maintain patience and be determined to attain positive results following the treatment of BPD. Furthermore, for some parents, the diagnosis of BPD in a child could be overwhelming. You may seek help from online or local support groups in such scenarios. Consult your child’s doctor if you notice any abnormal behaviors (especially suicidal thoughts or attempts) in your children.

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.

activities to manage borderline personality disorder in children [infographic]
Illustration: MomJunction Design Team

Key Pointers

  • Intense mood swings, binge-eating, and substance abuse could be signs of borderline personality disorder (BPD) in children.
  • A psychologist may study the child’s behavioral patterns to diagnose BPD.
  • The treatment may include medication, counseling, and lifestyle changes such as eating healthy food and exercising.
  • To assist a child with BPD, be patient, talk to them in a straightforward manner, and be consistent with their appointments.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
  1. Borderline Personality Disorder
    https://www.mottchildren.org/health-library/ty6802
  2. Quick Guide to Borderline Personality Disorder
    https://childmind.org/guide/quick-guide-borderline-personality-teens-young-adults/
  3. Childhood Disorder
    https://www.momjunction.com/articles/childhood-disorders-types-causes-symptoms-treatment_00789762/
  4. Development and course of BPD.
    https://www.borderlineintheact.org.au/living-with-bpd/development-and-course-of-bpd/
  5. Borderline Personality Disorder (BPD).
    https://my.clevelandclinic.org/health/diseases/9762-borderline-personality-disorder-bpd
  6. Borderline Personality Disorder.
    https://www.health.harvard.edu/a_to_z/borderline-personality-disorder-a-to-z
  7. Dorina Winter et al.; (2015); Can’t stand the look in the mirror? Self-awareness avoidance in borderline personality disorder.
    https://bpded.biomedcentral.com/articles/10.1186/s40479-015-0034-9
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Dr. Ritika Shah

Dr. Ritika Shah is a certified lactation counsellor (CLC) from iNational Health Care Academy, Singapore and a dental surgeon with more than seven years of clinical experience across various cities in India. She did her graduation in Dentistry from KM Shah Dental College. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to...
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Dr. Neha Bhave Salankar

(MD)
Dr. Neha Bhave Salankar is a consultant psychiatrist at Bhave Institute of Mental Health based in Nagpur. Having been a meritorious student throughout, she bagged the prestigious gold medal for medicine in MBBS as well as in MD psychiatry. She also took training in Child and Adolescent Psychiatry at National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru. She is...
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