Not long ago, mental health care professionals believed borderline personality disorder could not be diagnosed in people under the age of 18. However, Blaise Aguirre, the medical director of a residential treatment program for adolescents with borderline personality disorder at McLean Hospital, believes that this condition often surfaces in childhood or adolescence and that early intervention is key to the provision of successful treatment. In addition, the American Psychiatric Association has issued specified guidelines for clinicians to follow when diagnosing borderline personality disorder in adolescents, suggesting their position on the matter has also changed.
According to the National Education Alliance for Borderline Personality Disorder, symptoms of borderline personality disorder include fear of abandonment, difficulty maintaining relationships, impulsivity, suicidal behavior or self-mutilation, mood swings, difficulty controlling anger, excessive risk taking behaviors and paranoia. These behaviors are seen in both adults and adolescents with the disorder, although symptoms may manifest differently in adolescents. For instance, adults with borderline personality disorder may engage in risky behaviors like gambling or driving too fast. Adolescents that aren’t old enough to drive might engage in behaviors like drinking or having unprotected sex (adults might do those things too, of course).
Despite the new guidelines issued by the American Psychiatric Association, some clinicians still hesitate to diagnose borderline personality disorder in adolescents. If you think your child might suffer from borderline personality disorder, you may want to ask mental health care professionals how they feel about the diagnosis before asking them to evaluate your child. However, you should not attempt to diagnose your child yourself; professionals have extensive training in how to make a diagnosis and while it’s good to educate yourself, doing some reading about the disorder doesn’t really qualify you to make a diagnosis.
Treatment for borderline personality disorder usually involves psychotherapy. A particular type of therapy, known as dialectical behavioral therapy (DBT), has been found especially effective with many patients. It’s a type of cognitive therapy that teaches patients specific skills, including skills for emotional regulation, communication and improving interpersonal relationships. Not all therapists are trained in the use of DBT so if your adolescent has borderline personality disorder, you may want to look for one that has training and experience with that form of therapy.
Doctors do not generally prescribe medications to treat borderline personality disorder itself, but medications can be used to treat other disorders or certain symptoms that sometimes go along with borderline personality disorder. For instance, adolescents with borderline personality disorder may suffer from anxiety or depression, which often respond well to medication. However, few psychotropic drugs have been approved for use in adolescents by the Food and Drug Administration and some studies have found that some antidepressants can lead to suicidal feelings in young people, so medications should be used carefully and only under the supervision of an experienced child psychiatrist.
Adolescents with borderline personality may require inpatient treatment at times. For instance, suicidal adolescents or those that injure themselves excessively may need the structure and security of an inpatient unit for safety’s sake. For the most part, though, borderline personality disorder is treated on an outpatient basis.
National Education Alliance for Borderline Personality Disorder. http://www.borderlinepersonalitydisorder.com/FAQ.shtml . About Borderline Personality Disorder.
Psychology Today. http://www.psychologytoday.com/blog/stop-walking-eggshells/201006/borderline-personality-disorder-in-adolescents . Borderline Personality Disorder in Adolescents.