Borderline personality disorder in teens isn’t common, but it is serious. 

Studies show that borderline personality disorder (BPD) occurs in about 3% of adolescents. And the impact can be extreme, with BPD appearing in 78% of teens who visit the emergency room for suicidal behaviors. 

The Ridge provides qualified residential care for teens and young adults who struggle with mental health challenges, including borderline personality disorder. Below, we’re sharing the basics of BPD in teenagers that parents need to know, including signs, causes, and how to care for your child (and yourself) in the face of a BPD diagnosis. 

Understanding BPD in Teenagers

Borderline personality disorder is a mental health condition characterized by unstable moods, impulsive behaviors, and insecurity in relationships. 

While they sound like typical teen struggles, teens with BPD experience these issues more intensely and persistently than their peers. In many cases of teen borderline personality disorder, there are also underlying causes that make treatment more complex. 

For many years, experts weren’t sure you could reliably diagnose BPD in a teen. However, we now know that BPD can be diagnosed as early as age 11, and in fact, the patterns of behavior associated with BPD often emerge in adolescence, if not earlier. 

Signs of Teen Borderline Personality Disorder

To diagnose BPD in teen patients, clinicians look for at least a one-year pattern of instability and identity disturbances, with specific signs that include:

• Extreme emotional sensitivity and mood swings
• Intense fear of abandonment
• Unstable and intense relationships with peers and family
• Impulsive and risky behaviors, such as self-harm or substance use
• Chronic feelings of emptiness
• Difficulty managing anger and frequent outbursts
• Paranoia or dissociative episodes under stress

If you’ve noticed one or more of these signs in your teen, be careful not to jump to conclusions. They could be indicative of another mental health disorder or developmental challenge and should be assessed by a professional before you plan the next steps. 

What Causes Borderline Personality Disorder?

There is likely no single cause of borderline personality disorder. Instead, BPD is generally caused by a combination of factors such as:

• Genetic predisposition and family history of mental health issues
• Childhood trauma or neglect
• Unstable or abusive home environment
• Emotional sensitivity and temperament
• Peer pressure and social dynamics

Research suggests a potentially strong genetic component to BPD; however, data on the hereditary nature of BPD is sparse, and we have a lot more to learn about how and why borderline personality disorder shows up in adolescents. 

Borderline Personality Disorder Treatment for Teens

Left untreated, borderline personality disorder can lead to self-harm and other dangerous behaviors, with more than 30% of individuals with BPD self-harming at the age of 12 or younger, and another 30% initiating self-harm behaviors between the ages of 13 and 17. 

Because of the severity of the illness, borderline personality disorder treatment for teens tends to be more focused on clinical care than lifestyle changes (though those are often necessary, too). This includes specialized residential treatment programs like The Ridge RTC, where teens receive 24/7 support in a safe and home-like setting, usually for one to three months.

Individual and Family Therapy Options

Psychotherapy is a cornerstone of BPD treatment. This includes Dialectical Behavior Therapy (DBT), Cognitive Behavior Therapy (CBT), and other evidence-based approaches. Family-focused therapies are also heavily recommended and help with family skills around communication and boundaries. 

Medication 

There are no medications approved solely for BPD. However, certain types of medications, including mood stabilizers and antidepressants, can be a helpful addition to a therapy-focused treatment plan. 

Emotional Regulation Skills

Healthy coping strategies are a must for borderline personality teens, both for managing current symptoms and for managing the disorder long-term. These include tools for emotional regulation such as self-soothing, self-awareness, and constructive emotional expression. 

Supporting a Teenager with BPD

Remember: BPD is an illness. You and your teen are on the same team here – even (and perhaps especially) when it doesn’t seem like it. 

As well as getting help from a provider who specializes in teen borderline personality disorder, you can provide support by promoting open and non-judgemental communication in your home, encouraging healthy coping mechanisms, and being clear and consistent in the boundaries you set for your teen.

Take care of yourself, too. You can do this by managing stress and being proactive about avoiding burnout, as well as finding one or more people you can talk openly with about what you’re going through. 

The Ridge RTC: Compassionate Care for BPD Teens

Borderline personality disorder in teens cannot be cured, but it can be well-managed. Seek professional help right away if you notice signs of BPD, and explore our website for more information and resources on teen mental health. We are here to help however we can, and you can reach us 24/7 for information on teen BPD treatment options.