Borderline personality disorder in teens is a mental health condition characterized by unstable behavior, particularly regarding mood and relationships. Teens with borderline personality disorder are impulsive, rapid acts of cycled emotions of fear and anger, intense affection and disillusionment, and any number of different risky activities from unsafe sex to substance use.

Borderline personality disorder (BPD) is difficult to diagnose, as some of its symptoms can be closely related to other conditions, particularly mood disorders such as bipolar disorder, major depressive disorder, and anxiety disorders – from generalized anxiety to post-traumatic stress disorder (PTSD). However, once properly identified, treating BPD in teens can help reduce symptoms and lead to more stability.

Treatment for borderline personality disorder in teens centers on long-term psychotherapy, as well as intensive treatments to target any co-occurring disorders, should they be diagnosed. At Visions Treatment Centers, we utilize several different forms of therapy to help teens identify a working, sustainable borderline personality disorder treatment plan.

Signs and Symptoms of Borderline Personality Disorder in Teens

The origin of BPD as a diagnosis is rooted in an older, outdated view of mental health. It stems from being on the border between neurosis and psychosis. Neurosis was a term used in the early days of psychiatry to refer to any combination of symptoms involving anxious feelings and poor general functioning, without losing touch with reality, while psychosis refers to symptoms of confusion, delusion, and hallucination.

Teens with borderline personality disorder may display signs of depression and anxiety, but they may also rapidly change their self-image, perceive reality in a distorted way, and be emotionally “unstable”, hence the definition of being between states of milder “neurosis” and more severe psychosis depending on the intensity of the condition. Signs of BPD in teens include:

  • “Intense” relationships, i.e. deeply emotional and often swinging between states of infatuation and loathing
  • Unstable with other people, often devolving from conversation into rage or sorrow
  • Emotional instability, in the form of inappropriate responses and nonsensical mood changes, i.e. affective dysregulation
  • Impulsive behavior, risk taking, ignoring danger
  • Unusual perception of reality, mild cognitive and sensory distortions (from sudden self-hatred and intrusive thoughts to hearing voices)
  • Long-term negative feelings, ranging from low mood to sudden pangs of shame and panic
  • Short-term suicidal ideation


Symptoms of BPD in teens can vary significantly in severity, and a teen does not need to have all these symptoms to be diagnosed with borderline personality disorder. However, because many of them are present in different conditions, it is critical to consult a professional and get a thorough diagnosis of any and all potential co-occurring disorders, or real culprits. The main characteristic setting borderline personality disorder apart from similar conditions is in how these symptoms combine, particularly emotional dysregulation, disturbed thinking (from intrusive thoughts to voices and hallucinations), impulsive behavior, and unstable relationships.

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Treatment for Borderline Personality Disorder in Teens

Treatment for borderline personality disorder in teens revolves around helping adolescents avoid destructive or dangerous coping mechanisms, while learning to identify and distinguish between normal thought and intrusive or disrupted thoughts. At Visions Treatment Centers, we utilize a thorough assessment process to determine whether a teen has co-occurring issues, ranging from codependent drug use to major depressive disorder, to create treatment plans accordingly. Our treatment programs for borderline personality disorder in teens include (but is not limited to):

Psychotherapy

Talk therapy options for teens with BPD vary greatly from one-on-one dialectical behavior therapy (DBT) to tackle and avoid negative coping mechanisms and help improve emotional stability, to group therapy, therapeutic living (residential care), experiential therapy to help identify better coping habits, and more.

Medication

There is no medication to treat BPD directly, but antidepressants and antipsychotic medication may be used if certain symptoms point to multiple conditions, or if the symptoms are severe enough to warrant pharmacological help.

Symptom self-management is a long-term process, and an important aspect in treating borderline personality disorder in teens. While BPD is a lifelong condition, its symptoms can be alleviated, depending on the severity of the symptoms and the efficacy of the treatments. It is important for teens with BPD to adopt coping mechanisms and regularly utilize therapy or mindfulness to remain cognizant of the disorder and create stability.