Teen Borderline Personality Disorder

Teen Borderline Personality Disorder

Authored by Pin Ng PhD

Edited by Hugh Soames

Reviewed by Michael Por, MD

Does My Teenager Have Borderline Personality Disorder?

Mental health professionals were often reluctant to make a borderline personality disorder diagnosis in the past. The reluctance to make such a diagnosis left many young persons and their families with more questions than answers. They still didn’t know what is troubling their teenager. In addition, many teenagers were unable to receive the treatment and support they desperately needed due to mental health professionals choosing not to make a borderline personality disorder diagnosis.

Today, the decisions for early interventions on the behalf of mental health professionals are changing. With a greater global focus on mental health, more mental health professionals are competently treating teenagers with borderline personality disorder. The decisions to intervene early on are greatly changing the treatment and outcomes for young persons.1https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6257363/

What is teen borderline personality disorder?

Teen borderline personality disorder is one of mental health’s most complex illness. It is defined by unstable moods, behaviors, and relationships. Individuals suffering from borderline personality disorder may grapple with self-image issues, feelings of self-doubt, a strong fear of abandonment, and low self-worth.

Suffers of teen borderline personality disorder may often have trouble restraining their emotions. Intense emotional reactions can be exhibited. These strong emotional reactions may result in suicidal behavior or self-harm. Borderline personality suffers may have co-occurring disorders including depression, anxiety, substance abuse, or eating disorders.

What are the symptoms of teen borderline personality disorder?

Parents need to fully understand borderline personality disorder to help their teenagers. They need to spot the symptoms of borderline personality disorder to help their loved ones gain treatment. Fortunately, there are some characteristics that indicate borderline personality disorder in teens.

Behavioral dysregulation is exhibited when a teenager engages in self-harm. Self-harm is any activity that includes cutting or burning one’s own skin or punching walls. Risky sexual behavior, substance abuse, and impulsiveness are other forms of dysregulation. These activities rarely represent a desire to gain attention for teenagers with borderline personality disorder. Instead, they typically provide a type of relief from emotional pain.

Borderline personality disorder in teenagers has other signs such as individuals having trouble with interpersonal relations. In particularly, the teenager may have a fear of being abandoned. Regulating emotions may be difficult and teenagers may go from feeling very anger to sad in a few minutes. Borderline personality disorder sufferers may also have irrational or paranoid beliefs, which are known as cognitive dysregulation. They may exhibit signs of self-dysregulation or feeling empty without a sense of self.2https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3811088/

The early signs of teen borderline personality disorder

Personality disorders do not necessarily come out of nowhere and suddenly appear. Borderline personality disorder is seen early on but gathers pace during an individual’s childhood and teenage years. As adolescents, the individual may have displayed disruptive behaviors, changes in emotional regulation, intense swings in mood, clingy behaviors alternating with dismissive attitudes, unsettled and highly charged emotional friendships.

A large percentage of young persons who demonstrate borderline personality disorder symptoms prior to the age of 19 will continue to display these symptoms until mid-adulthood. An early diagnosis will lead to earlier treatment. A child and/or teen displaying the early signs and symptoms of borderline personality disorder should be carefully monitored by mental health specialists to prevent it from evolving further.

Teen borderline personality disorder is an official diagnosis in DSM5

The Diagnostic and Statistical Manual of Mental Disorders, also known as DSM5, has extended borderline personality disorder diagnosis to individuals under 18-years-old in the most recent update of the manual. Mental health professionals with extensive experience in treating and managing borderline personality disorder may consider the diagnosis accurate in cases where there is a pattern of behaviors that are, ‘a pervasive, persistent and unlikely to be a particular developmental stage’.

DSM5 criteria for teen borderline personality disorder diagnosis:


  • Individual takes steps to avoid perceived or real abandonment
  • An instability in interpersonal relationships, difficulty making and keeping friendships
  • Identity disturbance, taking on or borrowing identities or views from others
  • Impulsiveness and risk-taking
  • Self-harm and/or suicidal thoughts and behaviors
  • Instability
  • Feelings of emptiness and/or numbness for much of the time
  • Intense anger or rage that may be difficult to control
  • Stress-related paranoia or dissociation

Experiencing five out of the nine criteria is indicative of borderline personality disorder.

How common is borderline personality disorder in teenagers?

Borderline Personality Disorder impacts around 3.5% of the general population. A Hong Kong study estimated that borderline personality disorder affects between 3% and 11% of the population. Research has found that borderline personality disorder is exhibited by around 30% of individuals seeking treatment in mental health services.

Suffers of the personality disorder are 50-times more likely to act in suicidal behaviors. Seventy-eight-percent of teenagers and adolescents attending emergency medical departments for suicidal behaviors meet the criteria for a borderline personality disorder diagnosis. Non-suicidal self-injury or self-harm occurs in around 58% of people diagnosed with borderline personality disorder.

Is teen borderline personality disorder treatable?

The simple answer to the above question is, yes! Borderline personality disorder is treatable despite it being very complex. After establishing an accurate diagnosis, families and teenagers are able to get the evidence-based treatments they need.

Once a diagnosis is made, therapy begins. Individuals take dialectical behavior therapy (DBT) to treat the disorder. DBT is an effective form of therapy that targets self-harm and suicidal behaviors, drug use, and other destructive behaviors. During treatment, mental health professionals typically work with teenagers to break down their behaviors and teach them skills to handle difficult emotions and relationships.

DBT is the gold standard treatment for borderline personality disorder. The treatment emphasizes the development of four skills: mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. In addition, suffers are taught a combination of cognitive behavioral techniques (CBT) and mindfulness practices are deployed to help individuals grasp a better control over their impulsive, self-destructive behavior to promote a different way of managing intense emotions.

Unfortunately, a stigma still remains around teenagers with borderline personality disorder. The good news is that there is help available to teens and parents. With a great interest in mental health, people are now able to get the treatment needed and live productive lives.

The best rated teen BPD treatment clinics


  1. Paradigm
  2. Visions
  3. Newport Academy

Living with teen borderline personality disorder

References: Teen Borderline Personality Disorder

  1. Miller AL., Muehlenkamp JJ., Jacobson CM. Fact or fiction: diagnosing borderline personality disorder in adolescents. Clin Psychol Rev. 2008;28:969–981. [PubMed] []
  2. Chanen AM., Jovev M., Jackson HJ. Adaptive functioning and psychiatric symptoms in adolescents with borderline personality disorder. J Clin Psychiatry. 2007;68:297–306. [PubMed] []
  3. Winograd G., Cohen P., Chen H. Adolescent borderline symptoms in the community: prognosis for functioning over 20 years. J Child Psychol Psychiatry. 2008;49:933–941. [PubMed] []
  4. Chanen AM., Kaess M. Developmental pathways to borderline personality disorder. Curr Psychiatry Rep. 2012;14:45–53. [PubMed] []
  5. Zanarini MC., Frankenburg FR., Ridolfi ME., Jager-Hyman S., Hennen J., Gunderson JG. Reported childhood onset of self-mutilation among borderline patients. J Pers Disorders. 2006;20:9–15. [PubMed] []
  6. Sharp C., Pane H., Ha C., et al Theory of mind and emotion regulation difficulties in adolescents with borderline traits. J Am Acad Child Adolesc Psychiatry. 2011;50:563–573. [PubMed] []
  7. Paris J., Zweig-Frank H. A 27-year follow-up of patients with borderline personality disorder. Compr Psychiatry. 2001;42:482–487. [PubMed] []
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