What is Borderline Personality Disorder in Adolescents like?
These are the typical characteristics and symptoms of BPD in adolescents
Being a teenager is not easy. Adolescence is the transition stage that occurs between childhood and adulthood, it includes a wide range of transformations. During this period -which goes from 12 to 18 years old- adolescents experience a series of important changes both in their bodies and in the way they relate to the world.
The number of physical, social, emotional, sexual and cognitive changes that occur in adolescence can cause different feelings and reactions both in children and in their immediate environment. This is part of the typical teenage experience.
Teenagers often exhibit strange behavior, they may even act impulsively, due to the unusual feelings and thoughts they experience as part of growing up. They may also spend a significant amount of time worrying about how to act in different social situations.
It is crucial to understand the difference between normal life stage behavior and symptoms of mental illness. In this article, we explore borderline personality disorder in youth in depth , to help make the distinction and decide when typical adolescent behavior is present and what signs might need attention.
What is borderline personality disorder?
Dealing with the symptoms of borderline personality disorder (BPD) can be confusing and frustrating for those close to the patient. This also happens in the case of adolescents: parents who have children with BPD do not understand exactly why their behaviors and reactions occur .
In addition, in the case of borderline personality disorder in adolescents there is some controversy in the diagnosis. In fact, we don't know much about how the disorder presents in adolescents; although the symptoms of adults with BPD are well known. This means that some patients are not evaluated correctly until they reach adulthood, which implies a series of problems in their development.
Borderline personality disorder is a serious mental illness manifested by a pervasive pattern of unstable emotions, relationships, and behaviors . People with BPD frequently exhibit the following symptoms: self-esteem issues, mood swings, self-image imbalances, lack of impulse control, and fear of abandonment and inappropriate anger. In some cases, they may include self-harm.
People with BPD have difficulty controlling their emotions in certain situations. It is common for those with BPD to also live with other mental disorders that may include: anxiety, depression, substance abuse, and eating disorders.
BPD affects approximately 2% of the world's population . However, many people with BPD are misdiagnosed as having PTSD, ADHD, bipolar disorder, or depression. Consequently, the real prevalence of people diagnosed with BPD may be higher than what is calculated, especially in those under 18 years of age.
It is essential to understand the signs and symptoms of BPD in adolescents. By recognizing the disease early and making an early diagnosis, it can be treated faster and more effectively.
Symptoms of Borderline Personality Disorder in Adolescents
There are a series of criteria collected by the DSM-5 for the diagnosis of BPD. This is defined by the presence of at least 5 of 9 of the signs, which include :
- Depression
- Frequent and intense mood swings
- Fear of abandonment or rejection
- Difficulty establishing and maintaining relationships
- Impulsive and risky behavior
- Paranoia
- self harm
- unstable self-image
- feelings of emptiness
Some of the symptoms collected, such as impulsive behavior, maintaining an unstable image of themselves and feelings of emptiness, may manifest differently in people under 18 than in adults. In addition, there are sometimes difficulties in distinguishing between the symptoms of borderline personality disorder and the typical challenges of adolescence . However, there are a number of criteria that can help identify BPD in adolescents.
behavioral dysregulation
Behavioral problems that involve self-destructive behaviors are one of the first signs that can show the presence of BPD in adolescents. Some teens with BPD may cut themselves, burn their skin, or hit the wall in order to hurt themselves. Other additional problems can also arise: adolescents with BPD may have risky sexual encounters or use substances.
relationship problems
Children and adolescents with BPD often face different difficulties in managing their relationships. Some may have a strong fear of abandonment, while others may manifest uncontrollable anger. In situations of extreme emotional distress, some adolescents with BPD may develop paranoid or irrational beliefs . This makes it difficult for them to establish and maintain relationships over time, these links include both friends and romantic partners.
strong emotional reactions
People with BPD often overreact to problems. The slightest mishap can feel like the end of the world , even if it's quite insignificant. It is also common for adolescents to experience a series of intense emotions when interacting with others, which can cause sudden changes in behavior and difficulties in relationships.
self esteem issues
Adolescents with borderline personality disorder may compare themselves negatively to other people who seem to be able to handle things that they seem incapable of with ease. You can also ask yourself: "Why don't others act like me?". These questions lead to serious self-esteem problems and a devalued self-image .
As we have noted above, it is difficult for health professionals and parents to determine whether an adolescent has early symptoms of BPD or is going through a normal phase of adolescence when these signs are observed.
Taking into account the symptoms we have just detailed, if an adolescent experiences intense emotions for a longer time than others or takes longer to return to a neutral state, this may mean the beginning of BPD . Overreactions to minor mishaps, and an inability to adaptively deal with them, where substance abuse or self-harm is the only way to make them go away—and feel better—are signs of a serious problem . Teens and families should seek help if they display any type of self-destructive behavior .
Diagnosis of Borderline Personality Disorder in Adolescents
Currently, BPD in adolescents is recognized as an official diagnosis . The most recent version of the Diagnostic and Statistical Manual of Mental Disorders, or (DSM-5) allows people under 18 years of age to be diagnosed with borderline personality disorder. However, some experts say that BPD should not be diagnosed until the individual's personality is fully formed. Although the provision technically allows the diagnosis of BPD in children under the age of 13, this is very rare.
In order to carry out an evaluation of BPD in adolescents, mental health professionals have to observe, in addition to the behaviors and diagnostic signs of the disorder, the intrinsic motivations for the appearance of this type of maladaptive behavior in the subjects.
For example, substance abuse or risky sexual behavior is not an unequivocal symptom that a person has BPD. However, if this behavior is used to avoid facing a problem or avoid feelings, this could mean the existence of a BPD underlying the manifestation of the behavior.
Although there is some controversy regarding the diagnosis of BPD, recent research suggests that children over the age of 11 are capable of understanding and explaining the motivations behind their behaviors. This makes it possible to carry out a diagnosis of the disease from an early age.
BPD symptoms tend to lessen in diagnosed adults as they age , especially after age 40. Currently, the course and prognosis of the disease in adolescents with BPD are still not fully understood. Although, research suggests that proper treatment can significantly improve the management of various symptoms.
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