top of page
Search

Borderline Personality Disorder in Teenagers

Amy Lian
Aug 27
4 min read
What is Borderline Personality Disorder (BPD)?:

Borderline Personality Disorder (BPD) is a complex mental health condition that affects the way individuals think about themselves and others, making it difficult to regulate emotions, maintain stable relationships, and develop a consistent sense of identity (National Institute of Mental Health, 2019). Adolescents with Borderline Personality Disorder often experience intense emotional reactions, impulsive behaviors, unstable self-image, and rapidly changing moods that interfere with daily functioning and relationships (“Borderline”, 2023a). Although Borderline Personality Disorder was once mainly recognized as a condition that could only be diagnosed in adults, research now shows that it can be accurately identified in adolescents when symptoms appear to be consistent, cause significant negative effects, and are not simply part of normal adolescent development (Guilé et al., 2018)


Prevalence in Teenagers:

Borderline Personality Disorder is more common among adolescents than previously believed. Research estimates that approximately 3% of adolescents in the general public population meet the diagnostic criteria for Borderline Personality Disorder, while the prevalence is significantly higher amongst teenagers receiving inpatient or outpatient psychiatric care (Guilé et al., 2018). Symptoms typically start to show during adolescence and early adulthood, which is why this developmental stage is critical for identifying the disorder and beginning treatment (“Borderline”, 2023b). Researchers emphasize that recognizing symptoms as early as possible can have the potential to improve long-term outcomes and reduce the severity of mental health difficulties (Kaess & Marialuisa Cavelti, 2025).


Causes and Risk Factors:

There is no single cause for Borderline Personality Disorder. In fact, researchers believe that this condition develops through a combination of genetic, biological, psychological, and environmental factors (National Institute of Mental Health, 2019). A family history of personality disorders or other mental health conditions may increase a teenager’s risk of developing Borderline Personality Disorder (“Borderline”, 2023b). Environmental factors including childhood trauma, emotional neglect, physical or sexual abuse, chronic family conflict, or invalidating home environments, have also been linked to a greater likelihood of the developing Borderline Personality Disorder (“Borderline”, 2023a). Additionally, research suggests that differences in certain brain regions, specifically areas that play a role in emotional regulation, decision-making, and impulse control may contribute to many of the symptoms that are experienced with adolescents that have Borderline Personality Disorder (National Institute of Mental Health, 2019). 


Signs and Symptoms:

Teenagers with Borderline Personality Disorder often struggle with intense emotions that seem overwhelming and difficult to manage. One of the most common symptoms is an intense fear of abandonment, which may cause adolescents to react strongly to real or perceived rejection  (National Institute of Mental Health, 2019). Relationships are often unstable with teens alternating between idealizing and devaluing friends or family members (“Borderline”, 2023b). Many adolescents may also experience an unstable sense of identity, causing frequent changes in interests, personal goals, self-image, or friendships (Guilé et al., 2018). Other common symptoms include impulsive decision-making, emotional outbursts, chronic feelings of emptiness, difficulty controlling anger, and periods of dissociation or suspicious thoughts during times of stress (“Borderline”, 2023b). 


Diagnosis and Treatment:

Diagnosing Borderline Personality Disorder in teenagers requires a comprehensive evaluation by a qualified mental health professional. Although the same diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are used for both adolescents and adults, clinicians must carefully consider whether symptoms have remained persistent for at least one year and are causing significant impairment in multiple areas of life (Guilé et al., 2018). Since many symptoms of Borderline Personality Disorder overlap with other mental health disorders or normal adolescence development, professionals also assess for certain conditions such as depression, anxiety disorders, bipolar disorders, ADHD, and eating disorders before making a diagnosis (Mayo Clinic, 2024).


After making a diagnosis, the most common and effective treatment for Borderline Personality Disorder is psychotherapy. One of the most widely recommended approaches is Dialectical Behavior Therapy (DBT), which teaches emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness skills. Other evidence-based therapies including, Mentalization-Based Therapy (MBT), may also help adolescents improve emotional regulation and relationships (Guilé et al., 2018). Although there is currently no medication approved specifically to treat Borderline Personality Disorder itself, medications may be prescribed to manage co-occurring conditions such as anxiety or depression when appropriate (Mayo Clinic, 2024). Family involvement is also an important part of treatment because supportive caregivers can reinforce healthy coping skills and improve treatment outcomes. 


Importance of Early Intervention and Conclusion: 

Early identification and treatment of Borderline Personality Disorder can significantly improve a teenager’s quality of life. Research has suggested that providing appropriate intervention during adolescence may reduce symptom severity, improve emotional regulation, strengthen interpersonal relationships, and decrease the possible likelihood of long-term mental health difficulties (Kaess & Marialuisa Cavelti, 2025). Experts also argue that delaying diagnosis because of concerns about labeling adolescents may prevent young people from reviving individualized treatments that have been shown to be effective (Chanen et al., 2020). Rather than waiting until adulthood, researchers recommend recognizing persistent symptoms early and providing evidence-based treatments to support healthy emotional, academic, and social development (Kaess & Marialuisa Cavelti, 2025). Everyone should be seen and valued, and get the intervention that they need and deserve, no matter how old they may be. 

Works Cited:

Borderline personality disorder (BPD) in teenagers: What to know. (2023a). In Healthline. https://www.healthline.com/health/borderline-personality-disorder-in-teenagers



Chanen, A. M., Nicol, K., Betts, J. K., & Thompson, K. N. (2020). Diagnosis and treatment of borderline personality disorder in young people. Current Psychiatry Reports, 22(5). https://doi.org/10.1007/s11920-020-01144-5

Guilé, J. M., Boissel, L., Alaux-Cantin, S., & Garny de La Rivière, S. (2018). Borderline personality disorder in adolescents: Prevalence, diagnosis, and treatment strategies.


Adolescent Health, Medicine and Therapeutics, Volume 9(9), 199–210. https://doi.org/10.2147/ahmt.s156565


Kaess, M., & Marialuisa Cavelti. (2025). Research review: What we have learned about early detection and intervention of borderline personality disorder. Journal of Child Psychology and Psychiatry. https://doi.org/10.1111/jcpp.70011


Mayo Clinic. (2024). Borderline personality disorder - diagnosis and treatment - mayo clinic. In mayoclinic.org. https://www.mayoclinic.org/diseases-conditions/borderline-personality-disorder/diagnosis-treatment/drc-20370242


National Institute of Mental Health. (2019). Borderline personality disorder. In Nih.gov.


Comments

Rated 0 out of 5 stars.
No ratings yet
Add a rating
bottom of page