Borderline personality symptoms are confusing, frustrating, and hard for loved ones to understand. This is particularly the case for parents or caregivers dealing with teens who have borderline personality disorder (BPD).
While we know a great deal about how borderline personality symptoms look in adults, we know much less about how the disorder presents in teens. In fact, there is still controversy over whether it is appropriate to diagnose teens with BPD. Still, many experts argue that teens can have BPD, and adolescent BPD is now recognized as an official diagnosis.
Borderline Personality Symptoms in Teens Versus Adults
While the symptoms of BPD recognized in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) are no different for teens and adults, several experts have argued that while the underlying symptoms are the same in adults and kids, they may present very differently in teens. Below are some examples of how BPD symptoms may manifest differently in a teen versus an adult.
Unstable Interpersonal Relationships. A key symptom of BPD in both teens and adults is instability in interpersonal relationships. In adults, this is most often characterized by "black or white" thinking about other people (also called idealization and devaluation), in which another person may at times be viewed as "perfect" or put on a pedestal, while at other times that person may be seen as evil or cruel. Teens with BPD also engage in idealization and devaluation, but they have an additional tendency to distort the nature of relationships (which is not as common in adults with BPD). For example, a teen with BPD might describe a teacher as a "girlfriend."
Impulsive Behaviors. Both adults and teens with BPD engage in impulsive behaviors, but teens tend to display a different pattern of behaviors than adults. For example, adults with BPD commonly engage in behaviors such as reckless driving and spending. Teens with BPD are more likely to run away from home, engage in sexual acts that are beyond their maturity level, or use drugs or alcohol.
Identity Disturbance. Both adults and teens with BPD have problems with identity. Adults with BPD tend to describe being unsure about who they really are, or experience swings from feeling good about themselves to feeling they are bad or even evil. Teens, who are less likely to think introspectively about identity, tend to show this identity confusion through their behavior. For example, kids with BPD may demonstrate gender identity confusion by cross-dressing, or may show that they are confused about their place in social hierarchies by engaging in behaviors that seem out of place. A teen with BPD might run for class president despite having no friends, or engage in socially inappropriate behavior and then be confused when he or she is rejected by others because of this behavior.
Chronic Feelings of Emptiness. Whereas adults with BPD describe feeling chronically empty, teens with BPD are more likely to describe feeling chronically and hopelessly bored. They may also seem unable to invest their time in any activity that might bring them out of that boredom. They may say that they have no interests.
Borderline Personality Symptoms in Teens - Let an Expert Weigh In
Because borderline personality can be so difficult to diagnose in a teens, and because the symptoms can look different than they do in an adult, it is critically important to seek expert advice if you think your teen may have BPD. While an expert in adolescent BPD can be hard to find, there are some centers that specialize in evaluating and treating BPD in adolescents. For more information on how to find a professional, read these articles:
Aguirre BA. Borderline Personality Disorder in Adolescents: A Complete Guide to Understanding and Coping When Your Adolescent Has BPD. Fair Winds Press; 2007.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR Fourth Edition. American Psychiatric Association, 2000.
Friedel RO. Borderline Personality Disorder Demystified: An Essential Guide for Understanding and Living with BPD. Da Capo Press; 2004.
Sharp C, & Romero C. “Borderline Personality Disorder: A Comparison Between Children And Adults.” Bulletin of the Menninger Clinic. 71:85-114, 2007.