Borderline Personality Disorder in Adolescents

The emotional turmoil that people with Borderline Personality Disorder (BPD) experience can significantly compound the difficulties of adolescence, and lead to high risk behaviors (such as substance abuse, self-injury, risky sexual behavior, binge eating, purging, shoplifting, or suicidal behavior), relationships problems, high levels of family conflict, and/or poor academic performance. Many adolescents with BPD are misdiagnosed with depression, anxiety disorders, ADHD, bipolar disorder, or PTSD, and may receive inappropriate treatment for years. When adolescents receive multiple and/or conflicting diagnoses, an evaluation for BPD may be indicated.

Research indicates that when people with BPD receive effective treatment during adolescence, the lifelong trajectory of the disorder changes dramatically, and people report better functioning in all areas of life.
The gold-standard of treatment for BPD in adolescents is Dialectical Behavior Therapy for Adolescents and Families (DBT). In this model, the teen receives individual behavioral therapy, and also learns skills in a weekly class, along with one or both parents or caregivers. Adolescents also receive between-session “skills coaching” by the individual therapist, to facilitate faster generalization of skills to all areas of life.