As a clinical team that specializes in adolescent mental health, we’ve met countless families who are navigating the unique challenges of parenting a teen with BPD. 

When we first begin working together, parents often express feeling overwhelmed, frustrated, and in some cases, feeling hopeless. This is usually because they’ve tried to get answers and help for their teen in the past, but nothing seemed to be enough.

But the truth is, what’s underneath the overwhelm, frustration, and despair is often fear. 

Fear that their teen will continue to struggle with things like intense emotional reactivity, an overwhelming fear of abandonment, unstable relationships, and self-harming and impulsive behaviors, and that there’s little that can be done.

We know that nothing is more upsetting for a parent than watching your child experience pain, and feeling helpless to stop it. Fortunately, with borderline personality disorder, a diagnosis and compassionate care can make a huge difference in a teen’s life. 

In fact, with appropriate interventions (like Dialectical Behavior Therapy) partial or full recovery from BPD is actually the norm, not the exception.

So what do parents need to know about BPD? These are the five things we hope families will keep in mind as they support their teen with BPD.

1. The signs of BPD in teens aren’t always easy to spot.

While borderline personality disorder has a reputation for being an explosive disorder, this perception isn’t entirely true. 

How much a teen outwardly expresses their emotional distress is very individual, and in fact, some teens who are struggling will become secretive and self-punishing, rather than simply lashing out at others.

The common signs of BPD in teens include:

Your teen doesn’t need to exhibit all of these signs to have BPD.

The diagnostic criteria requires only five of these to be present, but as we’ll review below, diagnosing a teen is a little more complex than diagnosing an adult.

2. An early BPD diagnosis can feel controversial, but it doesn’t need to be.

Because teens are still developing, and some of the diagnostic criteria for BPD can be common in adolescence (albeit on a smaller scale, like moodiness, identity conflicts, impulsivity, and sensitivity to rejection), there are valid questions about whether or not teens should be diagnosed with borderline personality disorder before reaching adulthood.

Some clinicians may not specialize in BPD as well, which makes finding a clinician with experience treating adolescents with BPD especially crucial, as they may misdiagnose teens due to a lack of familiarity.

Diagnosing a teen with BPD should never be regarded as an insult or mark of shame. 

When a compassionate clinician validates their experience, teens and their families often experience relief, and most importantly, a clearer path to more appropriate and effective care, ensuring better outcomes for the long term. 

This is why our team is passionate about providing destigmatized and evidence-based care — including early diagnoses where appropriate — for teens with BPD.

To ensure a BPD diagnosis is appropriate for your teen, a clinician should consider:

It can be tempting to advocate for a delay in diagnosis, as BPD can be quite stigmatized, leading well-intentioned parents and even clinicians to avoid making the diagnosis until adulthood.

However, early and appropriate intervention for teens with BPD are crucial for ensuring that they’re receiving effective treatment, as BPD is not approached in the exact same way as other mental health conditions, despite some similarities in their presentation.

A correct diagnosis made early can be lifesaving, too, as people with BPD have a much higher risk of suicide than the general population, particularly if they do not receive early and appropriate care.

Learn more: Can a Teen Be Diagnosed With Borderline Personality Disorder?

3. There are many factors that can lead to the development of BPD in teens.

Psychologist Marsha Linehan pioneered what’s called the biosocial theory, which suggests that developing BPD in childhood is often due to an invalidating environment combined with biological (or inherent) vulnerabilities. 

In short, emotional invalidation is when a parent or caregiver regards their child’s emotions as unreasonable or irrational, and something to suppress, hide, or contain. 

Research shows that genetic factors are among those biological vulnerabilities, suggesting that some teens may simply inherit a predisposition for being emotionally sensitive and reactive, and may need more time to self-soothe and regulate.

Emotional invalidation is not the only environmental factor or trauma that may contribute to BPD.

Some other factors can include emotional, physical, or sexual abuse; experiencing an acute traumatic event, like an illness or loss; a high conflict household; neglect or separation from a caregiver; or being raised in an emotionally unstable environment, like having a parent with substance use problems.

Learn more: What Causes Borderline Personality Disorder in Teens?

4. Parents can support teens by shifting one crucial part of their approach: Validation.

Knowing that emotional invalidation is a major factor in developing BPD, relating to teens from a more validating place can make a huge difference, both for the health of your relationship and their emotional well-being.

Some examples of shifting away from invalidation:

• “Why are you still upset? That happened three days ago.” Instead, try: “I see that you’re upset — it seems like this has really affected you. How can I support you?”
• “You’re so sensitive. You know I didn’t mean it that way.” Instead, try: “While it wasn’t my intention, I can understand how my choice of words really hurt you.”
• “Don’t be so dramatic. It isn’t that big a deal.” Instead, try: “It seems like this is dredging up some big feelings. Do you want to share what’s coming up for you?”
• “You’re 14 years old. You need to stop acting like a baby.” Instead, try: “It makes sense that you’re scared. Is this a ‘fix it’ moment where we problem-solve together, or a ‘feel it’ moment where we just have our feelings?”

It can be tempting to try to meet your teen with logic or dismissal when their emotions seem disproportionate. But what they actually need from you in that moment is empathy, listening, and curiosity. As we often say at Evolve, “Lead with love, not logic.”

If you’ve been parenting in a potentially invalidating way, this doesn’t mean that you’re bad, or that you’ve irreparably damaged your child or your relationship. What it does mean is that there’s still time to try a new approach, and parent in the way that addresses your teen’s unique needs.

5. Parenting a teen with BPD can be hard — but you don’t have to do it alone.

At Evolve, we believe that teens with BPD aren’t broken, hopeless, or bad, and our approach — rooted in evidence-based interventions like comprehensive DBT, shown to be highly effective  for BPD — ensures they don’t carry that mindset with them.

As a parent, it can be easy to look at your struggling teen and succumb to shame and self-blame. But just as your teen needs and deserves support, so do you. That’s why we offer free support groups for families, too.

With a compassionate and dedicated team, we’ve witnessed teens with BPD harness their sensitivity and channel their courage to become the creative, passionate, and empathetic adults they’re meant to be, with a healthy sense of self and connection with others.

It’s understandable to be scared for your teen. That’s why we’re here to hold the hope with you.