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My Teen Is So Impulsive…Do They Have BPD?

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT
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Your daughter goes on shopping sprees, ordering piles of clothes or accessories she really doesn’t need. Or your son drives erratically, leaving you to hang on for dear life while he speeds down the street. Your teen forgets things everywhere, is extremely spontaneous, and doesn’t think before acting. Or perhaps your son or daughter gets angry at the slightest provocation and won’t let things go…even for weeks.

The question is why. Why is your teen so emotionally sensitive? So reactive? And why are they so impulsive?

Teenage Years = Impulsive Years

Alyson Orcena, LMFT, Executive Clinical Director of Evolve Treatment Centers, says a measure of impulsivity in teens is very normal—even expected. That’s because unlike adults, the brains of teenagers are not yet fully developed.

“Think of the brain as a car,” says Orcena. “The limbic system is the highly reactive part of the brain that contains the amygdala, which is responsible for the fight, flight or freeze system. That’s like the gas in your car. Then you have the frontal lobe, responsible for executive function, logic, and preparedness. Those are the brakes. Problem is, the limbic system is fully developed in a teen, while the frontal lobe is not. It only becomes fully formed when someone is 25. So a teen’s brain is like having a car with just a gas pedal and no brakes.”

Most of us can think back to adolescence and realize that our emotions just felt more intense than they do now.

As an exercise for parents, “Think back to your first crush or first love,” suggests Orcena. “The emotions were so raw, so deep, so much. True, it was the first time you were experiencing them. But these feelings were actually more intense, because your frontal lobe was not yet fully developed.”

When It’s Not Just Impulsivity

However, some teens have very high levels of impulsivity, and need mental health assistance. When a teen is chronically impulsive – and when this behavior is causing issues with their relationships and daily living – it’s time to seek help. Sometimes, being too impulsive or emotionally reactive could be a symptom of oppositional defiant disorder (ODD), ADHD, or even borderline personality disorder. For example, a teen with borderline personality disorder doesn’t just get upset when they’re angry. They’ll smash dishes in the house, throw your possessions outside, or even threaten suicide when you do something that upsets them. Most teens with borderline personality disorder go from loving a person to hating them very quickly. They are also extremely sensitive to rejection—more than the average teen.

Does My Teen Have Borderline Personality Disorder?

Because symptoms of emotional sensitivity and impulsivity can be mistaken for typical adolescent development, one way clinicians determine whether an issue exists is through formal assessments. For example, the McLean screening for BPD is a ten-question assessment that teens can take to figure out if their issues require mental health treatment. The assessment considers a teen’s relationships, stability, sense of self, fear of abandonment, and more. If these types of behaviors are severely impacting the teen’s day-to-day life and functioning, they usually need mental health treatment at an adolescent intensive outpatient (IOP), partial hospitalization (PHP), or residential (RTC) program.

…Or Is My Teen Just Being a Teen?

Sometimes parents mistake their child’s symptoms for a mental health issue when their child is really just being, well, a teen. Because BPD symptoms are so similar to typical adolescent mood swings, many say the cure for teen borderline personality disorder is simply getting older. Waiting until they’re 25, when their frontal lobe is fully developed, gives a teen the highly important muscle of self-inhibition.

“Just the process of aging helps reduce their symptoms,” says Orcena. In fact, one study looked at self-reported BPD symptoms in adolescent twins every couple of years for ten years, starting when the twins were 14 and ending when they were 24. As the years went by, the adolescents’ symptoms reduced significantly.

The problem – and a very serious one, at that – is that teens with borderline personality disorder have a high rate of suicide and self injury. Thus, waiting until your struggling teen is 25 is obviously not the best option. When teens really do have mental health issues and do not receive treatment, this can threaten not just their wellbeing but also their health—and even life. Therefore, it’s vital to seek treatment for your teen as soon as possible. Evidence shows that early intervention gives teens the best possible chance of treatment success.

“If you give them treatment so they can survive long enough to get older, they have a high chance of getting better,” says Orcena.

Our Behavioral Health Content Team

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