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Why Adolescent Borderline Personality Disorder Treatment Works


Most borderline personality disorder (BPD) treatment programs focus on treating adults. People with this complex condition face significant stigma, even among mental health treatment providers. Borderline personality disorder is difficult to navigate because there is no clear path to treatment, nor is there a straightforward cure for the condition.

These factors caused clinicians to avoid diagnosing adolescents with borderline personality disorder for years. Additionally, many viewed the symptoms characteristic of the condition simply as part of puberty rather than a unique condition. Providers often viewed a BPD diagnosis as it as a mental health death sentence, figuratively speaking, which made adolescent borderline personality disorder treatment widely unavailable.1

Ignoring the symptoms of BPD in adults causes them to worsen with time. The same is true for young people showing BPD symptoms. Early intervention equips individuals with the skills needed to manage their symptoms. The sooner a person receives treatment, the better.

Thankfully, mental health providers’ attitudes shifted over the last decade. Growing numbers of clinicians are willing to consider diagnosing borderline personality disorder in adolescents. Expanding the availability of adolescent borderline personality disorder treatment gives young people a better chance of learning the tools they need early, before the condition sets in and the symptoms become more disruptive.

How does adolescent borderline personality disorder treatment work?

What is Borderline Personality Disorder?

Borderline personality disorder (BPD) is a mental health disorder that affects emotional regulation. It’s characterized by intense periods of anger, depression, and anxiety that can last from a few hours to multiple days. These long-term patterns of unstable emotions lead to poor self-image, impulsive decisions, and dysfunctional relationships with others.

An estimated 1.6 percent of adults in the United States age 18 and older experience borderline personality disorder. It’s also highly comorbid with other mental health disorders, such as anxiety, depression, or substance use disorder. According to a study published in Biological Psychiatry, 84.5 percent of people with BPD also have another co-occurring mental health disorder.2

Signs of Borderline Personality Disorder

Borderline personality disorder is characterized by extremes. The condition causes severe mood swings and affects the way a person sees and feels about themselves. Emotions and feelings often change suddenly and drastically, and it also impacts the way they view and feel about others. Their opinions about other people can shift from intense closeness to extreme dislike in the course of a few hours or days. Interests and hobbies can also change rapidly.

Some common signs of BPD include:

  • Distorted sense of self or self-image
  • Feelings of emptiness or hopelessness
  • Extreme efforts to avoid abandonment, whether real or perceived, often by diving headfirst into relationships or ending them abruptly
  • Intense and unstable relationships with friends and family members
  • Periods of intense moods that last for a few hours or a few days
  • Severe instances of anger that are difficult to control
  • Episodes of dissociation: feeling removed from themselves, observing themselves from outside their body, or feeling disconnected from reality
  • Impulsive or risky behaviors including spending sprees, binge eating, reckless driving, substance use or abuse, and/or unsafe sex
  • Self-harming behaviors
  • Suicidal ideation

Not everyone experiences all of the symptoms of BPD. Also, the frequency, severity, and duration of symptoms may differ from person to person. Since symptoms affect functioning and some can be life-threatening, intervention and treatment for BPD are vital.

Can Adolescents Have Borderline Personality Disorder?

Clinicians have long hesitated to diagnose adolescent borderline personality disorder. The teenage years are a time when young people begin to develop independence and learn who they are. That means mood swings, uncertainty about their sense of self, and chaotic relationships tend to be common experiences during adolescence.

However, mood swings and troublesome relationships are only part of a borderline personality disorder diagnosis. Individuals with BPD tend to take their efforts to avoid abandonment further than most people. Their risky behaviors, including substance abuse and self-harm, can also put them in danger.

Understandably, mental health providers are reluctant to diagnose BPD in adolescents. The condition is highly stigmatized, difficult to manage, and oftentimes treatment-resistant. But resisting diagnosis doesn’t make BPD go away. It only delays a young person’s access to treatment and the opportunity for early intervention.

Psychology professor Carla Sharp puts it this way:

“We ignore Borderline Personality Disorder at our peril, because compared with other mental disorders, BPD is among the leading causes of suicidal behaviors and self-harm in young people.”1

The sooner they receive adolescent borderline personality disorder treatment, the sooner they can learn the skills they need to succeed.

Treatment for Borderline Personality Disorder

Research suggests BPD develops as the result of a combination of biological and environmental factors that ultimately result in a lack of resilience against psychological stressors.3

Thankfully, resilience can be learned through evidence-based BPD treatment.

Psychotherapy is the primary tool for treating borderline personality disorder. Dialectical behavior therapy (DBT) is a therapeutic approach developed specifically for working with individuals who have BPD. It focuses on developing mindfulness skills that increase distress tolerance and interrupt negative thought patterns.

Adolescent borderline personality disorder treatment also usually includes family therapy as part of the process. Working through family relations in a therapeutic environment ensures every member feels heard. It also allows a therapist to observe, intervene, and correct communication difficulties among family members in the moment.

Currently there are no medications approved specifically for treating borderline personality disorder. However, some medications, such as SSRIs, are useful for reducing the severity of certain symptoms, including anxiety, depression, sleep disturbances, and psychotic symptoms. Using medication in conjunction with ongoing psychotherapy can teach people to manage their BPD.

Why Adolescent Borderline Personality Treatment is Vital

Withholding BPD-specific treatment from adolescents doesn’t protect them in the ways clinicians originally thought. Instead, providing adolescent borderline personality disorder treatment introduces emotional regulation tools from a young age. Equipping young people with these skills enables them to manage their symptoms before they set in and cause significant disruption in all life domains.

If you’re the parent of a teen with BPD, we advise seeking adolescent borderline personality disorder treatment for your teen as soon as possible. Placing them in an environment where they can develop emotional control and relationship skills sets them up for a successful life. Instead of fearing the idea of BPD treatment for your child, we encourage you to recognize that when you find them treatment, you saving them from unnecessary struggles as they grow up, and increase their chances of leading a full and productive life.


  1. Science News. (2021). Borderline personality disorder: Don’t ignore it.
  2. Biological Psychiatry. (2007). DSM-IV personality disorders in the National Comorbidity Survey Replication.
  3. StatPearls Publishing. (2022). Borderline Personality Disorder.
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