Borderline Personality Disorder
Borderline Personality Disorder (BPD) is known as a Cluster B condition characterized by difficulties regulating emotion. This means that people who experience BPD feel emotions intensely and for extended periods of time, and it is harder for them to return to a stable baseline after an emotionally triggering event.
This difficulty can lead to impulsivity, poor self-image, stormy relationships and intense emotional responses to stressors. Struggling with self-regulation can also result in dangerous behaviors such as self-harm.
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Symptoms Associated with BPD
People with BPD experience wide mood swings and can feel a great sense of instability and insecurity. According to the Diagnostic and Statistical Manual diagnostic framework, some key signs and symptoms may include:
- Frantic efforts to avoid real or imagined abandonment by friends and family
- Unstable personal relationships that alternate between idealization (“I’m so in love!”) and devaluation (“I hate her”). This is also sometimes known as "splitting"
- Distorted and unstable self-image, which affects moods, values, opinions, goals and relationships
- Impulsive behaviors that can have dangerous outcomes, such as excessive spending, unsafe sex, reckless driving, or misuse or overuse of substances
- Self-harming behavior including suicidal threats or attempts
- Periods of intense depressed mood, irritability or anxiety lasting a few hours to a few days
- Chronic feelings of boredom or emptiness
- Inappropriate, intense or uncontrollable anger—often followed by shame and guilt
- Dissociative feelings—disconnecting from your thoughts or sense of identity or “out of body” type of feelings—and stress-related paranoid thoughts. Severe cases of stress can also lead to brief psychotic episodes
What Causes Borderline Personality Disorder?
The causes of BPD are not fully understood, but scientists agree that it is the result of a combination of factors, including:
- Genetics: While no specific gene or gene profile has been shown to directly cause BPD, research suggests that people who have a close family member with BPD may be at a higher risk of developing the disorder
- Environmental factors: People who experience traumatic life events—such as physical or sexual abuse during childhood or neglect and separation from parents—are at increased risk of developing BPD
- Brain function: The emotional regulation system may be different in people with BPD, suggesting that there is a neurological basis for some of the symptoms. Specifically, the portions of the brain that control emotions and decision-making/judgment may not communicate optimally with one another
Key Symptoms in Teenagers (https://www.mcleanhospital.org/essential/teens-bpd)
Behavioral Dysregulation
This is one of the first signs people may notice, with some teens engaging in self-harming behavior. They may cut themselves, burn their skin, or punch a wall. Plenty of other issues may appear as well: the child or teen may use substances or engage in dangerous sexual behavior.
Relationship Problems
Many kids and teens with emerging BPD have trouble managing relationships. They may have an intense fear of abandonment or may have trouble controlling their anger. When very emotionally distressed, some teens may hold irrational or paranoid beliefs. These fears and beliefs may make it hard to develop friendships or romantic relationships.
Strong Emotional Reactions
There may be strong emotional reactions to seemingly minor issues, where they may appear to overreact to everything. Minor issues may feel like the end of the world.
It is difficult for health care professionals—and parents—to look at these signs and know whether an adolescent has emerging BPD or if the individual is simply going through a normal teenage phase.
With this in mind, a teenager who displays any or all of the characteristics associated with BPD might look around and ask themselves: “Does it seem that other people can deal with things I can’t deal with?” or “Why aren’t others struggling like I am?”
A teenager who feels strong emotions for longer periods than others or takes longer to get back to their emotional baseline may have the condition. Strong reactions to seemingly small irritations—a sense that minor issues feel like the “end of the world” and that behaviors like self-harm, drugs, or death seem to be the only way to make these stop—could be signs of a serious problem.
