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What is borderline personality disorder?

Borderline personality disorder (BPD) is a mental health condition that comes with extreme emotions, intense challenges with self-esteem, and difficulty forming strong, stable relationships with others. Teenagers with BPD are often angry, impulsive, and quick to believe that other people have wronged them.

Young people with BPD often harm themselves and they have a high risk of suicide. Symptoms of BPD usually show up in the teenage years. Early treatment can help people with BPD manage the disorder better.

What are the symptoms of BPD?

Symptoms of BPD include:

  • Unrealistic or unstable sense of self
  • Believing they’re worthless
  • Regularly feeling angry, empty, or hopeless
  • Mood swings
  • Finding it hard to control emotions, especially anger
  • Brief, intense periods of anxiety or depression
  • Fear of being abandoned and desperate attempts to avoid it
  • Paranoid thinking
  • Quickly changing from loving or admiring someone to disliking or criticizing them
  • Impulsive behavior, such as risky driving, unsafe sex, or alcohol and substance abuse
  • Self-harm
  • Attempting suicide

How is BPD diagnosed?

A mental health professional must diagnose BPD. To be diagnosed with BPD, a person must have at least five of the symptoms listed above by the time they’re a young adult.

What are the risk factors for BPD?

Kids are more likely to have BPD if they have a parent or sibling who also has BPD.

Experts view BPD as a combination of two big factors. The first is a natural tendency to get upset very easily. The second is growing up in a household that doesn’t help kids learn to handle big emotions. Without support as children, young people who experience especially strong emotions may develop unhealthy ways of coping.

What is the treatment for BPD?

The best therapy for BPD is dialectical behavioral therapy (DBT). DBT teaches patients skills to manage their emotions and stop harming themselves. It’s called “dialectical” because it’s about learning to balance two concepts that seem like opposites: the need for acceptance and the need for change. Long-term studies show that DBT works well for BPD.

There are no medications to treat BPD. However, medication can sometimes help specific symptoms of BPD, including depression, impulsive behavior and anxiety.

Teens with BPD who are in danger of suicide are sometimes hospitalized for treatment.

Risk for other disorders

It is common for people with BPD to have other mental health disorders at the same time. Disorders that often show up with BPD include depression, bipolar disorder, substance use disorder and eating disorders.

People with BPD are also at risk of suicide. If you think your child or teenager is suicidal, you can call the National Suicide Prevention Lifeline at 1-800-273-8255 or 911 if there is an emergency. Don’t wait — the risk of suicide in children and teenagers is very real.