6 Signs of Borderline Personality Disorder in Teenagers

Writer’s note: Hey, Psych2Goers! This article isn’t meant for diagnosing anyone or for the readers to self-diagnose or to personally attack anyone with BPD. It is meant to create awareness among the general public, so if you or someone you know may be struggling, don’t hesitate to seek professional help from Psychiatrists or other trusted professionals.

It is sometimes hard to delineate personality disorders since they can remarkably overlap with “normal” personality. However it is important to note that personality “disorders” are inherent and manifested as outstanding or extreme deviations from the common perception, thoughts, feelings, and identification with others that a person in a given culture normally exhibits (Kelly, 2020).

According to the current fifth edition of the Manual (DSM-5), in the narrative descriptions of the cluster B disorders, it is stated that borderlines and antisocial individuals are manipulative, each with a different objective. People with antisocial personality disorders manipulate to acquire wealth and power whilst the aim of borderline individuals is to obtain attention, positive feedback, or encouragement (Brogaard, 2020).

Arjan et al. (2019) reported that the first manifestation of borderline personality disorder (BPD) is during adolescence and can be reliably differentiated from healthy adolescent development. DSM-5 allows diagnosing BPD under the age of 18, if the symptoms are pervasive, persistent, not limited to a particular developmental stage or another mental disorder, and if the symptoms have been present for at least 1 year.

Now, Psych2goers, let’s take a look at the 6 signs of BPD in teenagers, shall we?

  1. Frequent and intense changes in mood

Picture this scenario…You have a new classmate who sits next to you in your class. Initially, he is a joy to be around, generous, happy-go-lucky. Quickly, you establish a relationship beyond mere acquaintance with this person. You think he is a sincerely good friend. You become best friends with him. One day, after a physical education class, when he returns to his desk, he notices his collection of manga books under his desk is gone. He looks at you with a menacing stare, “Did you take my manga books under my desk? I know you take them since you always beg me to lend them to you, but I always say to wait until I finish reading all first?! Are you kidding me?!” You give an apologetic smile to him, apologize sincerely even though you are not the one at fault. Yes, you admit you surreptitiously took one of them for a quick glance, but other than that, you never do it again. You say you simply don’t know how they can all disappear. However, he is still extremely furious. Since that day, he has cut all friendly conversations with you. You know from the other classmates that he badmouths you behind your back. You decide to not engage in anymore interaction with this friend, ever again.

What do you notice from the anecdote above?

It seems that this new colleague fits a classic portrayal of borderline personality type. There is a rapid fluctuation between love and hate. For them, everyone is either a saint or a devil. There are no in-betweens. The frequent and intense changes in mood makes it impossible to predict his behaviour socially and this eventually hampers his closest relationships (Geher, 2021).

2. Fear of abandonment or rejection

“We need to talk,” you texted your friend to discuss certain matters that she did yesterday in the class that annoyed you. 

“Why? You don’t want to be my best friend anymore? I will kill myself.” 

Your eyes were widened in shock as you received such a reply from her. 

In a close relationship, borderline individuals display behaviours originated from the fear of abandonment or rejection, which can include :

A. Clinging – bombardment of text messages, calls, turning up in front of your doorstep by surprise 

B. Manipulation to keep a relationship – lying, pretending to be pregnant, suicidal threats or gestures, threatening to spread malicious rumours to your family 

C. Complete rage at potential abandonment – Spreading rumours on the internet, sometimes physical abuse, verbal criticism

3. Difficulty maintaining relationships 

Darlene Lancer, JD, LMFT (2019) stated that borderlines are usually dependent individuals and they would usually find partners who are able to provide stability and to balance their variable emotions. Self-sufficient people or narcissists who outwardly appear to be in control with their feelings become easy targets for the borderline’s supreme charm and vulnerability. Non-BPDs may feel that borderline’s labile emotions are interesting and being with “healthy” people seem somewhat dull. This partner may look to be like the caretaking top dog, however on the contrary, both of them are dependent on each other, and it may be difficult for them to break away from the unhealthy relationship. Furthermore, this partner becomes an enabler and an emotional caretaker who gives in to the borderline’s control in the relationship. H/she even accommodates and apologizes when attacked in order to maintain the emotional connection in the relationship. Anyone who views the relationship from outside will definitely see how unhealthy their relationship is. If an emotionally healthy person gets entangled in a relationship with a borderline individual, h/she may recognize early on, regarding these red flags and eventually try to pull themselves out of the relationship. That is why most people may find it hard to maintain a healthy and sound relationship with borderline individuals. 

4. Impulsive and risky behaviour 

Joanna receives £500 as a monthly allowance from her parents. She is a student in a boarding school and all her school fees are being taken care of and the money is for extra expenses. She usually uses the pocket money to buy expensive shoes and clothes, and if it is not enough, she would “borrow” from her friends. However, she never pays her friends back. 

Borderline individuals may exhibit impulsive behaviour in at least two areas that are possibly self-damaging such as spending, sex, substance abuse, reckless driving, or binge eating (American Psychiatric Association, 2013).

5. Paranoia 

Derrick sends a text message to his significant other. However, after waiting for several hours, his text remains unreplied. Derrick is entirely convinced that he is so insignificant in his partner’s life that he is forgotten.  

“You know that’s not true, right? It’s impossible for your partner to forget you unless they suddenly develop amnesia,” his best friend challenges his thought process. 

“Yeah, I know you are right, but I remember when we were talking about our exes, I asked about the guy she was dating before me, and she casually said, “Oh yeah, I forgot about him.” 

In his mind, Derrick knows that his partner does not literally mean he forgets his ex’s existence, she just meant that she forgot to mention about him. However, that sentence kept repeating itself in his head over and over again. 

What do you think of the above scenario?

Derrick may be experiencing paranoia due to his extreme black-and-white thinking, in which his brain literally interprets it based on his feeling that he is worthless because she forgets to text him back. 

6. Recurrent suicidal behaviour or threats or self-harming behaviour 

Lydia found her daughter in her bedroom, cutting her arms with a pocket knife. 

“Just small cuts, mom,” she said to Lydia while looking into her eyes, “It’s not that deep. I just want to relieve my stress.”

Lydia was shocked and very rattled with that discovery.

BPD is associated with suicidal behaviours and self-harm. According to a 27-year follow-up study conducted by Paris  & Zweig-Frank (2001), up to 10% of BPD patients will die by suicide, with a reported mean age of 37 and a standard deviation of 10. Therefore, young patients who are frequent visitors to the emergency room are not at their highest risk of suicide. Pompili et al. (2005) conducted a meta-analysis which reported that suicidality is “more alarming” in young people, who display a high level of suicidal behaviours. However, most borderline individuals’ condition will gradually improve and those who die by suicide tend to be those who fail to recover (Paris, 2003). 

Final Thoughts

Similar to other personality disorders, BPD exists on a continuum, from mild to severe.

It was well-known that historically, in the mental health world, that BPD was almost impossible to treat. However, in the recent era, experts agree that this mental health condition is treatable with commitment to therapy, and greatly improve the patients’ quality of life. A finding from a 10-year follow-up study by Gundersan et al. (2011) showed that 85% of those with BPD were in remission by the end of the study. These patients also exhibited low rates of relapse, and  a great improvement in social functioning. 

In conclusion, it is important if you note your loved ones or yourself have the above signs, to seek help from mental health professionals so that proper treatments and interventions can be taken. 

REFERENCES

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013, 665.

Brogaard, B. (2020, August 19). The Emotional Toll of Living With a Borderline Individual. Psychology Today. https://www.psychologytoday.com/us/blog/the-mysteries-love/202008/the-emotional-toll-living-borderline-individual.

Geher, G. (2021, May 26). Why People with Borderline Personality Are Quick to Cut People Out of Their Lives. Psychology Today. https://www.psychologytoday.com/us/blog/darwins-subterranean-world/202105/why-people-borderline-personality-are-quick-cut-people-out.

Gunderson, J. G., Stout, R. L., McGlashan, T. H., Shea, M. T., Morey, L. C., Grilo, C. M., Zanarini, M. C., Yen, S., Markowitz, J. C., Sanislow, C., Ansell, E., Pinto, A., & Skodol, A. E. (2011). Ten-year course of borderline personality disorder: psychopathology and function from the Collaborative Longitudinal Personality Disorders study. Archives of general psychiatry, 68(8), 827–837. https://doi.org/10.1001/archgenpsychiatry.2011.37

Kelly, B. (2020, January 13). Borderline Personality Disorder: What It Is, Why It Matters. Psychology Today. https://www.psychologytoday.com/us/blog/psychiatry-and-society/202001/borderline-personality-disorder-what-it-is-why-it-matters.

Lancer, D. (2019, September 5). The Drama of Loving a Borderline. Psychology Today. https://www.psychologytoday.com/us/blog/toxic-relationships/201909/the-drama-loving-borderline.

Paris, J., Zweig-Frank, H.A. (2001). 27-year follow-up of patients with borderline personality disorder. Compr Psychiatry. 42(6):482-7.

Paris, J. Personality Disorders Over Time. American Psychiatric Press; Washington, DC, USA: 2003

Pompili, M., Girardi, P., Ruberto, A., Tatarelli, R. (2005). Suicide in borderline personality disorder: a meta-analysis.

Nord J Psychiatry. 59(5):319-24.
Videler, A.C., Hutsebaut, J., Schulkens, J.E.M. et al. (2019). A Life Span Perspective on Borderline Personality Disorder. Curr Psychiatry Rep 21, 51 https://doi.org/10.1

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