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Borderline personality disorder (BPD) is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a chronic, mental health disorder.

It is a serious psychological condition that is characterized by pervasive instability in moods, emotions, behaviors, and interpersonal relationships which interfere with one’s ability to function in everyday life. Although the cause of borderline personality disorder remains unknown, the National Institute of Mental Health (NIH) alludes to research that “suggests that genetics, brain structure and function, and environmental, cultural, and social factors play a role, or may increase the risk for developing a borderline personality disorder.” Many adolescents display some amount of personality disorder traits during adolescence, and it is considered a matter of typical, non-problematic development by developmental experts

Personality disorder traits become problematic when they become exclusive and rigid in one’s arsenal of coping mechanisms {check out Upwell’s FIDO chart to discover more}. BPD is very difficult to diagnose in young people because its symptoms strongly mirror symptoms of other mental health disorders. Up until very recently, borderline personality disorder was not considered to be diagnosable in people younger than age eighteen, as the personalities of people younger than eighteen are not technically considered to be fully formed. However, in the most recent publication of the DSM-5, it does indicate that BPD can now be diagnosed in people as young as age eighteen, and albeit extremely rare, can be diagnosed in children thirteen years old, and in some cases even younger.

Signs and Symptoms

Teenagers with borderline personality disorder feel prolonged, intense emotions and are unable to return to a neutral emotional baseline after facing an emotionally charged experience in a timely manner. This can affect all areas of one’s life as the duration it takes a young person with BPD to process, integrate, and recover from emotional challenges is elongated. The signs and symptoms of borderline personality disorder are highlighted in the diagnostic criteria that are outlined in the DSM-5. According to the DSM-5, to be diagnosed with BPD a young person must experience five or more of the following symptoms in a variety of contexts:

  1. Emotional instability
  2. Feelings of emptiness
  3. Efforts to avoid abandonment
  4. Impulsive behaviors
  5. Identity disturbances
  6. Inappropriate, irrational, and/ or intense bouts of anger
  7. Transient paranoid and/ or dissociative symptoms
  8. Unstable interpersonal relationships
  9. Suicidal and/ or self-harming behaviors

BPD directly affects how one feels about him or herself, one’s behavior as well as how one can relate to others. Hence, teens with a borderline personality disorder often struggle with relationship issues, lack self-esteem, have a poor self-image, and have an inability to appropriately self-regulate.

Treatment

The treatment for BPD often includes long-term participation in psychodynamic models of psychotherapy such as dialectical behavior therapy (DBT). DBT was developed by Marsha M. Linehan in the late 1980s, intended to be used as a means to treat chronically suicidal individuals diagnosed with a borderline personality disorder. It is founded on the principles of cognitive-behavioral therapy (CBT) and blends Eastern mindfulness techniques (e.g., awareness, mindfulness, and attentiveness to current situations and emotional experiences) to encourage acceptance and change. DBT emphasizes the psychosocial aspect of treatment. The primary goal of DBT, according to Psychology Today, is to “transform negative thinking patterns and destructive behaviors into positive outcomes.” DBT is intended to help treat individuals experiencing emotional dysregulation and/ or, those that are exhibiting self-destructive behaviors. Emotional dysregulation is a term used within the mental health field to denote irrational, poorly modulated emotional responses.

Dialectical behavior therapy is conducted in three different therapeutic settings, each with distinct goals: weekly individual therapy sessions, weekly DBT group skills training sessions, and as-needed phone coaching. The weekly DBT group skills training sessions are used to teach and help facilitate fostering skills in four core areas also referred to as the four modules (core mindfulness, distress tolerance, interpersonal effectiveness, and emotion regulation). Each module highlights distinct and specific skills that build upon each other. The entire DBT program takes about six months to complete, as six weeks are allocated to each of the four modules. Dialectical behavior therapy teaches applicable social and emotional skills, healthy coping mechanisms, and use mindfulness techniques to enable an individual to effectively cope with stress, live in the moment, regulate emotions, and improve relationships with others. 

Further Information and Support

Navigating the challenges that arise from living with mental illness, struggling with substance abuse, and/ or addiction can not only be all-consuming but are often impossible to effectively handle without proper support. If you are concerned for yourself or a loved one regarding mental illness, substance abuse, and/ or addiction we recommend reaching out for help as soon as possible. Bear in mind that you do not have to be on this journey alone. At {Upwell Advisors}, we offer unique, customized concierge therapeutic services to provide our clients with unparalleled support throughout every step of the recovery process. 

Feel free to reach to contact us anytime via email at sean@upwelladvisors.com. We look forward to supporting you on your journey.

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