Borderline Personality Disorder is a condition that affects a person’s thoughts, emotions and behaviour. It has this name because it used to be thought to be on the “borderline” between neurosis and psychosis, but it can also be called Emotionally Unstable Personality Disorder. We all have a mixture of personality characteristics, and sometimes these can be helpful and sometimes these can cause us problems – in Borderline Personality Disorder, the personality characteristics have an overall negative impact on the person’s life.
In some circumstances it can be diagnosed before the age of 18, though it is unlikely to be diagnosed in younger teenagers as the personality is still developing. It is more commonly diagnosed in females than males. When diagnosed in people younger than 18, it is sometimes described as emerging borderline personality disorder (EBPD).
Young people with borderline personality disorder may describe many of the following:
It is not clear why some people develop Borderline Personality Disorder, but most research indicates it is likely to be a combination of genetic, psychological and social factors.
People who have Borderline Personality Disorder are more likely than most people to have had difficult or traumatic experiences in childhood and adolescence. These experiences might include:
There is no single test to tell if someone has Borderline Personality Disorder. It is likely the assessment process will involve different mental health professionals, such as a psychiatrist, a psychologist and a psychiatric nurse. The assessment should involve not just the young person, but their parents/ carers, and other people who know the young person well such as teachers, social workers and support workers.
The assessment should consider the life story of the young person as well as their current difficulties. The psychiatrist will do a thorough mental health assessment to ensure there is no other mental health disorder which can be diagnosed.
The main treatment for BPD is psychological therapy, rather than medication. You may be offered medication to treat another mental health problem, such as depression or anxiety.
Research studies have been done into the effectiveness of various psychological therapies for BPD, with some positive results. Few studies have been done specifically with under 18s.
Working out what helps keep you well and what helps you cope when things are getting tough can help prepare you to ‘weather the storms’. This may be written down to form a personalised crisis plan.
There is evidence that admitting people with Borderline Personality Disorder to psychiatric hospital can increase the risk of self-harm, and is unlikely to have long-term benefit though it may temporarily relieve the crisis – for this reason, it is usually not helpful to consider hospital admission.
It used to be thought that Borderline Personality Disorder was untreatable, but research has shown that 85% of people who receive treatment don’t experience enough of the symptoms of BPD after 10 years to be given that diagnosis any more.