Teens with Borderline Personality Disorders
Borderline personality disorder (BPD) is one of the most controversial diagnoses in psychology today. According to BPD Central, one of the oldest and largest resources online, a personality disorder is described as "an enduring pattern of inner experience and behavior that deviates markedly from the expectation of the individual's culture, is pervasive and inflexible, is stable over time and leads to distress or impairment in interpersonal relationships."
When a person suffers from borderline personality disorder, it causes distress for both the individual who has the disorder and all of the people who interact with him.
Signs and Symptoms
The National Alliance for the Mentally Ill (NAMI) based in Arlington, Va., says that BPD is characterized by impulsivity and instability in mood, self-image and personal relationships. Individuals who have BPD have several of the following symptoms:
- Marked mood swings with periods of intense depression, irritability and/or anxiety lasting a few hours to a few days.
- Inappropriate, intense or uncontrolled anger.
- Impulsiveness in spending, sex, substance use, shoplifting, reckless driving or binge eating.
- Recurring suicidal threats or self-injurious behavior.
- Unstable, intense personal relationships with extreme, black-and-white views of people and experiences, sometimes alternating between "all good" idealization and "all bad" devaluation.
- Chronic boredom or feelings of emptiness.
- Frantic efforts to avoid abandonment – real or imagined.
"Our daughter has ran the gamut as far as being diagnosed with so many things," says Joan Anderson of Toronto, Ontario, Canada. "She was diagnosed with ADD many years ago and has since been diagnosed with bipolar disorder and possible borderline personality disorder."
Anderson has seen many of the symptoms in her child that are listed as possible signs of BPD. "She has incredible mood swings, and her perception of people is often clouded – no gray areas, just very black and white," she says. "It is often difficult to watch and very hard to understand as a parent."
Anderson has felt the wrath of her daughter's rages when she was in her early teens. After witnessing destructive behavior brought on by intense negative feelings, the Andersons decided to see a psychologist. "She is on medication and in therapy, and it does help, but it is often exhausting – she is so unpredictable," says Anderson. "The worst part has to be the social arena. It breaks my heart to see her push people away. Her personal relationships are virtually non-existent, and the ones that she does choose end up being negative influences. She seems to be drawn to the wrong people which feeds into the self-destructive attitudes."
Diane Roberts Stoler, health psychologist from Georgetown, Mass., says that with proper therapy the prognosis for individuals with BPD can be good to excellent. "Therapy is needed two to four times per week for five years or more," she says. "It entails reconstructive psycho dynamic therapy."
Stoler says the symptoms for BPD are similarly related to infancy. "Clingy behavior, problems with setting limits and boundaries, acting out, feelings of loathing and emptiness, developmentally arrested at age 2; therefore, behavior is similar to that of a 2-year-old with temper tantrums and seeing the world as black and white," she says.
In the Fog
There is so much to be learned about BPD that even the mental health community is still unsure of many aspects of the disorder. The causes are unclear. NAMI reports that the disorder appears to be related to depressive illness and neurological and attention deficit disorders. There are also biological factors that are being considered which may cause mood instability resulting in increased relational issues.
Because teenagers are often plagued to a certain extent with many of the symptoms listed, it is difficult to diagnose BPD in young teens. Some doctors hesitate to give a diagnosis until the late teens to early 20s.
BPD rarely travels alone. It most often exists with other psychological disorders such as:
- Post-traumatic stress disorder
- Mood disorders
- Panic/anxiety disorders
- Gender identity disorder
- Attention deficit disorder
- Eating disorders
- Multiple personality disorder
- Obsessive-compulsive disorder
Carol Quigley from Jacksonville, Fla., recalls that from the very start her daughter was a very fussy, cranky baby. "She seemed to over-stimulate far too easily," she says. "She rarely slept, and when she did fall asleep, the slightest noise would awaken her."
Quigley says her daughter had trouble all through school. She was tested for learning disabilities and placed on Ritalin for possible ADD. "The Ritalin didn't do much except to keep her more in the middle, emotionally speaking," says Quigley. "By middle school her problems really exacerbated. She began to show signs of depression and was ultimately prescribed antidepressants."
Quigley says that after that it got pretty wild. Her daughter fabricated stories of abuse, was self-mutilating and threatened suicide. She was defiant at school and at home. "I ultimately put her in a school, a much smaller school, specializing in dealing with kids with learning disabilities," says Quigley. "There she created so much havoc. She began to obsess over friends. She seemed unable to differentiate between someone being a 'friend' and somewhat more than a friend. She scared away peers by the droves."
High school wasn't any better. She wouldn't comply with her medication regime or the current treatment.
Quigley's story doesn't have a happy ending. By the time her daughter was a legal adult, there wasn't any more she could do to keep her under control. She began using drugs in high school, was threatening toward the family and hospitalized for suicidal threats. "She is now living in an adult living facility, a deplorable place for folks who can't or won't help themselves," says Quigley. "It breaks my heart."
One of the most difficult things for a parent is to let go of the control when your child has a disability. For Quigley, she has had to do just that. Unfortunately, her daughter fought the system that was trying so desperately to help her.
What Can Be Done
According to the Borderline Personality Disorder Research Foundation, the seriousness of BPD is compounded by the fact that it is difficult to treat. The very characteristics of the disorder – unstable relationships, intense anger – interfere with establishing the therapeutic relationship that is necessary for treatment. Unfortunately, despite the devastating nature of this disorder, BPD has not received the scientific and clinical attention that other health and psychiatric problems of equal, or even lesser, level of disability have received.