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Borderline Personality Disorder in Teens

BPD is a mental illness marked by instability in relationships and an overall difficulty in controlling emotions. If your teen exhibits these symptoms and has a drug abuse problem, they may have a co-occurring disorder. Call us now for more information.


6 min read

What Is Borderline Personality Disorder?

Unhappy girl sitting in a corner

Borderline personality disorder (BPD) can be described as a serious mental condition that causes unstable emotions, impulsive behavior and occasionally psychotic episodes. Patients with BPD are unable to regulate their thoughts or moods, which usually results in poor self-image, stormy interpersonal relationships and major difficulties fitting in with a crowd due to constant “acting out.” It’s a troublesome disorder to diagnose, and can often resemble symptoms of other psychological problems.

Facts About Borderline Personality Disorder

At least 1.6% and up to 6% of Americans may suffer from BPD, but there’s a reluctance among therapists to diagnose patients younger than 18. While thousands of kids struggle with the disorder or a number of its symptoms, only 40% of patients aged 15–18 meet the criteria for BPD after a 2-year follow-up.

Teens who suffer from borderline personality disorder can be at risk for extremely destructive behaviors and go on to develop co-occurring disorders, including mental health disorders, drug addiction and alcoholism. Between 50 and 70% of current BPD patients have a dual diagnosis, or simultaneous substance use disorder. Often, teens contemplate suicide, harm themselves and struggle with long-term issues with alcohol when diagnosed with borderline personality disorder.

What Causes Borderline Personality Disorder?

A young woman sitting alone

Researchers have been unable to pinpoint a direct cause of BPD. Like similar mental illnesses, it’s likely the result of combined factors. There is some evidence that improper brain function, such as impaired communication between different parts of the brain, can cause people to develop the disorder.

It also has strong hereditary links — teens who have a first-degree relative with BPD are 5 times more likely to develop it than others. And as with bipolar disorder and PTSD, traumatic life events (e.g. physical or sexual abuse, absent parents, witnessing violence) are often contributing factors in patients with BPD, as are environmental factors (e.g. being part of a community where unstable family relationships are more common).

According to the National Alliance on Mental Illness, 75% of patients diagnosed with BPD are women, but men have more often been misdiagnosed with PTSD or depression when they in fact suffer from BPD.

Symptoms of Borderline Personality Disorder

A young woman in need of help

Treatment professionals typically diagnose patients with BPD if they exhibit at least 5 of the following symptoms:

  • Unstable personal relationships that involve “splitting” — alternating between idealization and devaluation of friends and family members
  • Frantic efforts to avoid being abandoned by loved ones
  • Distorted self-image, which in turn affects values, opinions, moods and goals
  • Impulsive and often reckless behaviors, such as unsafe sex, reckless driving, excessive spending and substance abuse
  • Suicidal thoughts or self-harming behavior
  • Prolonged periods of irritability, anxiety and depressed mood
  • Chronic feelings of emptiness or boredom
  • Intense, inappropriate and uncontrollable anger, usually followed by shame and guilt
  • Dissociative or “out-of-body” feelings and stress-related paranoia

Certain symptoms of BPD can resemble bipolar disorder, schizophrenia or post-traumatic stress disorder. Your teen’s doctor will run extensive evaluations, consult previous doctors and possibly interview friends and family members to paint a clear picture. Borderline personality disorder is a relatively rare disorder in adolescents, but if your son or daughter is diagnosed, it needs to be treated as a serious and urgent issue.

Effects of Borderline Personality Disorder

Living with borderline personality disorder can take an immediate and drastic toll, primarily in the mind. Approximately 85% of BPD patients meet the criteria for at least one additional mental illness. As the illness persist, victims are susceptible to severe consequences in every aspect of their life. This can include:

People battling this disorder frequently develop other health problems, resulting from unhealthy behaviors and inconsistent self-care. Other illnesses commonly observed in BPD patients include:

  • High blood pressure
  • Diabetes
  • Arthritis
  • Chronic back pain
  • Fibromyalgia

Suicidal ideation or attempts are perhaps more prevalent in BPD patients than any other mentally ill patients — as many as 79% of BPD patients have a history of suicide attempts, and 3 out of 4 individuals with the disorder engage in self-harm or “nonsuicidal self-injury.” Between 8 and 10% of people diagnosed with BPD actually die by suicide. Females with the disorder are more prone to develop depression, anxiety or eating disorders, while males are more likely to develop substance abuse problems or antisocial personality disorder.

Risk of Substance Abuse


If your teen has borderline personality disorder or a similar mental health problem, they’re far more likely to experiment with drugs or alcohol than their peers. BPD commonly goes unnoticed and undiagnosed, particularly in young people. Without receiving professional help, teens struggling with these debilitating conditions might choose to self-medicate with illicit substances. BPD is also associated with risky behavior and poor judgment, often involving substance abuse. Even a single use can send them to the hospital for a number of reasons, but one time is rarely enough.

In the event your teen starts using, they may quickly develop an abusive habit or an addiction. Approximately 51% of Americans diagnosed with BPD at some point in their life met the criteria for a substance use disorder (SUD) in the past 12 months. Knowing this, it’s of the utmost importance that you identify symptoms of BPD early on and get your son or daughter the treatment they need.

Does My Teenager Need Treatment?

If you notice signs of borderline personality disorder in your teenager, it is imperative that you act now to get them treatment. Especially when combined with substance addiction, BPD can be devastating and even deadly.

First, speak with a treatment provider such as your family doctor, who can assess the situation and provide professional diagnoses of BPD and addiction, if the illnesses are present. If addiction and BPD are both diagnosed, then the doctor will likely recommend rehab — possibly even inpatient treatment — because BPD is such a severely symptomatic mental illness. If you’re not ready to head to the doctor yet, we at are also available to speak with you — completely free of charge — to discuss the situation. We can provide you with free resources that will point you in the right direction, and help you take the next step towards wellness.

We at know how devastating it is to have a child suffering from BPD and addiction. Over the years, we’ve spoken with many parents who have shared in your pain, but have seen their child grow strong and healthy after treatment. Sometimes BPD is a lifelong illness, but with proper and consistent help, this disorder can be beat. We want so much to help you. Just reach out. Let’s get your child well again.


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