BPD in Youth and Young Adults

Before 2013, the Diagnostic and Statistical Manual (DSM-5) recommended limiting the diagnosis of BPD to those 18 and over. This is no longer the case because research supports early diagnosis and treatment and indicates that BPD specific interventions may reduce the severity of  symptoms and improve long-term outcomes for recovery. This means that more children, teenagers and young adults are being diagnosed and treated for BPD in both inpatient, long-term, and outpatient settings.

For this reason, it is essential for educators and parents to have the tools to support those with a  BPD diagnosis in schools. This support will improve retention and promote educational success. 

Why Adolescence is a Critical Period to Treat BPD and Provide School Support

Adolescence is a stage of development marked by physical and psychological changes. Issues of independence and identity arise and it can be a time of experimenting. During this stage many young people begin experimenting with drugs, alcohol, sexuality, social groups, and money management.  It’s a time of transition as adolescents begin separating from parents, focusing more on social and romantic relationships, and developing their own identity and interests.  

Those diagnosed with BPD, however, are delayed in achieving many of these hallmark milestones of adolescent development. They have difficulty forming relationships, separating from parents, and demonstrating independence socially, financially, and functionally in school and in the community.

Adolescents with BPD are at risk for highly impulsive behaviors and maladaptive ways of coping with shifting emotions. This includes self-harm behaviors (cutting, self-mutilation, burning, head banging, etc.), bullying, peer maltreatment, drug and alcohol abuse, sexual risk taking, stealing, and eating disorders. Adolescents with BPD are also at high risk for suicidality. Up to 70% of those diagnosed with BPD attempt suicide, and it’s estimated that up to 10% succeed.

It is vitally important that school administrators, health care professionals, and family members support adolescents diagnosed with BPD through the challenges of adolescence. They are not displaying typical teenage behaviors like “rebellion” or “angst.”  They are suffering from a serious mental illness and need a supportive environment.  Intervention and treatment saves lives during this extremely vulnerable stage of life.