Whilst borderline personality disorder (BPD) can be diagnosed in adolescents, some clinicians may be reluctant to do so ; I summarize some of the main reasons for this below :
– Symptoms of borderline personality disorder (BPD) may overlap lap to some degree with non-pathological (‘normal’) adolescent behaviors which can somewhat muddy the waters when it comes to attempting to make a clear, unambiguous and unequivocal diagnosis.
– The personality of the adolescent is still developing and is not yet fully formed
– Although it is less the case now than it was (in even the relatively recent past) a diagnosis of borderline personality disorder (BPD) is still often perceived as being stigmatizing and can potentially make the adolescent feel yet worse about himself/herself when his/her self-esteem and sense of self-worth is already extremely low (low self-esteem and low sense of self-worth are hallmark symptoms of BPD).
However, some individuals also feel a great sense of relief to have a diagnosis as it helps them to understand the root causes of their dysfunctional behaviors and therefore feel less guilty (feelings of intense, irrational guilt are another hallmark symptom of BPD).
Also, of course, an accurate diagnosis helps to ensure appropriate and effective treatment is given (see RISK OF SUICIDE below); at present, the most effective treatment for BPD is considered to be dialectical behavioral therapy (DBT). Whilst DBT is a therapy that was initially developed in order to help to treat adults with BPD, it is possible to adapt it to the needs of the adolescent. However, the majority of clinicians are still reluctant to make the diagnosis of BPD in young people who are under the age of eighteen years.
– Because BPD has its roots in childhood experience, it is likely that some clinicians are worried about diagnosing BPD in the adolescent in case the parents may regard it as a negative judgment upon them and therefore become upset or angry.
However, if the parents’ behavior has seriously damaged their child, then alerting them to the fact may galvanize them into making a concerted effort to improve the manner in which they treat the young person (sadly, of course, this can’t be guaranteed ; indeed. abusive parents may feel humiliated at take it out on the child).
– Because BPD sufferers tend to be gravely misunderstood, even by those entrusted with their care and treatment, some clinicians may be reluctant to diagnose adolescents with BPD in case it results in them being treated with prejudice and discriminated against by other clinicians they may come into contact with in later life,
THE RISK OF SUICIDE :
It is vital to remember that one in ten (yes, 10%) of individuals with BPD end up dying by suicide. This statistic demonstrates the vital importance of the earliest possible therapeutic intervention for those suffering from this profoundly painful and complex condition. Clearly, a prerequisite to effective treatment is sensitive, timely and accurate diagnosis.
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David Hosier BSc Hons; MSc; PGDE(FAHE).Click here for reuse options!
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