diagnosing borderline personality in adolescence

By: Jadon Webb, MD, PhD

Borderline personality disorder is one of the most misunderstood (and sometimes even feared) diagnoses, even though it can have a great outcome! 

One of the most controversial aspects of borderline personality is whether it can be diagnosed in those under 18 years of age. 

Patients (and even many clinicians) often believe that borderline personality disorder (BPD) cannot ever be diagnosed under age 18. We have even come across mental health teachers in academic settings who believe this! 

But this is not true. BPD absolutely can - and should - be diagnosed in adolescents when it fits criteria. 

To drive this point home, a major study published in Feb 2022 in JAMA Psychiatry (a prominent journal) looked at effective therapy treatments for people diagnosed with BPD as young as age 15. If one of the top psychiatric journals in the world includes 15 year-olds diagnosed with BPD, this can help end the debate and ease the minds of any that are worried about whether adolescents can be diagnosed.

We feel it is essential to accurately diagnose the true problem, and unfortunately many youth get inaccurately diagnosed as having “bipolar”, depression, ADHD, or other diagnoses when the true diagnosis is BPD. This can have serious consequences. Inaccurate diagnoses can lead to years of unnecessary medications and psychotherapy that is aiming at the wrong core problem.

If an adolescent is suffering from the severe emotional instability that can come with BPD, they deserve a proper diagnosis, no matter the age. We hope to see the culture shift this way in the years to come!

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