Teen Borderline Personality Disorder is an intensely difficult mental health condition that causes sufferers to experience long-term, chronically distorted views of the world and relationship with others. Patients often experience “black or white, all-or-nothing” thinking with a markedly negative outlook that impacts relationships, social skills, and even the ability to focus and be productive in academics or hobbies.

There is a distinct link between BPD and low feelings of self-worth, self-esteem, and inadequacy. This causes sufferers to “act out” and struggle to self-regulate emotions. Teens with BPD often offend and ostracize others without meaning to, making inappropriate comments or experiencing frequent emotional outbursts.

What Does Teen Borderline Personality Disorder Look Like?

  • Teens with BPD may be aware of their negative behaviors, and may even feel guilty or want to change them, yet struggle to do so. Despite their best efforts, they often fail to improve or maintain relationships.
  • BPD is associated with compulsive, negative and reckless behavior. These behaviors often lead to shame; this worsens symptoms.
  • Teen Borderline Personality Disorder causes patients to become rigid, inflexible, negative, and challenging. They may be self-destructive or lash out at others around them, developing maladaptive behaviors or even falling into trouble with the law.

Signs of Teen Borderline Personality Disorder

Spontaneous and frequent spending

Inability to maintain or grow relationships

Feeling suspicious of kindness

Rapid, often severe mood swings

Intense feelings of anxiety or depression

Self-isolation and withdrawal

Pushing people away, yet feeling lonely

Frequent use of recreational drugs

Preoccupation with death and/or suicide

Inability to trust loved ones or friends

Rigid, black-or-white thinking and behaviors

Different Types of Teen Borderline Personality Disorder

Discouraged Borderline – Patients who are “discouraged” are markedly depressed and often experience intense despair. They may seem overly serious, angry, or irritated, and are often self-destructive.

Impulsive Borderline – Teens with the impulsive form of BPD are considered “risk-takers,” yet the risks they take are rarely healthy.

Petulant Borderline – Petulant BPD causes teens to struggle mostly with relationships. They are often embroiled in social drama, and obsess about disappointing others.

Self-Destructive Borderline – Self-destructive behaviors can occur in any form of BPD, but in the self-destructive form itself, are often much more severe.

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Teen Borderline Personality Disorder Treatment | Paradigm San Francisco

What Are The Causes Of Teen Borderline Personality Disorder?

Researchers aren’t yet sure exactly what causes teen Borderline Personality Disorder; however, we do have some clues. Genetics, trauma and abuse, intense stress, and child sexual, physical, or emotional abuse all greatly increase the risk for BPD to develop.

Teen Borderline Personality Disorder is actually quite rare, affecting just 0.9 percent to 3 percent of the population. Unfortunately, it is almost impossible to predict when they will occur and whether one patient will experience BPD over another. The best approach is to weigh the risk factors and seek treatment early if risks exist.

Genetics – Teens who are directly related to someone with Borderline Personality Disorder, or another personality disorder, are more likely to develop the condition themselves. It isn’t yet clear whether this is due to genetics or consistent environmental influences.

Trauma and abuse – Extreme trauma and abuse can lead to the development of Borderline Personality Disorder. Early experiences like child sexual abuse or witnessing an intensely traumatic event (such as an active shooter event) may cause deep and permanent emotional scars; BPD is the patient’s way of self-protecting, even though it is maladaptive. Teens who develop BPD as a result of trauma very frequently experience low self-esteem and very often suffer from Post-Traumatic Stress Disorder (PTSD).

Stress at home or in school – Intense, chronic stress can be extremely disabling for teens, and may eventually lead to Borderline Personality Disorder. However, even intense, short-term stressors, such as a break-up or failing a class, may trigger a worsening of symptoms for some teens.


of all Americans suffer from Borderline Personality Disorder


of all BPD sufferers have other comorbid mental health conditions


of all BPD sufferers experience intense, chronic anxiety

How Can I Help My Teen with Multiple Borderline Disorder?

Differentiate the person from the disease – Living with and loving a teen with Borderline Personality Disorder can be extremely difficult sometimes. You may feel as if you are “walking on eggshells” or unable to engage with them for fear of setting them off. Know that this experience is a result of the disease, not just your teen behaving badly.

Teen Borderline Personality Disorder often causes sufferers to struggle with relationships, socialization, and showing familial love. They may seem to withdraw or push you away, yet immediately become upset about being ignored or feeling lonely. You may find yourself struggling to determine why their thinking is so irrational, compulsive, impetuous, or self-destructive; they may even become nonsensical or unpredictable.

Be there and offer support – As a parent, the number one contribution you can make to your teen’s healing process is to simply be there and be willing to stick it out for the long run. This can seem like a momentous task early on in treatment, but it is incredibly important. Do everything you can to learn the truth about Borderline Personality Disorder, why it is so stigmatized, and how your teen personally experiences BPD.

Knowing where to turn for help, where to get information, or what to do if symptoms become so severe you fear for your teen’s safety is your most critical first step. Then, you should seek guidance on how to best respond to outbursts and meltdowns. Stay calm and be mindful of the fact that teens with BPD are so much more than just their disorder.

Therapy (for yourself and your teen) is the best way to learn about BPD and develop new management skills as a parent. Therapists can help you empower your teen to understand their own behavior, how to change it, how to reduce symptoms, and even how to recognize the positive traits associated with BPD – such as creativity and empathy.

Be honest and appreciative – Teens with Borderline Personality Disorder thrive on attention and recognition – positive or negative. Often, some attention is better than none, even if it is maladaptive. Being honest with your child about how you feel and praising them when they do well is extremely important in BPD treatment. In fact, positive reinforcement is much more effective than punishment because outbursts are rarely malevolent, but simply a result of a lack of ability to self-regulate instead.

What Types of Teen Multiple Borderline Disorder Treatment Are Available?

Treating teen Borderline Personality Disorder isn’t easy, but it is possible. The best approach is long-term therapy for most patients, but other approaches may help depending on your teen’s condition. Therapists, psychiatrists, and doctors often work together to create a multifaceted treatment plan that addresses the needs of the whole patient.

Teaching teens how to recognize their outbursts, their negative thinking patterns, and new social skills is often remarkably effective in creating long-term change. Therapists work with teens to show them how to label their feelings, recognize positive and negative thought patterns, and regulate stress reactions after triggers that cause them to act out. Then, they show them how to apply those skills in interpersonal relationships, too.


Medication cannot cure Borderline Personality Disorder; however, it may help some patients reduce their symptoms just enough to engage with therapy or restore function. This is especially true if teens suffer from another condition, such as Bipolar Disorder or Anxiety. Optional treatments include Selective Serotonin Reuptake Inhibitors (SSRIs), Selective Serotonin Norepinephrine Inhibitors (SNRIs), antipsychotics, benzodiazepines, and mood stabilizing drugs.

Talk Therapy

Talk therapy is the most well-researched approach for treating Borderline Personality Disorder, and has the most evidence-based support for improving prognosis. However,  because the nature of Borderline Personality Disorder is attention and fear of abandonment, traditional formats like Cognitive Behavioral Therapy (CBT) may be all but ineffective or even cause symptoms to become worse.

Instead, Dialectical Behavioral Therapy (DBT) is used. This form of therapy focuses on teaching teens to self-regulate their emotions and stay “in the moment,” which can help with fears of abandonment or the impulsive need to “act out.” It’s also one of the best therapy formats for helping sufferers learn how to have healthy social relationships because it shows teens how to identify and manage triggers at home, in school, or even at play.

The goal of psychotherapy – whether DBT, CBT, transference-focused therapy, or some other approach – is always to help teens better understand themselves. Through self-understanding, teens re-learn self-love, develop stronger self-esteem, and are better able to react to social scenarios in a positive, healthy, growth-inducing manner. They learn how to judge character the right way (without being negative), how to effectively self-protect, and how to break free from obsessive needs for attention or black-and-white thinking patterns about themselves.

Alternative Therapies

Paradigm’s care team knows that every Borderline Personality Disorder patient is unique, and that means some patients benefit more from alternative therapies. Options like mindfulness training, meditation, equine therapy, animal-assisted therapy, exercise therapy, and even music or dance help teens to reconnect with themselves and discover who they really are. These activities reduce anxious energy, re-ground the patient and give them a solid foundation.

Teen Borderline Personality Disorder Treatment at Paradigm San Francisco

Paradigm San Francisco’s new center is structured to provide teens with a supportive, healing environment where they can grow, learn, and heal. Treatment centers are small, intimate, and specifically kept at low populations to allow staff to provide one-on-one support.

Time and Place

At Paradigm San Francisco, we don’t focus on specific treatment timeframes. Instead, we work hard to customize every treatment path to the patient. Rather than creating a 30-day plan or a 90-day plan, your teen works at their own pace to heal and get better. Our therapists are equipped and prepared to provide individualized treatment plans for every patient, encouraging teens to play an active role in their own care.

Being Among Others

Teens with Borderline Personality Disorder often struggle with socialization. At Paradigm, they will learn to effectively communicate and practice their skills with their peers, all while maintaining a sense of self. This includes managing intense emotions or reactions.

“Outstanding! I believe Paradigm saved our daughters life and taught me invaluable things about how as her mother I can best support her in her journey to healing.

– Dee

Frequently Asked Questions About Teen Borderline Personality Disorder

How long does therapy take?

There’s no one defined length of therapy required to “cure” teen Borderline Personality Disorder. You will move at your own pace and progress through milestones at your own rate, eventually feeling “normalized” and able to socialize in a healthy manner. Your outbursts, obsessive behaviors, and compulsions will lessen, giving you the power to take back your life and avoid harming your most intimate relationships with friends and family members. This process can take time.

Why don’t people with personality disorders know they have one?

Let’s address the facts first: this isn’t always true. If you know how to identify a personality disorder, you may already know you’re struggling. But many people struggle to recognize how their own coping skills and behaviors are flawed when they have a personality disorder like BPD. This occurs for a few different reasons.

Firstly, our own reality is often the most “real” to us. The ability to relate to the reality of others is a learned skill. Furthermore, having BPD may make it harder to understand that the way you feel isn’t the same as most people feel; you may even assume that everyone feels or experiences the world in the same way you do.

While there is no “right” or “wrong” way to think, it is important to be able to discern reality and opinion so you can better moderate your behavior and reactions. It’s about being socially and emotionally well, staying safe, and understanding yourself and others. Life isn’t always black and white; you’re valuable, too, and deserve to feel secure in who you are.

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