Mood swings, intense relationships, and a shifting sense of identity are all parts of typical teenage development. When a teen’s emotions or relationships seem more extreme than usual, parents often wonder where the line falls between normal adolescent turbulence and something that needs professional attention.
While they can resemble ordinary adolescent growing pains, personality disorders can dramatically impact a teen’s emotional and social development. Recognizing the behavioral patterns of personality disorders can help families understand their teen’s experience and support them with the help they need.
What Is a Personality Disorder?
The American Psychiatric Association describes a personality disorder as a way of thinking, feeling, and behaving that deviates from cultural expectations, causes distress or problems functioning, and lasts over time. These patterns typically show up in how a person sees themselves, treats others, and manages their emotions.
Personality disorders differ from short-term emotional struggles because they are lasting patterns of behavior, not temporary reactions to a stressful event.
Why Adolescence Is a Complicated Time for Diagnosis
Because teens are still forming their identities and personalities, it’s much more complicated to diagnose a personality disorder in a teenager versus an adult. Healthline notes that the official guidebook of mental disorders used by mental health professionals (the DSM-5-TR) allows for those still in their youth to be diagnosed with personality disorders under current guidelines. However, diagnosing youth with personality disorders can be controversial despite this fact.
Even so, researchers have found that certain behavioral patterns can be reliably identified before adulthood. One study published by the American Psychiatric Association notes that as many as 15% of 14-year-olds and 13% of 16-year-olds show symptoms of borderline personality disorder. The research notes that these patterns are distinguishable from normal adolescent development.
Common Signs to Watch For in Teens
Personality disorders can look different depending on the specific pattern involved, but certain signs tend to stand out in teens. Borderline personality disorder (BPD) is the pattern most often studied and diagnosed in adolescence. The American Academy of Child and Adolescent Psychiatry explains that intense and frequent mood swings, impulsive behaviors, self-harm, and difficulties in relationships can point to BPD. While almost all young people struggle with emotional regulation at times, they note, these experiences are more extreme and last longer for teens with the condition.
Mclean Hospital’s Deconstructing Stigma initiative describes some other possible symptoms of emerging BPD in adolescents. These can include:
- Unstable relationships with family members and friends
- An intense fear of abandonment
- An unclear or constantly shifting self-image
- Chronic feelings of emptiness or loneliness
- Explosive periods of anger
- A feeling of being out of touch with reality
Parents do not need to determine on their own whether a teen’s struggles amount to a personality disorder. What matters most is recognizing when a teen’s emotional intensity or relationship patterns are disrupting their daily life. A comprehensive evaluation from a mental health professional is the appropriate next step whenever these patterns persist and interfere with a teen’s functioning.
Treatment Options for Adolescent BPD
Numerous professional treatment options exist for BPD. Dialectical behavior therapy (DBT) is the most established treatment for teens showing borderline personality traits. DBT was originally developed specifically to help individuals manage their BPD symptoms in healthy ways. It teaches skills for managing intense emotions and improving relationships.
DBT for Adolescents, or DBT-A, is a specialized version of DBT designed to meet the unique needs of teens struggling with BPD and other mental health conditions. A clinical trial published through the National Center for Biotechnology Information found that adolescents treated with DBT-A showed significant reductions in self-harm and suicidal behavior, with improvements sustained a year after treatment ended.
The Mayo Clinic notes that other forms of talk therapy, including cognitive-behavioral therapy (CBT) and mentalization-based therapy, can also be highly effective in treating individuals with BPD. CBT helps individuals reframe negative beliefs and thought patterns. Psychology Today notes that mentalization-based therapy helps individuals think before they react to their own feelings or the feelings of others. These treatments can be combined with medication and other methods, depending on what each person needs.
Other Personality Patterns That Can Emerge in Adolescence
BPD is the most researched pattern in teens, but personality disorders are generally organized into three broader clusters. The American Psychological Association notes that these categories group disorders by shared features. Teens can show traits from any of these clusters, but doctors usually wait until adulthood to give a formal diagnosis.
Cluster A patterns are often described as odd or eccentric. This cluster includes paranoid, schizoid, and schizotypal personality disorders.
Cluster B, the same group that includes BPD, is described as dramatic or emotional. This includes narcissistic, antisocial, and histrionic personality disorders.
Cluster C patterns are described as anxious or fearful. These include avoidant, dependent, and obsessive-compulsive personality disorders.
In teens, these patterns are usually seen as emerging traits rather than fixed diagnoses. A comprehensive evaluation from a mental health professional can help determine whether what a teen is experiencing reflects a passing developmental stage or a more enduring pattern that would benefit from support.
Professional Treatment for Teen Mental Health at Pillars Adolescent in Concord, Massachusetts
Emerging personality patterns can be difficult for teens and families to make sense of on their own. Our teen outpatient treatment programs are designed to provide comprehensive evaluation and compassionate, evidence-based care for teens navigating mental health challenges. We’re located at 80-1 Beharrell St. in Concord, Massachusetts.
Our Full-Day Teen Outpatient Treatment Program provides intensive, structured support for teens whose symptoms are significantly affecting daily functioning. For teens who need ongoing clinical support with more scheduling flexibility, our Half-Day Teen Outpatient Treatment Program offers a format that can be readily integrated into school and family life.
Our clinical team incorporates DBT, CBT, and other evidence-based approaches to help teens build emotional regulation skills and healthier relationship patterns. We keep parents and family members informed and involved every step of the way.
Compassionate, Evidence-Based Evaluation and Support
Teens struggling with their emotions, identities, and relationships need proper support tailored to their unique needs. A teen’s challenges may stem from a personality disorder or from other mental health conditions, but early evaluation and treatment are critical no matter what. These tools can help teens build the skills they need for healthier relationships, a more stable sense of self, and long-term growth.
Take the first step toward healing and happiness for your teen and your family. Contact Pillars Adolescent today at 855-828-0575 for compassionate support, personalized care, and answers to your questions.
