Support for kids with potential personality disorder

[Anonymous]

I am a therapist. These are my general thoughts about teenagers and personality disorders.

Personality disorders are not officially diagnosed until adulthood because they require a pattern of behavior that adds up to a disordered way of relating, somehow. Arguably, many teenagers have personality disorders that are developmentally appropriate and resolve when they develop better skills or address other issues. Of course, longterm patterns don't emerge out of nowhere, so it's possible that this therapist is just pointing out potential red flags.

I have always found it really important to help kids understand that relational skills like active listening, empathy, accountability, etc. are things that can be learned. You can also get better at things like self-compassion and self-soothing and appropriate emotional regulation. When they don't develop those skills, toxic relational patterns can become entrenched and toxic. The older people get, the harder it becomes to ask for and receive help with learning skills, and the less likely people are to seek assistance.

Professionally, I'd absolutely recommend DBT work. Some kids get a lot out of peer group therapy for DBT, while others do better with an individual therapy program. Frankly, I wish DBT was taught in schools in like 9th grade so that all kids have the tools. It will never happen, but I think it would be more useful than whatever they're doing in PE in 9th grade.

[Anonymous]

I suspicious of DBT. They tried it in schools and it worsened kids mental health. You can look it up.

[Anonymous]

Anonymous wrote:I suspicious of DBT. They tried it in schools and it worsened kids mental health. You can look it up.

We had a whole thread on that article. There is also a ton of positive published research on actual DBT compliant programs with young people who have emotional dysregulation.

[Anonymous]

Everything that I was going say has been mentioned - and wow thank you to the therapist who connected some dots. As someone with loved ones with personality disorders, indeed they are not officially diagnosed until later in adulthood. And DBT has been a great help (there is a DBT workbook one used with their therapist https://www.amazon.com/Dialectical-Behavior-Therapy-Skills-Workbook/dp/1684034582) the other went to a group class.

[Anonymous]

Anonymous wrote:I am a therapist. These are my general thoughts about teenagers and personality disorders.

Personality disorders are not officially diagnosed until adulthood because they require a pattern of behavior that adds up to a disordered way of relating, somehow. Arguably, many teenagers have personality disorders that are developmentally appropriate and resolve when they develop better skills or address other issues. Of course, longterm patterns don't emerge out of nowhere, so it's possible that this therapist is just pointing out potential red flags.

I have always found it really important to help kids understand that relational skills like active listening, empathy, accountability, etc. are things that can be learned. You can also get better at things like self-compassion and self-soothing and appropriate emotional regulation. When they don't develop those skills, toxic relational patterns can become entrenched and toxic. The older people get, the harder it becomes to ask for and receive help with learning skills, and the less likely people are to seek assistance.

Professionally, I'd absolutely recommend DBT work. Some kids get a lot out of peer group therapy for DBT, while others do better with an individual therapy program. Frankly, I wish DBT was taught in schools in like 9th grade so that all kids have the tools. It will never happen, but I think it would be more useful than whatever they're doing in PE in 9th grade.

there was just a research study showing that teaching DBT to teens in school leads to worse mental health outcomes …

[Anonymous]

Anonymous wrote:I suspicious of DBT. They tried it in schools and it worsened kids mental health. You can look it up.

Just came here to say that. But the study was about providing DBT to a group of kids at school with no diagnosis or mental health challenges, not to kids with diagnoses/mental health issues, like OP’s child.

I don’t think BPD should be diagnosed in teens without a LOT of observation & differential diagnosis. It would depend too much on what parents say, and parents are not objective about their role in eliciting behaviors from kids/teens. But I think there’s plenty of support for DBT being effective in treating emotional regulation & suicidality for teens.

[Anonymous]

NP here. My 21 year old DD was diagnosed with both BPD and Narcissistic Personality Disorder a few months ago.

It explains her terrible behavior. Frankly, every day living with her is just hell on earth. On my darkest days, I wish that I had aborted her when I was pregnant.

Of course I still love her. But she does a lot of things that make her hard to love.

[Anonymous]

Anonymous wrote:I suspicious of DBT. They tried it in schools and it worsened kids mental health. You can look it up.

That was a form of DBT that was less intense, less structured, shorter in format and moved into a school platform. It can’t be compared with DBT in an individualized setting nor did the researchers make that claim.

[Anonymous]

Yes to a wait and see approach while knowing a personality disorder MAY (and I stress simply MAY) be something you deal with in the future. DBT has been extremely helpful for my anxious, ADHD child with similar profile.