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Children with borderline personality disorder
Borderline personality disorder is usually diagnosed in children in early adolescence but signs may be apparent prior to receiving the official diagnosis. Some family members have seen symptoms as early as one year old when looking back; the baby appeared to cry frequently, finding it difficult to enjoy life.
Children with this disorder have been characterized by others as being demanding, attention seekers (needing more than other members of family), anxious, feeling sad, sensitive to criticism, easily frustrated with severe temper tantrums, have difficulty leaving home and going to school, experience stomach cramps often and have trouble eating.
In an interview that I had with a young lady recently diagnosed with borderline personality disorder she described the way she felt as a child.
" I found myself learning to withdraw emotionally and live on a very superficial level and when I got too hurt and upset I would rage as I knew no other outlet.. I became very stubborn, hard headed and down on myself and to this day.. when I get a compliment.. I internally think are they blind.. I am nothing special.. I am learning to self talk to bring myself esteem back up and my belief in myself. I don't know some days I feel like I am an alien on earth and don't fit in."
Many people do not find out that they have the disorder till later in life when it is more noticeable to others and not just a teenage rebellious stage. There has been dispute as to whether an accurate diagnosis of borderline personality disorder can be identified in children. If a child has experienced symptoms for more than one year then the DSM allows for a Borderline personality disorder diagnosis.
Borderline personality disorder parenting can be a challenge if the parent is not aware of the proper approach to take, this is where a mental health professional can help.
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Psychotherapy has always been the top method of treatment for children with borderline personality; the progression of improvement is slow and it is sometimes hard for the child to stay in therapy. When the therapist and child have built a good relationship with one another then the child can feel as if they have a safe place to come. While in psychotherapy a lot of work will be focused on being less impulsive and teaching the child to show better judgment in their lives.
Joel Paris, M.D. is a professor of psychiatry at McGill University in Montreal, Canada reports,
"In view of the frequency of reported childhood trauma in borderline patients, some therapists have suggested that BPD should be thought of as a form of post traumatic stress disorder. These clinicians tend to focus on uncovering negative events so as to help patients process them. However, there is no evidence that these methods are successful. In fact, there is some reason to suspect they can make patients worse, by focusing too much on the past, and not enough on the present. In addition, borderline patients can be particularly prone to develop false memories in psychotherapy."
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Dialectical behavior therapy
Dialectical behavior therapy also referred to as DBT was developed specifically for those who have borderline personality disorder. The treatment has been effective in lowering suicidal behaviors, hospitalization, anger, and social adaptation. While in DBT it is important to recognize the individual and the environment in which he/she lives in. It is believed that certain characteristics of the individual interact with conditions in their environment. The individual and the environment are continuously impacting one another. It is important to validate the person and the environment that he/she lives in and discuss how it affects them.
This type of therapy usually occurs weekly; there are weekly group skills training, therapist consultations and sometimes brief sessions over the phone in between meetings. The goal in therapy is replace maladaptive behaviors with skillfully effective ones.
First phase of therapy:
- Reduce life threatening behavior
- Reduce destructive behavior toward treatment
- Reduce threatening behaviors towards quality of life
- Increase in skills
At times a Family DBT may be considered to improve borderline personality disorder parenting:
- As education to family
- To improve family relationships
Dialectical behavior therapy-family skills training (DBT-FST) is available if a therapist deems it necessary. This is a way to learn more about borderline personality disorder parenting.
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Medications for treatment of BPD
As of the year 2000 the Federal Drug Administration mandates that any new medication expected to be prescribed to anyone under the age of 18 must undergo safety and efficacy studies in approval process.
- Neuroleptics - Navane, Stelazine and Flupenthixol
- Atypical Anti-psychotic Agents - Abilify and Zyprexa
- Mood Stabilizer - Depakote, Topamax, Lamictal and Tegretol
- Antidepressants - SSRI's, MAOI and Tricyclic Antidepressants
- Anti-anxiety Agents - Valium, Xanax, Restoril, Dalmane and Halcion
- Sedatives - Ambien
Please be sure to do research on the medication that has been prescribed. Keep track of your child's emotional state and possible side effects by writing them down. Your child may want to keep a log and have open communication with you so they can feel comfortable if they are feeling bad from the medication. It is very important to monitor your child and the way they are feeling on a daily basis. It is ideal for a mental health professional to prescribe the medication and not a doctor who may not be specialized in mental health.
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1. Robert O. Friedel, M.D. Borderline Personality Disorder in Children http://www.bpddemystified.com/index.asp?id=20
2. Dr. Aguirre interview. BPD in Children and Adolescents http://www.bpdcentral.com/pdf/BPD-In-Children-and-Adolescents.pdf
3. Joel Paris, M.D. Borderline Personality Disorder http://www.jwoodphd.com/borderline_personality_disorder.htm
4. Perry D. Hoffman, Alan E. Fruzetti and Charles R. Swenson. Dialectical Behavior Therapy -Family Skills Training http://www.dbtselfhelp.com/html/family_skills.html
5. Drug Use Research & Management Program. Oregon State University College of Pharmacy. Psychotropic Medication Management in Children and Adolescents. http://pharmacy.oregonstate.edu/drug_policy/pages/dur_board/reviews/articles/PedPsychReview.pdf