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Difficulty with Diagnosis
It can be highly difficult to diagnose borderline personality disorders in children because children are usually not all that able to handle their emotions. But children with a family of history of BPD are likely to also have BPD. According to the National Alliance on Metal Illness (NAMI), many mental health professionals believe there is a genetic component to BPD.
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The Reluctance to Diagnose Children
Symptoms of BPD often develop during the teenage years. Some medical helalth professionals are understandably reluctant to diagnose borderline personality disorders in children – anyone under 13 – because of the risk of a malpractice lawsuit. It is much easier to diagnose borderline personality disorder in adolescents over the age of 13 primarily because the child is now considered old enough to get a grip on their emotions and impulsive behaviors.
But more and more other mental illness such as eating disorders and schizophrenia are appearing in children younger than 13. According to “The Family Intervention Guide to Mental Illness” (New Harbinger Publications. 2007), it is theoretically possible that symptoms of any mental disorder could begin showing in early childhood. BPD should not be summarily dismissed if a child shows the symptoms.
Another problem for medical professionals is that it is a common perception that BPD can occur in people who experienced terrible traumas as a children, such as sexual abuse. The Mayo Clinic even states that childhood traumas greatly increase a person’s likelihood of developing mental illness. If a child does not have a family history of BDP, does the doctor then risk the wrath of the parents by hinting that the child has suffered a trauma that the parents are unaware of?
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The highest diagnostic authority in the metal health field is the fourth edition of the American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Disorders Manual” or DSM-IV. It states that any child under 18 can get borderline personality disorder, although it's rare. The DSM-IV came out in 1994 and is currently undergoing massive revisions in the light of new research and findings about mental illnesses, including mental illness in children.
The DSM-IV is sometimes considered controversial, especially in its diagnosis of children with mental illness, outside of North America. But even the notoriously stodgy UK grudgingly admits that BPD may exist in children under 18 years old. One booklet put out by the National Health Services (NHS) even states that BPD “is not usually diagnosed before the age of 18 but symptoms can be recognised (sic) in younger people.” As stated in Help for Parents Whose Children have Borderline Personality Disorder, coping with children with BPD can be very difficult and finding the right treatment plan is of the utmost importance.
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It does seem that children under the age of 18 can have borderline personality disorder, especially if they have a family history of BPD or if they have suffered trauma. Not treating BPD can lead to self-harm or suicide in BPD patients, no matter what their age. BPD is a treatable mental illness and so a diagnosis of BPD for a child is not a death sentence.
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National Alliance on Mental Illness. “Borderline Personality Disorder: What you need to know about this medical illness.” http://www.nami.org/Template.cfm?Section=Borderline_Personality_Disorder_(BPD)&Template=/ContentManagement/ContentDisplay.cfm&ContentID=81017
“The Family Intervention Guide to Mental Illness.” Bodie Morey & Kim T.Mueser, Ph.D. New Harbinger Publications. 2007
The Mayo Clinic. “Borderline personality disorder: Can child abuse cause it?” Daniel K. Hall-Flavin, M.D. http://www.mayoclinic.com/health/borderline-personality-disorder/AN01093
National Health Services. “NICE Guidance: Borderline Personality Disorder.” http://www.nice.org.uk/nicemedia/pdf/CG78PublicInfo.pdf