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Q: “Can Teenagers Have Borderline Personality Disorder?”

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Q: “My son has attention deficit hyperactivity disorder (ADHD), though we are starting to think that he is showing signs of borderline personality disorder (BPD), too.

Can BPD even be diagnosed in teenagers? If so, what does BPD look like in teens? How can we differentiate BPD symptoms from ADHD?”As noted in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), children and adolescents may be diagnosed with a personality disorder (excluding antisocial personality disorder) in the “relatively unusual” cases in which the individual’s maladaptive personality traits are “pervasive, persistent, and unlikely to be limited to a particular developmental stage or another mental disorder.” Additionally, a child or teen must have shown symptoms for at least one year to merit a diagnosis for a personality disorder.So while it’s possible for children and teens to be diagnosed with BPD, it’s also true that some medical circles may think that child and adolescent patients are far too young for a BPD diagnosis.

Part of the reluctance may come from the sheer number of factors that could explain someone’s behaviors and traits — especially in adolescence.

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Premenstrual dysphoric disorder (PMDD) is a serious but treatable condition that affects 5.5% of people who menstruate.1 A severe version of premenstrual syndrome (PMS), PMDD is a mood disorder characterized by marked sadness, irritability, depressed mood, and/or anger, and other behavioral and physical symptoms that appear during the luteal phase of the menstrual cycle (about two weeks before menses) and remit within a few days of menstruation.2 The symptoms of PMDD cause significant distress and functional impairment.It’s not a requirement that PMDD symptoms appear leading up to every period, though symptoms must have occurred in most of the menstrual cycles during the past year. A diagnosis of PMDD, per the DSM-5, should also be confirmed by tracking daily symptoms during at least two menstrual cycles.PMDD often co-occurs with other psychiatric disorders, including major depressive disorder (MDD) and anxiety disorder.34 Individuals with PMDD are also at greater risk for suicide and suicidal behavior.3 Research on PMDD and attention deficit hyperactivity disorder (ADHD) is limited, though a 2021 study of 209 women with ADHD found that more than 45% of them reported having symptoms suggestive of PMDD.5In a recent ADDitude survey, two-third of women surveyed said they experienced PMS and/or PMDD.
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