Missed diagnosis and no treatment: BPD’s risk to adolescents

The contrast is striking. Katherine Duff gives off the attractive aura of an 18-year-old woman in good health and good humour. But when she begins to speak of what she has been dealing with since she was a child, a different image emerges.

“Every single day seems like it’s going to be the end,” she told W5. “Every single thing that you do requires so much work that you always are wondering if it’s worth it, if you should just give up now.”

When Katherine was 15, she did give up and tried to end her own life. She survived and then tried again at 16. Her parents had begun a desperate search to try to find out what was wrong with her, and to find a treatment that would help her. Eventually, they would learn she was suffering from a psychiatric condition called, Borderline Personality Disorder. Or BPD.

It is characterized by enormous mood swings, emotional outbursts, inexplicable anger and self-harm. And it is extremely dangerous. Statistics show that up to ten percent of patients who’ve been hospitalized for BPD end their own lives.

Neurological imaging studies suggest that people with BPD have an overactive amygdala, the part of the brain where emotions are processed, and an underactive pre-frontal cortex, that regulates those emotions. Genetic and environmental factors may also play a role. It is believed that between 2 and 6 per cent of the general population is affected in different degrees. And according to one study, it affects just over three per cent of children over the age of 11. But a clear picture is difficult to establish because the symptoms are so varied, they can be mistaken for other conditions or simply be undiagnosed. And among adolescents, it can be dismissed as a phase of normal adolescent development.

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