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

In a desperate email to one psychiatrist, Larry wrote, “There are days when I feel like I’m going to lose Ben if we have to wait until he turns 18 for treatment! What else can I do?”

Ben never was officially diagnosed as suffering from BPD. And never would be. One evening, his father found him hanging in his bedroom. It was a week after his 15th birthday.

Dr. Blaise Aguirre is an American psychiatrist who specializes in BPD. He runs a residential treatment centre for adolescent girls at the McLean Hospital in Boston, Massachusetts. He said that BPD patients often are stigmatized as being difficult to treat and as a result, some psychiatrists may be reluctant to label adolescents with it. There sometimes is also wishful thinking that the symptoms may be just a temporary adolescent phase. But things, Dr. Aguirre said, are beginning to change. “We’re speaking about it more,” he said. “Increasingly, we get calls here at the hospital from clinicians who used to say for example, that they have a 16 year old who may be exhibiting some of symptoms of Borderline Personality Disorder. Now they’re saying they have a 16 year old who has BPD.”

In some ways, that is what happened to Katherine Duff. Her initial diagnosis was bipolar disorder. She was prescribed medication. But if anything, her condition deteriorated further leading to her first suicide attempt at 15. Clearly, something else was going on too. And then a psychiatrist at Hincks-Dellcrest in Toronto, a major centre of children’s mental health care, met with Katherine’s parents.

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