Does Early Intervention Improve Outcomes?
A recent reconsideration of criteria allows for the diagnosis of BPD in adolescents. This welcome change enables earlier intervention, which improves long-term outcomes. Dialectical behavior therapy (DBT) has been the gold standard for teaching the skills needed for managing emotional dysregulation. It is a structured program that acknowledges the needs for acceptance and change, and offers skills to handle both. Learning these adaptive skills as early as possible is better than having to unlearn unhealthy behaviors later.
Stimulants are helpful for managing the symptoms of emotional dysregulation connected to ADHD. However, these medications may over-stimulate traumatized brains, already on high alert, and exacerbate symptoms. Unfortunately, no medications have been consistently helpful in treating BPD symptoms. Medication options may be further limited by the likelihood of substance dependence or abuse. In addition, the goals of psychotherapy differ significantly. The focus for those with ADHD is inhibiting impulsive responses, while those with BPD and a trauma history work toward safely revealing their secrets.
The importance of correct diagnoses is underscored by these treatment differences, and highlights the necessity for trauma-informed evaluations, which are not yet part of ADHD evaluations. Without treating both disorders, the likelihood of therapeutic success is minimized.