This article is a bit longer than I usually write and share as it contains recent research and its findings. Recently I engaged in a discussion with one of my previous students who is in her second year and doing her graduation in medicine. She shared her career goals with me, and it seems she is doing great. But then her mood suddenly changed. She always shared her aspirations and anxiety with me during her school days as a student. It seems she wanted to share something with me as she keeps expressing dissatisfaction with whatever she is doing. ‘I don’t like how I am or how my life is going…. It’s not what I expect…nobody understands me…… I messed up my life……in fact, I have no life.’ I patiently listened to what she wanted to share. We engaged in a conversation in which I tried to calm her down. After a while, she seemed relaxed, as if she was waiting to empty her heart out to someone. After this meetup, I wonder why a person develops self-dissatisfaction and how it impacts their lives?
As a teacher, I am aware that it is difficult of being a teenager. Teens go through many changes, including social and educational changes and hormonal mood swings. I observe that sometimes teens act without thinking if they will get into trouble, with out-of-character actions, thoughts, and feelings part of the typical teen experience. Other times, emotions may overpower them and maybe even control their actions. Some young people may also spend a lot of time being overly worried about social situations. It’s significant to tell the difference between a ‘typical’ teen’s moodiness and signs of a mental health condition, such as borderline personality disorder (BPD).
What is Borderline Personality Disorder?
Borderline personality disorder (BPD) is a complex mental health condition in which people often struggle with self-image, mood swings, impulse control, an intense fear of abandonment, and low feelings of self-worth.
BPD may cause people to have difficulty controlling their emotional reactions to certain situations. It’s not unusual for people with BPD to live with other mental health conditions, such as eating disorders, anxiety, depression, and substance use disorder.
Self-Disgust and BPD
According to recent research published in Personality and Individual Differences, ‘ self-disgust’ in adolescents is an early sign of developing Borderline Personality Disorder (BPD) in adulthood. Diogo Carreiras, Marina Cunha, and Paula Castilho explain in their research that ‘Although personality disorders are usually diagnosed in adults, they present a developmental path and initial symptoms that can be detected at early ages. This was why we decided to study borderline symptoms in adolescence.”
Past research has identified the following emotional patterns and behaviours to be among the most common symptoms of BPD:
- Feelings of abandonment and hyper-reactivity to rejection
- Feelings of emptiness
- A negative self-view, often with harsh self-criticism
- Risk behaviours, including self-harm
Precursors to BPD that tend to present themselves in adolescence are as follows:
- High impulsivity
- Suicidal behaviours
- Emotional instability
- Uncontrolled anger
- Paranoid ideation (i.e., being suspicious about others’ intentions)
The Four Sources of Self-Dissatisfaction (self-disgust)
Carl E Pickhardt, PhD, a psychologist and public lecturer in Austin, Texas, has discussed four rooted causes related to adolescent self-disgust in one of his articles. These are:
- Peer Pressure
- Demanding Parents
- Social Pressure
Dissatisfaction breeds the motivation to change, to act more grown-up. The young person becomes less tractable when told what must and must not be done. The world of peers has a lot to answer for, with the constant comparison and competition and criticism for not attaining “enough.” Consider some commonly perceived deficiencies that can breed self-dissatisfaction.
- Not being knowledgeable enough: ‘I am out of it!’
- Not being competitive enough: ‘I am a loser!’
- Not being popular enough: ‘I am never invited!’
Demanding parents who cannot be satisfied usually inspire dissatisfaction in the adolescent. ‘Because my parents are never pleased no matter how hard I try or well I do, that’s how I am with myself. Of course, I hate it when they ask if I couldn’t have done better, but part of me always wonders if they’re not right.’ When parents invest in their child, they expect some return, often one that causes them to feel good about themselves. Parental dissatisfaction is carried to a damaging extreme by expressing parental disappointment (‘You have really let us down!’). When this occurs, it can be heavy going for the adolescent who can feel like they have lost loving standing in parental eyes and may never recover positive regard that has been lost.
In adolescence, identity becomes attached to fashionable dress, cool products one owns, and entertainment one has experienced. But it’s hard to stay ahead of the curve because no matter how much one has or does, there is always more to have or do, and someone you know has that or has done that already. So when his daughter complains that she has nothing to wear and the dad complains that she has a closet full of her size clothes, neither one is lying. Teenagers are always running behind the times, and if they can’t catch up, they are in danger of not fitting in and being treated that way by their peers.
A study published in 2014 suggested that rates of borderline personality in teens are slightly higher than in adults. This may be related to the fact that some teenagers display BPD due to stressful events, but many are more likely to recover. Kids who experience externalizing disorders such as oppositional defiant disorder (ODD) and attention-deficit hyperactivity disorder (ADHD) appear more likely to develop BPD symptoms in adolescence. And the presence of depression in adolescence seems to predict BPD during adulthood.
Am I Showing BPD Symptoms?
However, It is difficult for health care professionals and parents to look at the signs and know whether an adolescent has emerging BPD or if the individual is simply going through a typical teenage phase. With this in mind, a teenager who displays any or all of the characteristics associated with BPD might ask themselves: ‘Does it seem that other people can deal with things I can’t deal with?” or “Why aren’t others struggling like I am?’ A teenager who feels strong emotions for more extended periods than others or takes longer to get back to their emotional baseline may have the condition. Strong reactions to seemingly small irritations, a sense that minor issues feel like the ‘end of the world’. That behaviours like self-harm, drugs, or death seem to be the only way to make these stops could be signs of a severe problem. Teens with these actions and reactions should seek help for their symptoms.