Borderline personality disorder (BPD) is a serious mental health condition that affects the way people think about themselves, manage their emotions, and build relationships with others.
People living with BPD often experience very strong emotions that can change quickly.
They may struggle with fear of being rejected or abandoned, have unstable friendships or family relationships, act impulsively, and sometimes experience self-harm or suicidal thoughts.
These challenges can make daily life extremely difficult. Although effective treatments are available, many people are not diagnosed until adulthood, after years of emotional suffering.
A new study is helping scientists better understand that the roots of BPD may begin much earlier than previously believed. Researchers are now identifying emotional and social warning signs in childhood that could help doctors recognize children who may benefit from support long before adulthood.
The research was led by Dr. Diana Whalen, a professor of psychiatry at Washington University in St. Louis.
For many years, BPD was mainly viewed as an adult disorder because it is usually diagnosed after the age of 18. However, Dr. Whalen and her team believe that the condition develops gradually over many years, with early warning signs appearing during childhood.
The researchers have been studying young children who may have a higher chance of developing BPD later in life.
Their findings suggest that children who regularly hide feelings of sadness instead of expressing them may be more likely to develop symptoms as they grow older. Children who struggle to recognize, understand, or talk about their emotions also appear to be at greater risk.
Being able to identify emotions is an important life skill. Children who can name and explain their feelings often find it easier to ask for help, solve problems, and recover from upsetting experiences.
When children cannot understand what they are feeling, emotions may become overwhelming and much harder to manage.
The study also found that social relationships may provide important clues. Some children who later show signs of BPD become extremely sensitive to rejection. They may believe that other people dislike them even when there is little evidence. For example, if a classmate forgets to say hello or cannot play with them one day, they may think the friendship is over. Unlike most children, who move on fairly quickly, these feelings can stay with them for a long time.
Another possible warning sign is becoming very upset when close friends spend time with other children. While many children sometimes feel jealous, those at higher risk for BPD may experience much stronger emotions that are difficult to control.
The researchers are also exploring whether social media could make these feelings worse. Online communication continues throughout the day and night, unlike face-to-face interactions that naturally end when school finishes.
Children may repeatedly look at messages, photos, or social media posts, giving them more opportunities to worry about being ignored or left out. Scientists are still studying whether this constant online environment increases emotional distress in children who are already vulnerable.
Although these findings are important, researchers emphasize that having one or more of these behaviors does not mean a child will definitely develop BPD. Many children experience emotional ups and downs while growing up, and most do not develop the disorder.
Instead, these behaviors should be viewed as possible risk factors that deserve attention if they are severe, long-lasting, and interfere with everyday life.
The good news is that BPD can be treated. One of the most successful treatments is dialectical behavior therapy, often called DBT. This therapy teaches practical skills for managing emotions, coping with stress, improving relationships, and making healthier decisions. Some people may also benefit from medications that help manage certain symptoms, although medicine alone does not treat the disorder itself.
Dr. Whalen believes that recognizing risk factors earlier could reduce years of suffering. Many adults with BPD say they struggled with emotional pain, loneliness, or suicidal thoughts from a very young age. Earlier support may improve emotional skills before problems become more severe.
Parents should not panic if their child is shy, emotional, or sensitive. However, if a child consistently struggles with friendships, has intense reactions to rejection, finds it very difficult to manage emotions, or shows signs of self-harm or talks about suicide, it is important to seek help from a qualified mental health professional. Early assessment does not mean a child will receive a diagnosis of BPD, but it can identify areas where support may help.
The researchers hope their work will lead to earlier recognition, better treatment, and healthier futures for children who may be at risk. Their findings suggest that paying attention to emotional development during childhood could make a real difference in preventing long-term suffering and improving quality of life.
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