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Can Borderline Personality Disorder Be Diagnosed in Middle Age?

BPD diagnosis middle ageBorderline Personality Disorder (BPD) is most commonly diagnosed when a person is in their 20s or early 30s, when the symptoms of BPD are most severe. Though the severity of BPD symptoms diminishes with age, it is possible to get a BPD diagnosis when you are older.

“BPD can be diagnosed any time in adulthood,” says Max K. Shapey, LCSW, in Evanston, Ill.“I have certainly diagnosed clients with BPD in the age range of 45 to 60 who haven’t had that diagnosis before.”

Can You Outgrow BPD?

You can’t naturally outgrow Borderline Personality Disorder. However, it’s observed that some of the symptoms of the psychiatric disorder become less severe over time. The cause for why this happens is unknown. Here are some reasons why experts think this happens:

Burn out: People with Borderline Personality Disorder often benefit from the natural mellowing that occurs as one grows older. For example, traits of BPD such as impulsivity and aggression tend to follow a downward slope with age, even in the general population. Similarly, these symptoms lessen in individuals suffering from BPD. This can sometimes lead people to believe that a person has recovered from their BPD.

Learning: While some people will learn to mitigate their Borderline Personality Disorder symptoms by undergoing BPD treatment, many will just learn to work their way around their disorder. They identify situations that bring out the worst in them and begin to avoid them. For example, a woman who has seen many of her relationships ruined because of her psychiatric disorder may stop dating and decide never to marry. A need for employment also forces some individuals with BPD to exert control over their symptoms.

Under-diagnosis/Misdiagnosis: Individuals with Borderline Personality Disorder may be unlikely to enter BPD treatment because of the stigma attached to the disorder, or because they don’t believe there is anything wrong with them.

Misdiagnosis is also a factor. “There are many people who are misdiagnosed as Bipolar [Disorder] when in fact they are BPD. They share some attributes, and for those clinicians who follow a recipe-book style of diagnostic analysis, they are more inclined to jump for the more familiar — and more easily treated — diagnosis of Bipolar,” says Shapey.

Because some people are misdiagnosed and some are never diagnosed, they will continue to bear the burden of BPD into middle age.

The Road to Recovery

Even when someone is diagnosed with Borderline Personality Disorder in middle age, there is hope for recovery. However, it may be more difficult to treat BPD as you get older.

“The younger adult with BPD may be more flexible, better able to engage in therapy, and make change; or the root causes of their disorder may be more recent in memory and therefore they may be more resistant to change,” Shapey says. “The older adult may have behaviors that are more entrenched.”

Borderline Personality Disorder treatment is the only way maladaptive traits can be eliminated. So, as difficult as it may be to treat BPD later in life, you should not give up on BPD treatment. It’s your way of reclaiming a normal and functional life – no matter what age you are.

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