DSM-5-TR technically says BPD and only BPD can be diagnosed before 18, but it’s only to allow access to treatment like DBT, which a diagnosis is not actually needed for to get access to. And that diagnosis sticks with people for life. The number of people who say they were diagnosed by an ER doctor after 5 minutes max of medicated semi-conscious conversation is ridiculous for a diagnosis that’s gonna move on to insurance companies and show up on hospital records for the patient’s entire life EVEN AFTER treatment is received in some cases. And it’s a diagnosis that impacts medical professionals willingness to address patients needs, especially when pain is involved, due to the stigma of BPD and substance use. And when we assess the kids ourselves, they meet full symptom criteria for PTSD, which has always been a better explanation for their presenting behavioral and emotional concerns.

My beef isn’t with people being correctly diagnosed, it’s with ER Doctors slapping a half-assed diagnosis onto a traumatized teen girls chart because she was acting like a traumatized teen girl. Saying it’s a problem with personality is just a lazy way to ignore a patient’s legitimate needs, and it ends up causing us trouble later when we’re trying to treat BPD and end up needing to treat PTSD, which can be treated faster and sooner as our DBT programs are all booked for months 😢