“Quiet” borderline personality disorder (BPD) is a term often used to describe individuals with borderline personality disorder who do not necessarily exhibit the more overtly profound or dramatic behaviours often associated with the condition.
Unlike the classic symptoms of BPD, which can involve intense mood swings, explosive anger, and emotional outbursts, individuals with “quiet” BPD may internalise their emotional struggles and exhibit far more subtle signs and symptoms.
“Quiet” BPD is not currently a recognised subtype in terms of clinical diagnosis.
Instead, it is a term that refers to people who meet the criteria for diagnosis of borderline personality disorder but who don’t fit the typical profile. (What Is Quiet Borderline Personality Disorder? verywell mind, Arlin Cuncic, MA, 7 November 2023.)
Research shows that because of the covert nature of “quiet” BPD, the condition is frequently undiagnosed or misdiagnosed, meaning that individuals often do not receive the proper help and support they need to manage their symptoms and achieve lasting remission from the disorder.
This article explores “quiet” borderline personality disorder, its symptoms, and various effective treatments that can help.
If you are concerned that you or a loved one may have symptoms of “quiet” BPD, you should speak to a mental health professional who can advise you on next steps.
Contact our friendly team in Toronto today for further information and support and kickstart your journey to lasting transformation and recovery.
Understanding “quiet” borderline personality disorder
“Quiet” BPD, sometimes called “high-functioning” BPD, is one of ten personality disorders recognised in the Diagnostic and Statistical Manual of Mental disorders (DSM-5).
Due to the subtle nature of “quiet” BPD symptoms, it can be challenging for friends and family members to recognise when a loved one might be struggling with the disorder.
One factor that distinguishes “quiet” BPD from typical borderline personality disorder is that the symptoms (which often include shame, anger, sadness and fear of abandonment) are expressed inwardly.
For instance, individuals with “quiet” BPD tend to experience all the intense emotions of traditional BPD but will internalise their emotional pain – often causing a person to criticise or turn on themselves.
Although people with “quiet” BPD appear as though they are coping well with the demands of everyday life, they are living a private experience that is anything but functional. (What Is Quiet Borderline Personality Disorder? verywell mind, Arlin Cuncic, MA, 7 November 2023.)
Therefore, individuals with the disorder must understand the signs and symptoms of “quiet” BPD so they can quickly get the support and treatment they need and deserve.
Signs and symptoms of “quiet” borderline personality disorder
Although the symptoms may present differently in each individual, the common signs and symptoms of “quiet” BPD are typically categorised in the following way:
Struggling with inner (extreme) emotional pain
- Trying to deny or suppress your anger
- Experiencing extreme mood swings that can last a few hours or a few days, which you keep to yourself
- Thinking that it’s better to present a calm and pleasant exterior to others despite struggling with inner turmoil such as guilt, anger or shame
Shifting the blame onto yourself
- Having low self-worth and believing you are better off alone
- Taking responsibility for other peoples’ emotions and behaviours and blaming yourself for any conflicts you may have with others
- Analysing and critiquing everything you do
- Believing that you are an annoyance or a burden to other people – thus, you tend to keep your emotions and feelings to yourself
Isolating yourself from others
- Feeling empty, numb and detached from the world and other people
- Cutting yourself off from people who may have angered or upset you
- Withdrawing or isolating yourself when you feel angry or hurt
- Fearing new relationships or connections because you are afraid that you will end up getting hurt again
- Convincing yourself that you do not need to rely on others and being overly independent
Other symptoms of “quiet” BPD may include:
- Extreme fear of abandonment
Much like traditional BPD, individuals with “quiet” BPD may experience an intense fear of being abandoned or rejected by those around them.
- Difficulty developing and maintaining relationships
Establishing and maintaining meaningful connections to others can be challenging for “quiet” BPD sufferers due to a fear of rejection or concerns about being unworthy or “not good enough”.
- Self-destructive behaviours
It is common for people with “quiet” BPD to engage in self-destructive behaviours, such as self-harm or substance abuse as a way of coping with emotional pain or distress.
- Extreme sensitivity
Those with “quiet” BPD may be overly sensitive to perceived abandonment, rejection, or criticism, leading to a heightened emotional response to specific situations or interactions with others.
As mentioned, “quiet” BPD can present differently in each individual.
Diagnosis and treatment for “quiet” BPD must be carried out by a mental health professional based on a thorough assessment and evaluation of your experiences and symptoms.
If you or someone you know is struggling with symptoms of “quiet” borderline personality disorder, seeking professional help is crucial for understanding and managing the condition so you can lead a happy and fulfilling life.
Diagnosis of ”quiet” BPD
To receive a diagnosis of “quiet” BPD, a person must meet five of the following nine criteria for BPD, according to a list of symptoms outlined in the DSM-5.
These include:
- A history of unstable relationships that involve idealising and then devaluing a person. This is sometimes called “splitting” or black and white thinking.
- Problems with impulsive or risky behaviour.
- Chronic/rapid mood swings and experiencing intense emotions.
- Pervasive feelings of emptiness and low self-worth.
- Intense or uncontrollable anger.
- Engaging in frantic efforts to avoid actual or perceived abandonment.
- Having an unstable image of yourself or identity.
- Engaging frequently in self-harm and suicidal ideation.
- Dissociation (i.e., a feeling of being disconnected from yourself, which may feel like you are having an out-of-body-experience).
Risk factors
While the exact causes of “quiet” BPD are unclear, researchers have noted several risk factors that may play a role in the development of the disorder, including the following:
- Genetics
Researchers note that genetic components may be involved in the development of “quiet” BPD. For instance, individuals with a family history of BPD or other personality disorders may be at a higher risk of developing the condition themselves.
- Environmental factors
Traumatic events, including abuse, neglect, and chaotic or unstable family environments during childhood, may increase the risk of someone developing “quiet” BPD.
- Biological factors
Researchers found that specific imbalances in neurotransmitters, which are responsible for sending chemical messages to the brain, may play a role in the development of “quiet” BPD.
- Early abandonment
Experiencing significant loss, attachment rupture, or abandonment, especially during a person’s early years, can be a contributing factor to them developing “quiet” BPD later on.
Complications
Studies show that as well as living with the unpleasant symptoms of “quiet” BPD, those with the condition also experience secondary effects of having this personality disorder.
Listed below are just some of the complications individuals with “quiet” BPD often encounter:
- When in a relationship, someone with “quiet” BPD may notice a pattern of the other person ending things due to the intensity of their symptoms.
- Not having many close friends or deep connections with others, leading to loneliness and isolation.
- Difficulty expressing emotions or needs, particularly in interpersonal relationships. An individual with “quiet” BPD may also have trouble describing how they feel which can lead to unresolved or complicated relationship issues.
- Trouble accepting everyday challenges, including job loss, financial problems, and separation, leading to unhealthy beliefs related to self-image.
- Fearing being alone but simultaneously pushing others away.
- Confusion around identity, values, views, and likes and dislikes.
Treatment for “quiet” BPD
Although “quiet” BPD can be an extremely challenging condition to live with, various treatments can help you manage your symptoms and live a happy, functional life.
Some effective treatments for “quiet” BPD include:
Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy is an effective treatment for “quiet” BPD and other personality disorders.
This treatment helps to modify unhelpful thoughts and behaviours that fuel the problems a person may be experiencing.
Your therapist may ask you to record and examine your thoughts and feelings, looking for specific distortions such as black-and-white thinking or other destructive thought patterns.
Dialectical behaviour therapy (DBT)
Various studies have shown that dialectical behaviour therapy is one of the most effective treatments for “quiet” borderline personality disorder.
DBT focuses on four key areas, including emotional regulation, interpersonal effectiveness, distress tolerance, and core mindfulness, which are some of the main challenges BPD sufferers frequently struggle with.
This treatment helps you recover and change any unhelpful behaviours that may contribute to or worsen your condition.
Group therapy
Connecting with others who share similar experiences can provide a sense of community, support and understanding.
Group therapy offers those in recovery healthy coping strategies, validation, and a foundation for shared learning and transformation, leading to more favourable treatment outcomes.
Social skills training
Social skills training is essential in BPD treatment and can help improve interpersonal interactions and social connections.
It can also benefit those who experience difficulties forming and maintaining relationships with others, which is often a significant challenge for those with “quiet” borderline personality disorder.
Other effective treatments
Other effective treatment options for “quiet” BPD include the following:
- Schema therapy
- Mentalisation-based therapy
- Transference-focused therapy (TFP)
- Psychiatric medication
- Trauma-informed treatment
Living with ”quiet” BPD
We understand that living with “quiet” borderline personality disorder presents unique challenges, especially as the symptoms are often internalised and are not as noticeable to other people as typical BPD can be.
However, there are some things you can do to manage the condition (as well as engaging in professional treatment), including:
- Setting healthy boundaries helps prevent emotional overwhelm and is vital for maintaining a healthy relationship with yourself and others.
- Increased self-awareness – Understanding your triggers, emotions and coping strategies can increase self-awareness, allowing you to cultivate a deeper understanding of yourself and empowering you to manage your feelings and behaviours more effectively.
- Having a solid support network – Building and maintaining a healthy support network can be invaluable, particularly during tough times. Moreover, cultivating meaningful connections with supportive people can help to increase your self-esteem and well-being, reducing your risk of relapse.
How Centres for Health and Healing can help
Centres for Health and Healing provides a specialised treatment program to treat borderline personality disorder (BPD) that is tailored to each client’s individual needs and preferences.
We adopt an integrated treatment approach that incorporates several therapeutic methods and techniques.
With our strategic approach, mixed therapeutic methods, and staff with decades of experience, Centres for Health and Healing provides the setting, resources, and tools necessary for deep transformational healing.
Seeking professional help for borderline personality disorder can seem daunting at first. However, it is the first courageous step to a fulfilling, healthy, and happy life.
If you are experiencing “quiet” BPD symptoms or are worried that you may have another mental health disorder, please contact us today to discuss treatment options.
We are here and ready to help you.
Additional resources
- What Is Quiet Borderline Personality Disorder? Verywell mind, Arlin Cuncic, MA, 7 November, 2023
- All About Quiet BPD (Borderline Personality Disorder), Healthline, Kristeen Cherney, 13 July, 2022
- What is Quiet BPD? Everything You Need to Know, Forbes Health, Lizzie Duszynski-Goodman, 28 September, 2023
