Table of ContentsView AllTable of ContentsBPD and Quiet BPDSymptomsCausesDiagnosisTreatmentPrognosisCoping
Table of ContentsView All
View All
Table of Contents
BPD and Quiet BPD
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Coping
Quietborderline personality disorder(BPD) is not an official mental health condition. It describes people who meet the criteria of a BPD diagnosis but who don’t meet the typical profile for the condition. Sometimes quiet borderline personality disorder is referred to as high-functioning BPD, as people may seem fine outwardly but are struggling inside with intense feelings.
With BPD, a person experiences an ongoing pattern of disordered and sometimes extreme moods, self-image, and behavior. People with BPD may be impulsive and have difficulty in relationships. They may also experience intense episodes of anger,depression, andanxietylasting from a few hours to several days.
This article discusses the symptoms, causes, and treatment of quiet BPD, and how traits differ from other BPD types. It explains how treatment and healthy lifestyle choices can help people cope with quiet BPD.
Borderline personality disorder affects up to 2.7% of people worldwide and is present in about 12% of people receiving outpatient therapy for a mental health disorder.It’s less clear how often people develop a “quiet” and therefore less visible type of BDP, although many symptoms are shared.
The main difference is that people diagnosed with BPD typically act out (with angry outbursts, for example) while people with quiet BPD direct their distress at themselves. This less-visible form can lead to delays in diagnosis because symptoms can be similar to depression and other disorders.
BPD is a complex disorder, with nine different criteria for a positive diagnosis to be accurate, and five required, based on the Diagnostic and Statistical Manual (DSM-5) of the American Psychiatric Association.That allows for 256 possible combinations of traits that can lead to a BPD diagnosis.
Borderline Personality DisorderAngry or emotional outbursts directed at and blaming othersHighly visible mood swings and intense emotionsChronic feelings of emptiness and distance from your lifeQuiet Borderline Personality DisorderInternalizing anger and shame directed at yourselfSuppressing intense emotions and detaching from othersEmptiness and numbness that leads to despair and self-harm
Borderline Personality DisorderAngry or emotional outbursts directed at and blaming othersHighly visible mood swings and intense emotionsChronic feelings of emptiness and distance from your life
Angry or emotional outbursts directed at and blaming others
Highly visible mood swings and intense emotions
Chronic feelings of emptiness and distance from your life
Quiet Borderline Personality DisorderInternalizing anger and shame directed at yourselfSuppressing intense emotions and detaching from othersEmptiness and numbness that leads to despair and self-harm
Internalizing anger and shame directed at yourself
Suppressing intense emotions and detaching from others
Emptiness and numbness that leads to despair and self-harm
Symptoms of Quiet BPD
People with quiet BPD meet the criteria for aBPD diagnosis, but their symptoms are directed inward, internalizing the anger and blame within themselves instead of others. People with quiet BPD work hard to hide their struggles from others, not showing their symptoms on the outside.
People with quiet BPD share many of the same traits that are part of a BPD diagnosis. These include:
People with quiet BPD often mask their BPD traits and appear calm, even when they’re struggling in their inner lives. They often want to please people at cost to themselves, and may withdraw from others when upset rather than working things out. They may engage in"splitting" behavior" (black-and-white thinking or swinging from one extreme to another, with little provocation).
People with quiet BPD may experience a few of these symptoms or many of them. The frequency, severity, and duration of the symptoms can vary from one person to another.
BPD in Their Own WordsIn a small study based on interviews with 12 females diagnosed with borderline personality disorder, their emotions are described as “an intertwining of different voices shouting over each other and creating an unbearable chaos of thoughts and agony within their bodies.”
BPD in Their Own Words
In a small study based on interviews with 12 females diagnosed with borderline personality disorder, their emotions are described as “an intertwining of different voices shouting over each other and creating an unbearable chaos of thoughts and agony within their bodies.”
Causes of Quiet BPD
The exact cause of BPD is not yet clear. Research suggests that several factors may play a role in the development of BPD:
Are Women More Likely to Have BPD?Research suggests that BPD occurs about as often in males as it does in females. However, females are more likely toseek treatmentand therefore, their numbers may be more visible.
Are Women More Likely to Have BPD?
Research suggests that BPD occurs about as often in males as it does in females. However, females are more likely toseek treatmentand therefore, their numbers may be more visible.
The Four Types of Borderline Personality Disorder
Diagnosis of Quiet BPD
Be Honest About Your SymptomsThe hallmark of quiet BPD is holding in feelings and emotions. Although it may not be comfortable, the more open you are about feelings and experiences with a mental health professional, the better they will be able to help you. It’s important to find a therapist or care provider with whom you can form a bond of trust.
Be Honest About Your Symptoms
The hallmark of quiet BPD is holding in feelings and emotions. Although it may not be comfortable, the more open you are about feelings and experiences with a mental health professional, the better they will be able to help you. It’s important to find a therapist or care provider with whom you can form a bond of trust.
Treatment for Quiet BPD
Therapies
There are a number of therapies that can be used to treat BPD:
Other therapies used to treat BPD include mentalization-based therapy,transference-focused therapy, andschema-focused therapy.
Medications
Medicationsare not typically used as the main treatment for BPD. However, they may be prescribed to treat conditions such as:
Why Does My Mood Change So Fast?
Prognosis for Quiet BPD
Without treatment, people with BPD may be:
BPD is also associated with significantly higher rates of self-harm and suicidal behavior than the general population.
It is important for people with any form of BPD to seek out and commit to treatment. With professional help, symptoms (andquality of life with BPD) can improve.
Help Is AvailableIf you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat1-800-273-8255for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
Help Is Available
If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat1-800-273-8255for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
Coping With Quiet BPD
Quiet BPD should be treated under the guidance of a mental health professional. Other strategies may also help. You can:
Living with Borderline Personality Disorder (BPD)
Summary
People with quiet BPD meet the criteria for a BPD diagnosis, but instead of acting out as in typical BPD, their symptoms are directed inwardly. People with quiet BPD become adept at not showing their symptoms on the outside.
Psychotherapy is the standard treatment for BPD. Radically open dialectical behavioral therapy may be especially helpful for quiet BPD. Medication may also be prescribed. If you’re experiencing signs of quiet BPD, see your healthcare provider.
BPD is associated with increased rates of self-harm and suicidal behavior. If you’re considering hurting yourself, seek help immediately. With treatment, the symptoms of BPD can improve.
11 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Mental Health.Borderline personality disorder.Leichsenring F, Fonagy P, Heim N, Kernberg OF, Leweke F, Luyten P,et al.Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies.World Psychiatry. 2024 Feb;23(1):4-25. doi:10.1002/wps.21156.Bray, S. (2024).Borderline Personality Disorder Workbook: DBT Strategies and Exercises to Manage Symptoms and Improve Well-Being. Simon and Schuster.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 5th edition. 2013. doi:10.1176/appi.books.9780890425596.Moltu C, Kverme B, Veseth M, Natvik E.How people diagnosed with borderline personality disorder experience relationships to oneself and to others. A qualitative in-depth study.Int J Qual Stud Health Well-being. 2023 Dec;18(1):2152220. doi:10.1080/17482631.2022.2152220.Skoglund C, Tiger A, Rück C, Petrovic P, Asherson P, Hellner C,et al.Familial risk and heritability of diagnosed borderline personality disorder: a register study of the Swedish population.Mol Psychiatry. 2021 Mar;26(3):999-1008. doi:10.1038/s41380-019-0442-0.Bozzatello P, Garbarini C, Rocca P, Bellino S.Borderline personality disorder: Risk factors and early detection.Diagnostics (Basel). 2021;11(11):2142. doi:10.3390/diagnostics11112142.Kulacaoglu F, Kose S.Borderline personality disorder (BPD): in the midst of vulnerability, chaos, and awe.Brain Sci. 2018;8(11):201. doi:10.3390/brainsci8110201.Gilbert K, Hall K, Codd RT.Radically Open Dialectical Behavior Therapy: Social Signaling, Transdiagnostic Utility and Current Evidence.Psychol Res Behav Manag. 2020 Jan 8;13:19-28. doi:10.2147/PRBM.S201848.van Agteren J, Iasiello M, Lo L, Bartholomaeus J, Kopsaftis Z, Carey M,et al.A systematic review and meta-analysis of psychological interventions to improve mental wellbeing.Nat Hum Behav. 2021. doi:10.1038/s41562-021-01093-wAmerican Music Therapy Association.Fact sheets for music therapy with specific populations.
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute of Mental Health.Borderline personality disorder.Leichsenring F, Fonagy P, Heim N, Kernberg OF, Leweke F, Luyten P,et al.Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies.World Psychiatry. 2024 Feb;23(1):4-25. doi:10.1002/wps.21156.Bray, S. (2024).Borderline Personality Disorder Workbook: DBT Strategies and Exercises to Manage Symptoms and Improve Well-Being. Simon and Schuster.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 5th edition. 2013. doi:10.1176/appi.books.9780890425596.Moltu C, Kverme B, Veseth M, Natvik E.How people diagnosed with borderline personality disorder experience relationships to oneself and to others. A qualitative in-depth study.Int J Qual Stud Health Well-being. 2023 Dec;18(1):2152220. doi:10.1080/17482631.2022.2152220.Skoglund C, Tiger A, Rück C, Petrovic P, Asherson P, Hellner C,et al.Familial risk and heritability of diagnosed borderline personality disorder: a register study of the Swedish population.Mol Psychiatry. 2021 Mar;26(3):999-1008. doi:10.1038/s41380-019-0442-0.Bozzatello P, Garbarini C, Rocca P, Bellino S.Borderline personality disorder: Risk factors and early detection.Diagnostics (Basel). 2021;11(11):2142. doi:10.3390/diagnostics11112142.Kulacaoglu F, Kose S.Borderline personality disorder (BPD): in the midst of vulnerability, chaos, and awe.Brain Sci. 2018;8(11):201. doi:10.3390/brainsci8110201.Gilbert K, Hall K, Codd RT.Radically Open Dialectical Behavior Therapy: Social Signaling, Transdiagnostic Utility and Current Evidence.Psychol Res Behav Manag. 2020 Jan 8;13:19-28. doi:10.2147/PRBM.S201848.van Agteren J, Iasiello M, Lo L, Bartholomaeus J, Kopsaftis Z, Carey M,et al.A systematic review and meta-analysis of psychological interventions to improve mental wellbeing.Nat Hum Behav. 2021. doi:10.1038/s41562-021-01093-wAmerican Music Therapy Association.Fact sheets for music therapy with specific populations.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Institute of Mental Health.Borderline personality disorder.Leichsenring F, Fonagy P, Heim N, Kernberg OF, Leweke F, Luyten P,et al.Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies.World Psychiatry. 2024 Feb;23(1):4-25. doi:10.1002/wps.21156.Bray, S. (2024).Borderline Personality Disorder Workbook: DBT Strategies and Exercises to Manage Symptoms and Improve Well-Being. Simon and Schuster.American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 5th edition. 2013. doi:10.1176/appi.books.9780890425596.Moltu C, Kverme B, Veseth M, Natvik E.How people diagnosed with borderline personality disorder experience relationships to oneself and to others. A qualitative in-depth study.Int J Qual Stud Health Well-being. 2023 Dec;18(1):2152220. doi:10.1080/17482631.2022.2152220.Skoglund C, Tiger A, Rück C, Petrovic P, Asherson P, Hellner C,et al.Familial risk and heritability of diagnosed borderline personality disorder: a register study of the Swedish population.Mol Psychiatry. 2021 Mar;26(3):999-1008. doi:10.1038/s41380-019-0442-0.Bozzatello P, Garbarini C, Rocca P, Bellino S.Borderline personality disorder: Risk factors and early detection.Diagnostics (Basel). 2021;11(11):2142. doi:10.3390/diagnostics11112142.Kulacaoglu F, Kose S.Borderline personality disorder (BPD): in the midst of vulnerability, chaos, and awe.Brain Sci. 2018;8(11):201. doi:10.3390/brainsci8110201.Gilbert K, Hall K, Codd RT.Radically Open Dialectical Behavior Therapy: Social Signaling, Transdiagnostic Utility and Current Evidence.Psychol Res Behav Manag. 2020 Jan 8;13:19-28. doi:10.2147/PRBM.S201848.van Agteren J, Iasiello M, Lo L, Bartholomaeus J, Kopsaftis Z, Carey M,et al.A systematic review and meta-analysis of psychological interventions to improve mental wellbeing.Nat Hum Behav. 2021. doi:10.1038/s41562-021-01093-wAmerican Music Therapy Association.Fact sheets for music therapy with specific populations.
National Institute of Mental Health.Borderline personality disorder.
Leichsenring F, Fonagy P, Heim N, Kernberg OF, Leweke F, Luyten P,et al.Borderline personality disorder: a comprehensive review of diagnosis and clinical presentation, etiology, treatment, and current controversies.World Psychiatry. 2024 Feb;23(1):4-25. doi:10.1002/wps.21156.
Bray, S. (2024).Borderline Personality Disorder Workbook: DBT Strategies and Exercises to Manage Symptoms and Improve Well-Being. Simon and Schuster.
American Psychiatric Association.Diagnostic and Statistical Manual of Mental Disorders. 5th edition. 2013. doi:10.1176/appi.books.9780890425596.
Moltu C, Kverme B, Veseth M, Natvik E.How people diagnosed with borderline personality disorder experience relationships to oneself and to others. A qualitative in-depth study.Int J Qual Stud Health Well-being. 2023 Dec;18(1):2152220. doi:10.1080/17482631.2022.2152220.
Skoglund C, Tiger A, Rück C, Petrovic P, Asherson P, Hellner C,et al.Familial risk and heritability of diagnosed borderline personality disorder: a register study of the Swedish population.Mol Psychiatry. 2021 Mar;26(3):999-1008. doi:10.1038/s41380-019-0442-0.
Bozzatello P, Garbarini C, Rocca P, Bellino S.Borderline personality disorder: Risk factors and early detection.Diagnostics (Basel). 2021;11(11):2142. doi:10.3390/diagnostics11112142.
Kulacaoglu F, Kose S.Borderline personality disorder (BPD): in the midst of vulnerability, chaos, and awe.Brain Sci. 2018;8(11):201. doi:10.3390/brainsci8110201.
Gilbert K, Hall K, Codd RT.Radically Open Dialectical Behavior Therapy: Social Signaling, Transdiagnostic Utility and Current Evidence.Psychol Res Behav Manag. 2020 Jan 8;13:19-28. doi:10.2147/PRBM.S201848.
van Agteren J, Iasiello M, Lo L, Bartholomaeus J, Kopsaftis Z, Carey M,et al.A systematic review and meta-analysis of psychological interventions to improve mental wellbeing.Nat Hum Behav. 2021. doi:10.1038/s41562-021-01093-w
American Music Therapy Association.Fact sheets for music therapy with specific populations.
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