Table of ContentsView AllTable of ContentsSymptomsDiagnosisCausesComplicationsTreatmentCopingHelping Someone Cope With Quiet BPD

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Table of Contents

Symptoms

Diagnosis

Causes

Complications

Treatment

Coping

Helping Someone Cope With Quiet BPD

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While it’s true that others won’t necessarily understand the degree to which you are living in despair, mental health conditions aren’t any less painful just because they’re not visible. Quiet borderline personality disorder (BPD) is one such condition, hence its name. In fact, one could argue that because of the hidden nature of quiet BPD, it’s almost more painful to deal with because you are often dealing with it entirely alone.

Whereas the typical presentation of BPD involves angry outbursts and obvious and outward self-destructiveness, those with quiet BPD have internalized emotional episodes(they turn their anger inward). For this reason, quiet BPD tends to go undiagnosed or misdiagnosed—and is sometimes referred to as “high-functioning” BPD.

However, this name is a misnomer. Although these individuals may seem to cope fine with the demands of daily life, they are in fact living a private experience that is anything but functional.

“This is an important distinction when it comes to the diagnosis of BPD,” explainsHannah Owens, LMSW. “While many diagnoses are made based on outward symptoms that are identifiable to an onlooker like a therapist or psychiatrist, diagnosing quiet BPD requires considering and respecting the person’s internal experiences that they self-report.”

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What Does Quiet BPD Look Like?

If you are wondering whether you or someone you know might be struggling with quiet borderline personality disorder, it can be helpful to read over some of the common signs and characteristics. The truth is that quiet BPD can be harder to identify than typical BPD as the signs are often not outwardly obvious.

For example, while a person with typical BPD might show outward signs of rage, a person with quiet BPD might turn that rage inward and engage in self-destructive behaviors.

Similarly, a person with typical BPD might have crying fits or throw tantrums, while someone with quiet BPD will become moody and withdrawn. Listed below are the some of the most common characteristics of quiet BPD:

Most of these symptoms overlap with the typical presentation of BPD, but the difference is how observable they are to others.—HANNAH OWENS, LMSW

Most of these symptoms overlap with the typical presentation of BPD, but the difference is how observable they are to others.

—HANNAH OWENS, LMSW

How Is Quiet BPD Diagnosed?

Quiet borderline personality disorder (BPD) is not a recognized subtype in terms of diagnosis; rather, it’s a term that refers to people who meet the criteria for diagnosis ofborderline personality disorderbut who don’t fit the typical profile.

In order to be diagnosed, you must meet five of the following nine criteria (paraphrased) according to theDiagnostic and Statistical Manual of Mental Disorders (DSM-5):

Most clinicians think of the borderline personality disorder case as being angry and explosive, but these individuals are instead quiet and hurting. People living with quiet BPD may feel misunderstood and receiving a correct diagnosis can feel as though a weight has been lifted off your shoulders. If you are wondering if you might meet the criteria for BPD, you could ask yourself the following questions:

What Causes Quiet BPD?

Are you wondering what might cause quiet BPD? In fact, thecauses are similar to the causes of typical BPD. Below are some potential causes of this type of personality disorder.

While there are no specific causes that would result in quiet BPD vs. typical BPD, it’s likely that one’s personality or temperament influences how the disorder manifests in terms of outward symptoms or inward symptoms.

In addition, a child who was berated for talking too much or being a nuisance might turn inward instead of outward.

Complications of Quiet BPD

Those who live with quiet BPD will experience secondary effects of having this personality disorder. This might mean having another mental health disorder, experiencing difficulties in relationships, or falling apart when faced with challenging life circumstances.

Below are some of the common compilations that can arise if you are living with quiet BPD:

“These are things that just about anyone could experience at one point or another,” says Owens. “However, the difference between sometimes facing these challenges and having BPD is the intensity and frequency of these situations and reactions and how much they influence your daily life.”

Treatment for Quiet BPD

Some people with quiet BPD may feel as though they do not deserve help because their problems are “not that bad.” Perhaps you appear to be functioning in most areas of your life, and to all outward appearances things mostly seem to be fine. However, the truth is that there aremultiple effective treatments that can help with the symptoms of quiet BPD. Below are some options to consider.

Cognitive-Behavioral Therapy (CBT)

Cognitive behavioral therapy is a form of talk therapy aimed at modifying unhelpful thoughts and behaviors that perpetuate the problems that you are experiencing. Specifically, a CBT therapist will have you keep thought records to examine your thoughts and look for distortions such as “black and white thinking” or “emotional reasoning.”

Then, you’ll be asked to generate alternative adaptive thoughts to use instead. Over time, gradual practice of examining your thoughts and being mindful of thinking errors is helpful for getting control of racing thoughts and reacting to your perceptions of situations rather than the situations themselves.

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Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy (DBT) was developed specifically for the treatment of borderline personality disorder. The objective of DBT is to teach you mindfulness strategies to manage stress, emotions, and distress. The goal is to improve your ability to relate to others without engaging in self-destructive patterns.

DBT teaches you that your feelings are important and that you should share them (even if that hasn’t been your tendency in the past). You will also learn about the “wise mind” and how it can help you to calm yourself.

Schema Therapy

Schema therapycombines a variety of different therapeutic approaches and has an emphasis on relationships. It was designed specifically for people with personality disorders, making it potentially helpful for those with quiet BPD.

A schema refers to a filter through which you view the world or your patterns of relating to other people (that you may have developed in childhood).

The goal of schema therapy is to work on these patterns that are causing you emotional distress so that you can find ways to get your needs met in more healthy ways.

Psychiatric Medication

Although there are no medications specifically approved for BPD, you could be prescribed amedicationto cope with a related issue such as anxiety or depression.

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Mentalization Based Therapy (MBT)

Mentalization refers to your ability to think about your thoughts, emotions, and needs as well as those of other people. Duringmentalization-based therapy, which is a form of psychodynamic therapy, you learn how your internal events can have an impact on what you do.

Thus, the goal of therapy is to improve your ability to reflect on your internal experiences and those of others.

For example, you might learn to see the difference between how you perceive a situation (that someone is rejecting you) and the actual event (a mild criticism). This process leads to better control over emotions and a better sense of self.

Transference-Focused Therapy (TFP)

Transference-focused therapy is another form of psychodynamic therapy that uses the relationship between the client and therapist as part of the therapy process. It is thought that how you relate to your therapist will in large part play out the same way as how you relate to other people in your everyday life. And, it’s likely that this way of relating to others developed during childhood with your earliest relationships.

The goal of the therapist is to figure out what patterns of interactions that you bring to therapy mirror how you behave out in the world.

Once these are determined, then your therapist has a better sense of how you feel, think, and interact with people in your day to day life. The goal of therapy is to develop a more emotionally mature self that experiences less internal volatility.

Coping With Quiet BPD

Below are some tips to cope if you are living with quiet BPD:

“If you are living with quiet BPD, you don’t have to suffer in silence,” advises Owens. “Speaking to a mental health professional can help you identify and deal with your symptoms, while confiding in friends expands your social support system and gives you people to turn to when you are feeling bad. Both of these resources, professional and personal, can make it easier to deal with your symptoms day-to-day.”

Perhaps you have recognized quiet BPD in someone you love or that person has already been diagnosed. What can you do to help support that person? Below are somesupportive strategies to help the person with quiet BPD:

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.For more mental health resources, see ourNational Helpline Database.

If you are having suicidal thoughts, contact theNational Suicide Prevention Lifelineat988for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see ourNational Helpline Database.

Keep in Mind

Be aware that many people in your position are misdiagnosed or not diagnosed at all. Even though this disorder is poorly understood and not often identified, that doesn’t mean that it is not treatable. If you fail to get anywhere with your family doctor, make an appointment with a mental health professional who specializes in borderline personality disorder. Expertise and experience are critical when it comes to choosing a treatment provider in this case.

How to Find a Therapist

3 SourcesVerywell Mind 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.NIMH.Borderline Personality Disorder.Psychology Today.Borderline Personality Disorder.Lo I.Signs of Quiet BPD - Are You Suffering in Silence?

3 Sources

Verywell Mind 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.NIMH.Borderline Personality Disorder.Psychology Today.Borderline Personality Disorder.Lo I.Signs of Quiet BPD - Are You Suffering in Silence?

Verywell Mind 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.

NIMH.Borderline Personality Disorder.Psychology Today.Borderline Personality Disorder.Lo I.Signs of Quiet BPD - Are You Suffering in Silence?

NIMH.Borderline Personality Disorder.

Psychology Today.Borderline Personality Disorder.

Lo I.Signs of Quiet BPD - Are You Suffering in Silence?

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