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Quiet Borderline Personality Disorder, Symptoms, Treatment & Resources

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Quiet borderline personality disorder can be much more complicated than BPD to diagnose and treat. Still, as with many mental health conditions, the earlier it’s diagnosed and intervention is started, the more successful treatment can be. Continue to read to know the top signs and symptoms.

What Is Quiet Borderline Personality Disorder?

Quiet BPD is an unofficial name for dealing with symptoms inside rather than externally. When you have a quiet borderline personality disorder (BPD), sometimes known as “high-functioning” BPD, you frequently direct your thoughts and feelings internally rather than externally.

As a result, you may have intense, turbulent thoughts, emotions, and behaviors, but you try to hide them from others. BPD is a mental illness that affects around 1.6% of the population. It is distinguished by mood and behavioral instability. There’s a lot of stigma around BPD, partly because many therapists once believed it was untreatable. However, nowadays, there are effective therapies and mental health treatment options to improve quality of life and even lead to “remission,” or no longer meeting the criteria for a BPD diagnosis. [1]

Quiet Borderline Personality Disorder Symptoms

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a person with typical BPD might have crying fits or throw tantrums, while someone with quiet BPD will become moody and withdrawn.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

  • Having unhealthy boundaries 
  • Becoming obsessed with a specific person and wanting to spend as much time as you can with that person
  • Self-isolation or avoidance as a form of self-protection when you are feeling overwhelmed
  • Self-harm is hidden from others so they don’t suspect something is wrong.
  • Being mean to others in a quiet way (e.g., giving the silent treatment)
  • A feeling of hopelessness all the time (e.g., existential angst)
  • Inwardly directed hostility, anger, or aggression (e.g., having a harsh internal critic, self-harm)
  • Having a poor self-image or rapidly changing self-image
  • Intense fear of rejection
  • Mood swings that can last hours to days (but that appear invisible to outsiders)
  • A pattern of idealizing others and then devaluing and discarding them
  • Taking small things personally (e.g., assuming someone is ignoring you)
  • Not being able to read others (e.g., thinking people are mad at you when they are not)
  • Racing or distorted thoughts
  • Fear of being alone or pushing people away
  • Self-sabotage that holds you back from reaching goals
  • Experiencing a feeling of being “triggered” that leads to uncontrollable internalized emotions (e.g., shame, guilt)
  • Having a hard time talking about your feelings
  • Feeling numb or empty inside
  • Derealization (feeling as though you are living inside a dream)
  • Problematic people pleasing (that causes problems in the long term)
  • Feeling as though it is wrong to have the emotions that you do (which results in trying to suppress them)
  • Feeling as though you are in a state of hypervigilance

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Quiet Borderline Personality Disorder Statistics

Quiet BPD is best managed with an interprofessional team, including psychiatrists, psychologists, pharmacists, mental health nurses, and social workers. In the United States, recent research has shown that 1.6% of the population has BPD. That number may seem small, but when you consider just how large the United States is, you may realize that 1.6% represents quite a large number of people. Borderline personality disorder is one of the most challenging mental health disorders to manage. [2]


1.4%

It’s estimated that 1.4% of the adult U.S. population experiences BPD.

Source: NCBI

75%

Nearly 75% of people diagnosed with BPD are women.

Source: NCBI

20%

Surveys have estimated the prevalence of borderline personality disorder to be 20% in the inpatient psychiatric population.

Source: NCBI


Quiet Borderline Personality Disorder

Facts Sheet

If you have quiet BPD, you may have low self-esteem and often feel angry, depressed, or anxious. In addition, you may have a history of self-harm, suicidal thoughts, or both. With quiet BPD, you may also feel guilt or shame. As a result, you might engage in self-destructive behaviors when trying to hide your feelings from others.

Strong emotions could lead to harmful behaviors like self-harm or heavy substance use. Note that while BPD is marked by “under-control” of emotional regulation, the hallmark of quiet BPD is “over-control.”


Quiet BPD Treatment

BPD was once thought untreatable. However, this isn’t the case, and we now know there are effective treatments for BPD. Many people with BPD find relief from distress through therapy.


Dialectical Behavioral Therapy

Dialectical behavioral therapy (DBT) was developed by psychologist Marsha Linehan. This form of therapy teaches you to live and cope with difficult and overwhelming emotions. DBT is the most common form of treatment for BPD. Each skill set helps alleviate symptoms associated with BPD.

Dialectical behavioral therapy teaches you four main skill sets:

  • Interpersonal effectiveness
  • Emotional regulation
  • Distress tolerance
  • Mindfulness

Mentalization-Based Therapy

Mentalization-based therapy helps you develop an awareness of your inner state. Another significant focus of mentalization-based therapy is developing empathy for other peoples’ experiences.

Research in 2018 suggests that this therapy could significantly reduce the severity of BPD symptoms and the severity of co-existing conditions and improve quality of life. The authors note that more research is still needed, though.


Medication

No single medication is effective for BPD, but medications may relieve some symptoms.

For example, medications may help with mood stabilization. If you think medication might help you, consider talking with a doctor about your symptoms.


When to Contact a Medical Professional

See your provider if you or someone you know has symptoms of borderline personality disorder. It is especially important to seek help immediately if you or someone you know is having thoughts of suicide.

You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.

If someone you know has attempted suicide, call 911 or the local emergency number immediately. DO NOT leave the person alone, even after you have called for help.

If you think you may benefit from quiet borderline personality disorder therapies, you can contact We Level Up FL for treatment resources.
If you think you may benefit from quiet borderline personality disorder therapies, you can contact We Level Up FL for treatment resources.

[3] Source: Borderline personality disorder – U.S. Department of Health and Human Services National Institutes of Health

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18 Signs You Grew Up With Quiet Borderline Personality Disorder

People with quiet BPD usually have lived with it for the better part of their lives, so an organization called The Mighty wanted to know what “signs” from childhood people can recognize now. They asked people in their BPD community to share what it was like to grow up with undiagnosed, or maybe not-yet-developed, quiet borderline personality disorder. [4]

Here’s what they had to say about the “18 signs you grew up with ‘quiet borderline personality disorder”:

1. “Physically punishing myself if I wasn’t the best at something, or if I thought I did something wrong.” — Rebecca B.

2. “Having huge emotional swings surrounded around people and their actions or statements. I was always told I was ‘too sensitive’ and now I realize it was so much more than that.” — Sami S.

3. “Obsessions… The placing people on a high pedestal… And one small thing makes them the worst.” — Maha D.

4. “Total and utter people-pleasing. I couldn’t handle anyone not liking me… And I would do or say anything to avoid conflict of any sort.” — Jenny B/

5. “Never feeling at home anywhere (I move a lot) or knowing who I am. Pushing people away by being too honest or bored quickly (because I’m already so used to abandonment).” — Lynda B.

6. “Compulsive lying. I’ve been a compulsive liar all my life, it took me until about a year ago to realize that it was something to do with BPD. I lied about the silliest little things when I was younger, and the lies gradually got bigger. I’ve become much more self-aware with it and have good control of it, but it was a shocking realization for me.” — Marisa C.

7. “I told everyone everything. People were put off by my deep dark emotional stories.” — Bre I.

8. “Always wanting to either fit in or totally not fit in. Never feeling like I belonged anywhere. No sense of self. One minute I’d be into one activity, person, idea, religion and then out of the blue, I’d lose all interest. I’d seek for approval and happiness in relationships and do whatever I could to avoid myself and my feelings.” — Nicole K.

9. “Being submissive and holding it together when I’d feel emotional for legitimate reasons, just because I got the message that being emotional in front of others was unacceptable.” — Lucy L.

10. “It was the realization that I said sorry all the time and still do. I apologize for everything and am always regretful even if it’s not my fault. I think it was because I never wanted anyone to be upset with me or see me as a bad person. The irony is that I saw myself as a horrible and bad person that no one would stay with.” — Suraya M.

11. “Attachment issues. My whole self-worth would be tightly knitted to everyone around me. My anxiety. I would watch out the window for hours for friends to come over and be seriously anxious.” — Kirsten A.

12. “Splitting. I used to always as a child go from idolizing someone to thinking they were sent straight from hell. It’s one of the ‘loudest’ BPD traits I have, and one of the only ones I show outwardly. It’s always made developing relationships and maintaining them super hard.” — Salmontha C.

13. “Over-rationalizing my emotions which makes me put up with what people put me through because I’ve learned that standing up for myself and my feelings backfires in the worst ways.” — Steff F.

14. “Breaking up good relationships because it was on my terms and also because of trust issues. Break up before they break up with me.” — Steve B.

15. “Dissociative symptoms from a young age — not feeling like ‘me,’ and looking in the mirror and not always recognizing myself.” — Arybella H.

16. “Doing anything I could to make people not leave me. Of course they did, but even when they did, I would do what I could to get them back or just completely cut myself off from everyone. There was no in-between.” — Rachel W.

17. “I was so scared to do something wrong. I avoided pushing boundaries and everyone would always comment what an ‘angel’ I was. I never would do anything that would make anyone mad at me.” — Melissa F.

18. “I kept looking for affection from everyone, and got too emotionally attached. Felt like I needed to be their number one constantly and always had rough relationships as I was growing up.” — Marie C.

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11 Hidden Signs Of Quiet Borderline Personality Disorder

Borderline personality disorder (BPD) is a mental health condition known for mood fluctuations and behaviors. People with BPD may also struggle with relationships as well as their self-image. It’s been suggested that there are “subtypes” of BPD, but this theory is unproven. One subtype is “quiet” BPD, which means you direct your struggles more inward, so others don’t notice. However, quiet BPD is not a recognized diagnosis. A person can only be diagnosed with BPD, not “quiet borderline personality disorder.”

Here are the 11 Hidden Signs Of Quiet Borderline Personality Disorder:

1. Self-Blame

Because people with BPD tend to feel more strongly than others, they experience emotions like guilt intensely. This can lead to chronic self-blame.

2. Mentally Retreating

When triggered, it’s normal to retreat inward to protect yourself. If this is something you consistently struggle with, you’re not alone.

3. Beating Yourself Up

As we mentioned, people with quiet borderline personality disorder often direct anger inward. This can lead to chronic negative self-talk. We encourage you to contact a therapist if you struggle with negative self-talk.

4. Being a People Pleaser

People-pleasing or “fawning” is a typical response to trauma. The majority of people with BPD have a history of trauma. In a recent study, researchers found BPD was the mental illness with the firmest link to childhood trauma. [5]

5. Being Afraid of Emotional Intimacy

Fear of abandonment can cause people with a quiet borderline personality disorder to retreat from relationships entirely. Unfortunately, this leaves people without the support friends, family, and partners can provide. Thankfully, many therapists specialize in relationship issues and can help you address your fears if this is something you struggle with.

6. Dissociation

According to Mental Health America (MHA), dissociation is a mental experience that causes a person to disconnect from their present circumstances, thoughts, memory, and identity. Like most symptoms, dissociation exists on a spectrum from mild to severe. Dissociation is common in people who have lived through trauma. [6]

7. Experiencing Internal Rage

Uncontrollable anger is one of the nine classic symptoms of BPD, and quiet borderline personality disorder is not immune to experiencing it. Though they may not act outwardly on their anger, the emotion can be intense and challenging to handle.

8. Fear of Abandonment

Making frantic efforts to avoid abandonment is one of the hallmark symptoms of a quiet borderline personality disorder and affects almost all people with the diagnosis.

Quiet borderline personality disorder can be difficult to diagnose and treat, but the earlier you seek help, the better the outcome. 
Quiet borderline personality disorder can be difficult to diagnose and treat, but the earlier you seek help, the better the outcome. 

9. Self-Sabotage

Self-sabotage, or a deliberate attempt to interfere with one’s growth or goals, can be expected for people with a quiet borderline personality disorder — especially if they struggle with self-harm tendencies.

10. Feeling Suicidal or Wanting to Self-Harm After Social Interactions

One of the most notable parts of BPD is having unstable and stormy interpersonal relationships. When quiet borderlines experience social rejection or letdowns, they may have painful internal experiences like suicidal thoughts or engage in self-harm.

11. Shutting Down

In the classic “quiet” style, a person with a quiet borderline personality disorder is more likely to internalize and shut down rather than act out or lash out.

Quiet Borderline Personality Disorder DSM 5

While quiet borderline personality disorder is not an official diagnosis, this term denotes a subtype of borderline personality disorder that tends to turn symptoms inward rather than outward (which makes it less obvious). Because of the hidden nature of quiet BPD, it often is misdiagnosed as something else (e.g., depression, social anxiety, autism) or takes longer to diagnose because of the lack of classic symptoms and quiet’ borderline personality disorder test.

Borderline personality disorder is diagnosed according to a list of symptoms in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). To be diagnosed, you must meet five of the following nine criteria (paraphrased):

  1. Engaging in frantic efforts to prevent actual or perceived abandonment
  2. A history of unstable relationships that involve idealizing and then devaluing a person (called “splitting” or black-and-white thinking)
  3. Having an unstable identity or image of yourself
  4. Problems with impulsive or risky behavior
  5. Frequent self-harm or suicidal ideation
  6. Rapid/frequent mood swings and the experience of intense emotions
  7. A chronic feeling of being empty
  8. Feelings of intense or uncontrollable anger
  9. Dissociation (disconnecting from yourself, having an “out of body” experience)

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Even though quiet borderline personality disorder is poorly understood and not often identified, that doesn’t mean it is not treatable.
Even though quiet borderline personality disorder is poorly understood and not often identified, that doesn’t mean it is not treatable.

Quiet Borderline Personality Disorder Test

Most clinicians think of the borderline personality disorder case as being angry and explosive, but these individuals are instead quiet and hurting.

People with a quiet borderline personality disorder may feel misunderstood, and receiving a correct diagnosis can feel like 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:

  • Do you have bad mood swings that can last days, but nobody around you knows how you feel?
  • Do you feel guilty or ashamed often, even though others might tell you that you have nothing to feel guilty about?
  • Do you blame yourself as your go-to response if you conflict with someone?
  • In relationships or friendships, do you tend to idealize someone but eventually decide that you don’t like them anymore (even if you don’t outwardly let them know)?
  • Does it feel like you are separate from everyone, empty, or numb all the time?
  • Does it sometimes feel like you are watching yourself go through the motions or like your life is “surreal”?
  • Do you tend to push it down or suppress it when you get angry?
  • Do you feel like a burden to others or that you are just taking up too much space?
  • When people hurt you, do you tend to cut them out of your life rather than try to discuss what happened?
  • If you get upset, is your tendency to go into withdrawal mode and not talk to anyone at all?

Contact We Level Up FL today for a free assessment if you’re looking for an accurate, quiet borderline personality disorder quiz or test. Each call is private and confidential.

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How To Treat Quiet Borderline Personality Disorder Symptoms

Borderline personality disorder historically has been viewed as challenging to treat. But with newer, evidence-based treatment, many people with this disorder experience fewer and less severe symptoms, improved functioning, and better quality of life. Patients with borderline personality disorder must receive treatment from a licensed mental health professional. Other types of treatment, or treatment from a provider who is not appropriately trained, may be ineffective or dangerous.

Many factors affect the time it takes for symptoms to improve once treatment begins. It is vital for people with borderline personality disorder and their loved ones to be patient and receive support during treatment.

Seek—and stick with—treatment.

Studies funded by the National Institute of Mental Health (NIMH) indicate that individuals with borderline personality disorder who don’t receive adequate treatment are more likely to develop other chronic medical or mental illnesses and are less likely to make healthy lifestyle choices. [6]

Psychotherapy

Psychotherapy, sometimes called “talk therapy,” is the first-line treatment for people with borderline personality disorder. Most psychotherapy occurs with a licensed, trained mental health professional in one-on-one sessions or with other individuals in group settings. Group sessions may help teach people with borderline personality disorder to interact with others and express themselves effectively.

Two examples of psychotherapies used to treat borderline personality disorder are:

  • Dialectical Behavior Therapy (DBT): This treatment was developed for individuals with borderline personality disorder. DBT uses concepts of mindfulness or awareness of one’s present situation and emotional state. DBT also teaches skills to help people control intense emotions, reduce self-destructive behaviors, and improve relationships.
  • Cognitive Behavioral Therapy (CBT): This treatment can help people identify and change core beliefs and behaviors resulting from inaccurate perceptions of themselves and others and problems interacting with others. It may help people reduce mood swings and anxiety symptoms and the number of self-harming or suicidal behaviors.

Medications

Because the benefits of prescription medication for borderline personality disorder are unclear, medications aren’t typically used as the primary way to treat the illness. However, in some cases, a psychiatrist may recommend medications to treat specific symptoms or co-occurring mental disorders such as mood swings or depression. Treatment with medications may require coordinated care from more than one medical professional. Medications also can sometimes cause side effects in some people. Find out more about borderline personality disorder medication.

Therapy for Caregivers and Family Members

Having a relative or loved one with the disorder can be stressful, and family members or caregivers may unintentionally act in ways that can worsen their loved one’s symptoms. Although more research is needed to determine how well family therapy helps with borderline personality disorder, studies on other mental disorders show that including family members can help support a person’s treatment. Families and caregivers also can benefit from therapy.

Family therapy helps by:

  • Allowing the relative or loved one to develop skills to understand and support a person with a borderline personality disorder.
  • Focusing on the needs of family members helps them understand the obstacles and strategies for caring for someone with the disorder.

Finding Help

Suppose you’re unsure where to get help. In that case, We Level Up FL can refer you to a licensed mental health professional, such as a psychiatrist or psychologist with experience treating quiet borderline personality disorder. If you need help starting the conversation, contact us today!

Popular Quiet Borderline Personality Disorder Frequently Asked Questions

  1. What does a quiet borderline personality disorder episode look like?

    This can look like poor self-image, excessive self-criticism, emptiness, and instability in goals, values and opinions.

  2. How severe is a quiet borderline personality disorder?

    Living with quiet borderline personality disorder can be exhausting and incredibly debilitating. It can stop a person from enjoying their everyday life as they struggle to cope with the intense thoughts and emotions they experience.

  3. Is Quiet Borderline personality disorder worse than BPD?

    Quiet borderline personality disorder can be much more complicated than BPD to both diagnose and treat, but as with many mental health conditions, the earlier it’s diagnosed, and intervention is started, the more successful treatment can be.

Search Quiet Borderline Personality Disorder & Mental Health Topics & Resources
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[1-2] Ripoll LH. Psychopharmacologic treatment of borderline personality disorder. Dialogues Clin Neurosci. 2013 Jun;15(2):213-24. DOI: 10.31887/DCNS.2013.15.2/lripoll. PMID: 24174895; PMCID: PMC3811092.

[3] Borderline personality disorder – U.S. Department of Health and Human Services National Institutes of Health

[4] 18 Signs You Grew Up With ‘Quiet Borderline Personality Disorder’ – The Mighty Available from: https://themighty.com/topic/borderline-personality-disorder/quiet-borderline-personality-disorder-bpd-signs-child/

[5] National Collaborating Centre for Mental Health (UK). Borderline Personality Disorder: Treatment and Management. Leicester (UK): British Psychological Society (UK); 2009. (NICE Clinical Guidelines, No. 78.) 2, BORDERLINE PERSONALITY DISORDER. Available from: https://www.ncbi.nlm.nih.gov/books/NBK55415/

[6] Borderline Personality Disorder – National Institute of Mental Health (NIMH)

[7] Subbarao BS, Silverman A, Eapen BC. Seizure Medications. [Updated 2022 Jul 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482269/

[8] Bandelow B, Michaelis S, Wedekind D. Treatment of anxiety disorders. Dialogues Clin Neurosci. 2017 Jun;19(2):93-107. DOI: 10.31887/DCNS.2017.19.2/bbandelow. PMID: 28867934; PMCID: PMC5573566.

[9] Olabi B, Hall J. Borderline personality disorder: current drug treatments and prospects. Ther Adv Chronic Dis. 2010 Mar;1(2):59-66. DOI: 10.1177/2040622310368455. PMID: 23251729; PMCID: PMC3513859.

[10] Borderline Personality Disorder – MentalHealth.gov U.S. Department of Health & Human Services