Quiet BPD: High-Functioning Borderline Personality Disorder BPD

What is "Quiet" BPD or High-Functioning BPD?

Borderline personality disorder (BPD) is a mental health challenge affecting around 1.6% of the global population. It is characterised by intense emotions of anxiety, anger, depression, and fear of abandonment combined with self-destructive behaviour. Due to challenges with emotional regulation, people struggling with BPD often have difficult relationships with their family members, friends, and partners. While mental health experts have a better understanding of this challenge, quiet BPD is still an understudied type.

Quiet borderline personality disorder is a form of BPD where the person directs their painful feelings (such as sadness, anger, and shame) towards themselves. Unlike other forms of borderline personality disorder, people with quiet BPD act inward rather than taking out their emotions on others. The internalisation of intense anger and other strong emotions creates concealed turmoil that can affect the person’s overall perception of the world surrounding them.

On the outside, most individuals with quiet BPD can seem emotionally stable and high-functioning. However, on the inside, they experience depression, anxiety, intense mood swings, low self-esteem, fear of abandonment, and negative feelings. However, with professional support, individuals can learn healthy methods to deal with their symptoms.

Quiet BPD Symptoms

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognises several characteristics of borderline personality disorder, including mood swings, intense anger, an unstable sense of self, and turbulent relationships. However, individuals with quiet BPD experience these symptoms in a unique manner that differs from other forms of borderline personality disorder.

Common characteristics of high-functioning BPD include the following:

Intense episodes of sadness, shame, and guilt directed towards self
Repressing and hiding mood changes
Social withdrawal
Extreme fear of rejection and sensitivity to criticism
Distorted self-image and low self-esteem

Causes of High-Functioning BPD

Medical experts are still unsure about the specific causes and risk factors leading to high-functioning BPD. Some studies have found genetic links, while others have highlighted brain changes and environmental factors. All in all, common causes of quiet borderline personality disorder include the following:

Genetic factors
Altered levels of neurotransmitters in the brain
Bullying and physical or sexual abuse
Dysfunctional family relationships
History of abandonment and rejection
War-related trauma

Quiet BPD Diagnosis

Getting diagnosed with high-functional borderline personality disorder can be an arduous process due to the overlap with symptoms of other challenges and the person’s tendency to mask their signs.

Instead of carrying out a specific test, licensed professionals typically use a combination of assessments and interviews to diagnose borderline personality disorder. According to the DSM-5, these are the main criteria for an official diagnosis:

Challenges and Impacts of High-Functioning BPD

Quiet borderline personality disorder can significantly impact an individual and their loved ones. This mental health challenge causes uncertainty about the person’s identity, dissatisfaction with oneself, and feelings of emptiness. People with high-functioning BPD experience frequent negative thoughts, fear of rejection, and regret about expressing their feelings.

Individuals with quiet BPD may oscillate between clinging to people around them in need of validation and them pushing them away to avoid criticism. This leads to frequent mood swings and switches in emotions, such as going from extreme excitement to deep sadness. Their outward manifestation doesn’t always reflect their emotional turmoil. For example, a person with quiet BPD can suddenly feel angry while simply appearing tired to those around them.

High-functioning BPD might cause individuals to set high expectations for their academic or professional performance. If the person doesn’t meet these expectations or receives constructive criticism, they may feel hopelessness, guilt, and shattered self-esteem. In these circumstances, people with quiet BPD might resort to harmful compulsive behaviours, such as overeating, alcohol or drug abuse, and certain repetitive rituals.

Coping Strategies and Self-Care

A sincere and insightful approach to mental health is the first step towards reaching your full potential while dealing with quiet BPD. Sharing emotional struggles is advisable, especially if you have a tendency towards self-harm. Reaching out to reliable relatives or friends is a beneficial move in times of overwhelming emotional struggle.

Taking care of one’s physical well-being is an essential part of self-care for individuals dealing with internalised emotions and stress due to quiet BPD. Therefore, you should prioritise healthy habits like maintaining a nutritious diet, engaging in regular physical activities, and getting quality sleep. Finally, attending regular appointments with a therapist is a vital part of overcoming the most challenging aspects of high-functioning borderline personality disorder.

Treatment Options

Dialectical behaviour therapy is the most favoured therapy option for individuals with a high-functioning BPD diagnosis. This therapy method offers individuals with quiet BPD a comprehensive treatment approach, including individual therapy, phone coaching between sessions, and group therapy focusing on skill building. Group therapy can improve the person’s emotion regulation and distress tolerance by equipping them with resources to overcome various interpersonal challenges.

Medication can be combined with psychotherapy to treat symptoms of BPD. Mindfulness can be particularly beneficial for people with quiet BPD because it increases their awareness of the present moment. This enables individuals to build an identity separate from the overwhelming internalised emotions rather than maintaining a destructive attachment to them. Whether you seek treatment for yourself or a loved one struggling with quiet BPD, finding a therapist with relevant experience is essential.

Leaf Complex Care Supports Individuals with BPD

At Leaf Complex Care, dismantling the stigma around borderline personality disorder (BPD) and providing individuals with compassionate support is our goal. We deliver humanised, person-centred care to people with high-functioning BPD in their own homes, allowing them to stay in their familiar surroundings and keep in regular contact with their loved ones.

Our impact-driven support workers strive to create a safe space for people with high-functioning borderline personality disorder. Your privacy, dignity, and human rights are imperative to the Leaf team. Our support workers always prioritise the independence of the people we serve and involve them in every decision about the assistance they receive.

We offer high-standard, CQC-regulated care for individuals with high-functioning BPD across the UK, with offices in Bristol, Slough, Somerset and the Midlands.