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What Is Quiet BPD and What Is Treatment Like? 

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Quiet BPD, or “high-functioning” BPD, is a subtype where individuals experience intense Borderline Personality Disorder (BPD) symptoms internally rather than outwardly. People with quiet BPD, also known as discouraged BPD, direct their emotions inward, trying to hide them from others, which can impact relationships and self-esteem. This blog will explore quiet BPD, its symptoms, and how it differs from traditional BPD, or quiet BPD vs. BPD. We’ll also delve into signs of quiet BPD, its impact on quiet BPD and relationships, and discuss effective quiet BPD treatment and quiet BPD therapy options. Additionally, we’ll address whether quiet BPD is real, examine potential causes, and consider if quiet BPD in men and quiet BPD in women present differently.   

What Is Borderline Personality Disorder (BPD)?  

Borderline Personality Disorder (BPD) is a mental health condition impacting a person’s ability to manage emotions effectively. It leads to difficulties with self-image, unstable relationships, and impulsive behaviors. BPD is characterized by extreme mood swings and an intense fear of abandonment. The condition typically begins in early adulthood, with symptoms ranging from mild to severe. 

Here are some stats and facts about BPD: 

  • It’s the most commonly recognized personality disorder. 
  • Almost 75% of people with BPD are women, though it may affect men equally, but they are more likely to be misdiagnosed. 
  • People with BPD have a higher risk of suicide and self-destructive behavior. 

Subtypes of BPD  

While the DSM-5 doesn’t officially recognize subtypes of Borderline Personality Disorder (BPD), experts have identified different ways BPD can present. These subtypes of personality disorders help understand how symptoms manifest differently in individuals. Here are four commonly discussed subtypes: 

  • Discouraged or Quiet BPD: People with this type tend to direct their emotions inward. They may be very dependent on others and clingy but become angry when they feel abandoned. 
  • Impulsive BPD: This type is marked by difficulty with impulse control. Individuals may be hyperactive and fail to think before acting, potentially causing harm to themselves or others. 
  • Self-Destructive BPD: Individuals with this subtype harbor intense feelings of bitterness and self-hatred. They direct their feelings inward, which can lead to dangerous or harmful behaviors towards themselves. 
  • Petulant BPD: People with petulant BPD fluctuate between explosive anger and feeling unworthy or unloved. They may have a strong need to manipulate or control others and become very possessive. 

What Is Quiet BPD? 

Quiet BPD, also known as “high-functioning” or discouraged BPD, is a subtype of Borderline Personality Disorder where individuals internalize their emotions rather than express them outwardly. While not an official diagnosis, it’s a term used to describe those who direct their struggles inward. People with quiet BPD experience intense emotions and fear of abandonment, but they tend to suppress their feelings, making them harder to spot. They may also have unstable relationships, intense anger, and frequent mood swings, but they keep their shifts in mood internal. It is thought that quiet BPD in men and quiet BPD in women present differently. 

How Is Quiet BPD Different from BPD? 

The main difference between Quiet BPD and typical BPD lies in how emotions are expressed. People with typical BPD externalize their feelings through impulsive behaviors and outbursts. Those with quiet borderline personality disorder internalize their struggles, directing feelings inward. Instead of outward anger, they may self-blame, isolate, or self-harm. This makes quiet BPD harder to diagnose because they don’t display erratic behavior, and symptoms resemble anxiety or mood disorders. 

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What Are the Signs and Symptoms of Quiet BPD? 

Signs of quiet BPD include internalizing emotional struggles rather than showing outward anger. Individuals may experience intense emotional turmoil, inner distress, anxiety, and mood swings while outwardly appearing composed. Other signs are a fear of abandonment, an unstable self-image, and impulsive behaviors directed at themselves. They might avoid relationships to protect themselves from rejection. 

Reframing Negative Thoughts 

People with Quiet BPD often struggle with self-blame, self-isolation, or even self-harm. They also suppress their emotions, hiding their inner chaos from others. They might feel intense anger or sadness but choose to internalize these feelings rather than express them outwardly. For example, instead of expressing anger or sadness explosively, individuals with quiet BPD may hold feelings inside. 

What Causes Quiet BPD? 

The causes of Quiet BPD are not fully understood, but research suggests a combination of genetic, environmental, and social factors may contribute. Genetics may play a role, as BPD can run in families. Childhood trauma, such as abuse, neglect, or separation, is often linked to BPD. Additionally, differences in brain structure and function, particularly in areas affecting emotions and impulsivity, may be contributing factors. Chaotic relationships and unstable family environments during formative years can also increase the likelihood of developing BPD and/or Quiet BPD. 

How Is Borderline Personality Disorder Diagnosed?    

The DSM-5 diagnoses Borderline Personality Disorder (BPD) as a pervasive pattern of instability in interpersonal relationships, self-image, and emotions, along with marked impulsivity, beginning in early adulthood. To meet the criteria for BPD, five or more specific symptoms must be present across multiple contexts, causing significant suffering or impairment in relationships and overall functioning. These symptoms include a fear of abandonment, unstable relationships, an unstable self-image, impulsive behavior, and suicidal tendencies. 

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How Is Borderline Personality Disorder Treated?    

Borderline Personality Disorder (BPD) is primarily treated through psychotherapy, also known as talk therapy, which aims to improve emotional management, reduce impulsivity, and enhance relationship skills. Medication may be used to address co-occurring conditions or specific symptoms. A short-term hospital stay may be recommended if you’re at risk of harming yourself or others. Effective treatment for Quiet BPD requires time, patience, and commitment. 

Psychotherapy for BPD 

Common behavioral therapeutic approaches for treating BPD can include: 

  • Dialectical Behavior Therapy (DBT): Teaches emotional regulation, distress tolerance, and interpersonal skills. 
  • Cognitive Behavioral Therapy (CBT): Helps change negative thought patterns and improve relationship issues. 
  • Mentalization-Based Therapy (MBT): Enhances the ability to understand one’s own and others’ mental states. 
  • Transference-Focused Psychotherapy (TFP): Explores emotions and relationship patterns through the therapist-client relationship. 
  • Systems Training for Emotional Predictability and Problem-Solving (STEPPS): A group-based treatment program involving family and caregivers. 

Holistic Therapy for BPD 

Holistic therapy addresses the whole person—mind, body, and spirit—to support overall well-being. It complements traditional treatments by promoting relaxation, stress reduction, and emotional healing. 

Here are some examples of holistic therapy approaches: 

  • Yoga 
  • Meditation and Mindfulness 
  • Massage Therapy 
  • Energy Healing (Reiki) 
  • Art and Music Therapy 
  • Acupuncture 
  • Sound Healing  
  • Herbal Medicine 

Medication for BPD  

The Food and Drug Administration hasn’t approved any drugs specifically to treat borderline personality disorder. However, medicines such as antidepressants, antipsychotics, or mood-stabilizing drugs may help with symptoms and conditions that occur with borderline personality disorder, such as depression, impulsiveness, aggression, or anxiety. 

Finding Help for Borderline Personality Disorder 

Seeking help for Borderline Personality Disorder (BPD) is a courageous step towards improving your quality of life. Effective treatments, primarily talk therapy such as DBT, MBT, and schema-focused therapy, can significantly reduce symptoms and improve emotional regulation. With commitment and the right support, managing BPD is possible. 

Footprints to Recovery Mental Health offers compassionate and evidence-based treatment programs tailored to your unique needs. Contact us today for a confidential consultation and take the first step toward a healthier, more fulfilling life. 

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