What Is ‘Quiet’ Borderline Personality Disorder?

Quiet BPD isn’t an official clinical diagnosis, but rather, a subtype. It’s also known as the “discouraged subtype” of BPD, a subtype suggested by psychologist Theodore Millon.

This subtype is often hard to spot. If you have quiet BPD, you direct moods and behaviors inward, so other people don’t see. Your emotions and behaviors may feel like a roller coaster with many ups and downs. You may have difficulty in your relationships due to fear of abandonment.

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.”

People with any type of BPD experience the same internal dysregulation and inner turmoil, but folks with quiet BPD are masterful at masking their pain — so they may appear cold, distance, or aloof as a result.

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) lists nine criteria as the symptoms of borderline personality disorder:

• avoiding abandonment, whether real or imagined
• intense and unstable interpersonal relationships
• a disturbance of identity, which results in an unstable self-image or sense of self
• impulsive behaviors in at least two areas that are self-damaging, such as spending money, sex, substance use, driving, or binge eating
• recurrent suicidal behaviors or threats, or self-harm
• instability of mood or reactive mood
• chronic feelings of emptiness
• inappropriate, intense anger, or difficulty controlling anger
• stress-related paranoid ideation, or severe dissociative symptoms that are temporary

While these symptoms are common with BPD, quiet BPD manifests differently.

With quiet BPD, you’ll likely try to hide these symptoms from others, resulting in intense periods of anger, guilt, or shame directed toward yourself.

You may hide impulsive behaviors or try to repress your moods. You might also withdraw or isolate from others.

Quiet BPD can take a toll on interpersonal relationships as you try to hide symptoms. It can also be challenging to maintain relationships due to extreme emotions and instability of moods and behaviors.

You may fear rejection from others or become extremely sensitive to perceived criticisms. You might worry that everyone will leave you — and this can plummet your self-esteem.

Within interpersonal relationships, sometimes you push people away, and sometimes you pull them closer. Sometimes you want people close, and other times you fear criticism or rejection so much that you push them away.

BPD is most commonly diagnosed in adults, but occasionally it can be diagnosed before age 18. In these cases, you must have symptoms for at least a year to be diagnosed.

BPD was once thought untreatable. However, this isn’t the case, and we now know that 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.

Dialectical behavioral therapy teaches you four main skill sets:

• interpersonal effectiveness
• emotional regulation
• distress tolerance
• mindfulness

DBT is the most common form of treatment for BPD. Each skill set helps alleviate symptoms associated with BPD.

Mentalizaton-based therapy

Mentalization-based therapy helps you develop awareness of your inner state. Another large focus of mentalization-based therapy is learning how to develop empathy for other peoples’ experiences.

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

Medication

There’s no single medication that’s effective for BPD, but some symptoms may be relieved with meds.

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

There are plenty of resources available if you need help with symptoms of BPD.

The National Education Alliance for Borderline Personality Disorder offers education, videos, blogs, and podcasts on their website for individuals who have been diagnosed with BPD and their loved ones.

The Mental Illness Happy Hour has a great podcast available here about BPD. Another podcast about BPD, based on personal experiences, is available here, called the Depth of Echoes Podcast.

If you’re looking for a therapist, the American Psychological Association has a searchable database of licensed psychologists throughout the United States. If you think you may benefit from DBT, you can use the Behavioral Tech’s directory.

Psych Central also has a weekly podcast “Inside Mental Health” approaching all things mental health, with a few episodes focused on BPD

Don’t be afraid to seek help. There are other people who have been in your shoes and found relief by seeking treatment.