Top 15 Symptoms of Quiet BPD, Causes, Treatment & Risk Factors

Quiet BPD

Symptoms of Quiet BPD – borderline personality disorder (BPD) is not a recognized subtype; rather, it refers to individuals who satisfy the diagnostic criteria for borderline personality disorder but do not fit the conventional profile.

According to the National Institute of Mental Health (NIMH), a borderline personality disorder is a mental condition characterized by a continuing pattern of fluctuating moods, self-image, and behavior. These symptoms frequently result in impulsive behavior and relational difficulties. People with a borderline personality disorder may have strong, hours-to-days-long episodes of anger, despair, and anxiety.

Unlike the conventional presentation of BPD, which includes angry outbursts and overt self-destructive behavior, persons with quiet BPD experience internalized emotional crises (they turn their anger inward).

Therefore, quiet BPD is frequently misdiagnosed or misinterpreted. This disorder is also referred to as “high-functioning” BPD on occasion.

What is Quiet BPD?

Quiet BPD – Borderline personality disorder is a mental disorder that is frequently characterized by mood swings and problems controlling emotions. This illness can cause individuals to have extreme mood swings that can linger for extended durations. According to the National Alliance on Mental Illness, BPD affects around 1.4% of U.S. adults, with 75% of those diagnosed being female.

There is controversy over the increased prevalence of BPD in women compared to men, particularly with the notion that certain behaviors may appear differently due to “typical” gender stereotypes. For example, guys are traditionally perceived to be more aggressive, therefore this behavior may receive a pass in certain groups.

According to Ernesto Lira de la Rosa, Ph.D., a psychologist in New York City and the media advisor for Hope for Depression Research Foundation, quiet BPD is not an established diagnosis. Rather, the word refers to one of four subtypes of BPD initially described by psychologist Theodore Millon, he adds, adding that these classifications are not universally accepted.

This subtype of BPD (also known as the “discouraged” subtype) is characterized by the same “feeling of instability in interpersonal relationships, self-image, affect, and impulsivity,” according to Dr. Lira de la Rosa. However, these individuals may internalize rather than externalize their behaviors.

Quiet BPD is also characterized by a strong attachment to one or two significant persons and a pervasive sense of vulnerability.

Symptoms of Quiet BPD

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

  • avoiding desertion, whether perceived or actual
  • strong and volatile interpersonal connections
  • An identity disturbance that results in an unstable self-image or feeling of self
  • at least two self-destructive impulsive activities, such as spending money, sex, substance usage, driving, or binge eating.
  • repeated suicidal acts, threats of suicide, or self-harm
  • unstable or reactive disposition
  • recurring sensations of loneliness
  • fury that is inappropriately fierce or difficult to control
  • Stress-related paranoid ideation or transient severe dissociative symptoms

While these symptoms are typical of BPD, the manifestation of quiet BPD differs. With quiet BPD, you will likely attempt to conceal these symptoms from others, leading to strong episodes of self-directed anger, guilt, or shame. You may attempt to conceal impulsive behaviors or suppress your emotions. You may also withdraw from people or isolate yourself.

Attempting to conceal Quiet BPD symptoms can be detrimental to interpersonal relationships. Extreme emotions, unstable moods, and erratic behavior can also make it difficult to establish relationships. You may dread rejection from others or develop a hypersensitive response to perceived critiques. You may fear that everyone will abandon you, which might diminish your self-esteem.

Sometimes you push people away in interpersonal connections, and sometimes you pull them closer. Sometimes you desire closeness with others, and other times you push them away out of fear of judgment or rejection. BPD is often diagnosed in adults, but it can occasionally be diagnosed in children and adolescents. In many instances, a diagnosis requires at least a year of symptoms.

What are the Causes of Quiet BPD?

The reasons for “Quiet BPD” are identical to the typical causes of borderline personality disorder. Like several other mental health illnesses, it is believed that an increased risk of BPD is hereditary (inherited). Studies According to Reliable Source, BPD may have hereditary links, but additional data is required to comprehend the connection.

Probably, genetics are not the only cause of Quiet BPD. Multiple studies have revealed that emotional and physical abuse, as well as early neglect, might enhance a person’s susceptibility. Exposure to unstable relationships or a personal history of unstable relationships may also play a role.

Brain abnormalities and variations in the neurotransmitter serotonin may be connected with BPDReliable Source. It is unclear, however, whether brain changes cause BPD or occur after the fact.

Complications Related to Quiet BPD

Personality disorders are so harmful and convoluted because they affect all facets of life. Rather, they affect every aspect of a person’s health and well-being negatively.

Among the most frequent problems of Quiet BPD are:

  • Relationships that are unhappy or discordant
  • Problems developing loving, trustworthy relationships with people
  • Increased usage of alcohol and other drugs to cope with intense emotions that turned inward
  • Co-occurring mental health problems such as depression and anxiety are more likely.
  • Struggling to overcome minor setbacks and obstacles
  • Suicidal ideas and attempts

Lo adds, “The greatest obstacle for a person with Quiet BPD is a profound loneliness.” They could feel imprisoned in their situation. They may sense that something is off and have a strong desire for connection, but are paralyzed by a fear of losing control. On the exterior, they may be high-functioning, but on the inside, they may feel lost and depressed.”

Meier further states, “In my experience, those whose BPD symptoms are more internalized tend to appear calm, nice, and agreeable. This can disguise the inner turmoil raging within and lead to environmental rejection. They may feel obligated to maintain this facade of serenity, lest they risk rejection and desertion. At the same time, they may feel profoundly misunderstood and dishonest – as if no one knows their “true” selves – so that even positive interactions and connections might feel questionable and unreliable.

How is Quiet BPD Diagnosed?

Quiet BPD

To be diagnosed with borderline personality disorder, a person must meet five of the Diagnostic and Statistical Manual of Mental Disorders’ nine criteria (DSM-5). The requirements consist of:

  • Frantic attempts to prevent actual or imagined abandonment
  • Alternating extremes of idealization and depreciation characterize this type of unstable and intense interpersonal connections.
  • Identity disruption (markedly and persistently unstable self-image or sense of self)
  • Impulsivity in at least two potentially self-damaging regions
  • Repetitive suicidal conduct, threats or gestures, or self-mutilating behavior
  • Affective instability caused by a significant mood reactivity
  • Persistent emotions of emptiness
  • Anger that is inappropriately fierce or difficult to control
  • Transient paranoid ideation or acute dissociation symptoms connected to stress.

Quiet Borderline Personality Disorder Treatment

Since it is impossible to diagnose quiet BPD, there are no typical therapies for this version of the disorder. In addition, the Food and Drug Administration (FDA) has not yet approved any drug to treat BPD.

Consequently, the majority of BPD sufferers find alleviation through several psychotherapies:

Cognitive Behavioral Therapy (CBT) A sort of talk therapy that analyzes thought and behavior patterns and aids in the development of coping mechanisms to overcome them.

Dialectical Behavior Therapy (DBT) This therapy, designed exclusively for BPD, promotes mindful emotion and stress control.

Schema TherapyA blend of many therapy modalities with an emphasis on interpersonal connections (i.e. may be used for quiet BPD and romantic relationships).

Medication –  There is no effective medicine for BPD, but certain symptoms may be alleviated with medication. Medications may assist with mood stabilization, for instance. Consider discussing your issues with a doctor if you believe medication could be helpful.

Even though there is no FDA-approved treatment for BPD, you may be prescribed medication if you suffer from another mental disorder. Furthermore, vitamins and supplements may provide alleviation for BPD.

What Therapy May Work Better for Quiet BPD?

When you have quiet BPD, you may find typical Dialectical Behavioral Therapy (DBT) materials irrelevant or even frustrating. DBT, as it is created for individuals with BPD, focuses on building distress tolerance and reducing conflicts, but these are not what you require.

If you have subdued BPD or overly controlled tendencies, you may benefit from a specialist treatment such as Radically-Open DBT as opposed to typical DBT.

Working relationally with an attachment-based therapist may also be beneficial. By undergoing an emotionally corrective experience, you are able to directly experience expressing yourself without shame, punishment, or humiliation. You have the opportunity to experiment with expressing anger assertively and being spontaneous and humorous. Then, you can apply the embodied learning of emotional vulnerability and openness to other aspects of your life, begin to relax, be self-compassionate, and forge meaningful relationships with others.

For many years, you have concealed your suffering. However, if you are prepared to take the initial step and let people who understand your unique nature get to know you, you can not only recover but also thrive.

What Can Trigger a Quiet BPD Episode?

Dr. Lira de la Rosa explains that pinpointing the triggers and warning indicators of a BPD episode can be challenging due to the condition’s complexity and the fact that not every individual is provoked by the same conditions. Nevertheless, the following circumstances may exacerbate symptoms:

People with BPD might be profoundly affected by their interpersonal relationships. Situations in which they feel rejected, criticized, or abandoned may trigger an episode of borderline personality disorder.

Loss or Rejection:  Loss or rejection, such as the end of a relationship or the loss of a job, can also trigger an episode of BPD in certain individuals.

Intrusive Thoughts: BPD may be exacerbated by disturbing pictures or ideas that appear without warning, especially those that evoke painful memories. To understand what causes your BPD, it may be good to reflect on previous episodes and the preceding experiences. These times may shed light on the causes of an incident. Individuals living with a family member or acquaintance with BPD may find it beneficial to consult with a mental health expert to have a better understanding of their loved one’s personal triggers.

Quiet BPD vs. Normal BPD

A borderline personality disorder is characterized by uncontrolled mood swings, poor self-image, impulsive behavior, excessive “black-and-white” thinking, self-harm, and an inability to sustain stable interpersonal connections, according to the National Institute of Mental Health (NIH). Additional characteristics of the illness include episodes of extreme rage, despair, or anxiety. The duration of quiet BPD symptoms ranges from a few hours to several days.

Quiet BPD cannot be distinguished easily from classic BPD, at least in an official sense. The Diagnostic and Statistical Manual of Mental Disorders (DSM) does not assign it a specific designation. Nonetheless, therapists and patients frequently distinguish between “quieter” cases and BPD’s more conventional symptoms.

“Quiet BPD differs from classic BPD because sufferers of Quiet BPD do not exhibit the same outwardly chaotic behavior as sufferers of classic BPD, and sufferers of Quiet BPD are generally high-functioning and withdraw themselves when experiencing symptoms. This makes diagnosing Quiet BPD challenging, as many of the symptoms resemble those of other conditions, such as anxiety disorders and mood disorders. In addition, as with classic BPD, many individuals with quiet BPD have experienced trauma in the past. Unlike “classic” BPD, which is characterized by bouts of apparent, violent outbursts, people with quiet BPD frequently direct their violence inward.

People with Quiet BPD still experience the strong emotional roller coaster that characterizes the disorder, but they exert great effort to suppress or ignore these feelings. Their concept of self is frequently defined by shame or self-hatred.

Risk Factors of Quiet BPD

Genetic, environmental, and social risk factors may raise the likelihood of having a borderline personality disorder, according to studies. These variables might include:

Family History

People who have a close relative (such as a parent or sibling) with a borderline personality disorder may be at a greater risk of getting the disorder themselves.

Brain Structure and Function

Research indicates that individuals with a borderline personality disorder may have structural and functional alterations in the brain, particularly in the regions that regulate impulses and emotions. However, the investigations do not indicate whether these alterations were risk factors for the disease or whether they were the result of the sickness.

Environmental, Cultural, and Social Factors

Many individuals with borderline personality disorder report traumatic childhood experiences, such as abuse, abandonment, or hardship. Others may have been exposed to conflict or relationships that were unstable or invalidating.

Although these characteristics may enhance a person’s risk of developing a borderline personality disorder, it is not certain. Similarly, individuals without these risk factors may develop the condition at some point in their lives.

How to Help Someone With Quiet BPD

If you know someone who is living with quiet BPD, you can provide support in the following ways:

  • Ask inquiries and pay close attention to their responses.
  • Feel sympathy
  • Attempt to affirm their emotions.
  • Encourage them to employ skills for self-soothing
  • Discuss scheduled family or group therapy sessions.
  • Establish appropriate limits in your interactions.
  • Recognize their triumphs
  • Encourage mindfulness methods
  • Take care of yourself and control your stress in order to be there for them.


Although it is impossible to diagnose quiet BPD, its existence cannot be denied. The internalization of emotions can be a significant setback for persons afflicted with the disorder, and it often goes unreported.

If you suspect a loved one is struggling, you should understand how to assist someone with BPD. Although this can be extremely difficult, people with BPD require a support system, particularly those with quiet BPD. And your assistance could be all that someone needs to beat their illness.

Frequently Asked Questions (FAQs) about Quiet BPD

Who can diagnose borderline personality disorder?

Simon A. Rego, PsyD, chief psychologist at Montefiore Medical Center and Associate Professor of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine in New York City, explains that BPD is typically diagnosed by a mental health professional, such as a psychologist, psychiatrist, or social worker.

What Causes Quiet Borderline Personality Disorder?

In the same way, as other personality disorders are frequently caused by abuse, trauma, heredity, and environmental circumstances, so is a silent borderline personality disorder. Without treatment, it may be impossible to determine the reason for the condition, despite the fact that you will want to know it.

Are Women More Likely to Have BPD?

Previous research demonstrated that the prevalence of BPD was greater in women than in men. Research indicates that BPD is more prevalent among guys than previously believed. Women are more likely to seek treatment, however.

Which Psychotherapy is Best for Quiet BPD?

DBT is the first-line treatment for BPD, but it tends to focus on the symptoms of those with classic BPD. Because quiet BPD is characterized by excessive control that is not under control, radically open DBT may be a more suitable treatment. Discuss with your mental health professional the technique that best suits you.

How is borderline personality disorder (BPD) diagnosed?

There is no definitive diagnostic test for borderline personality disorder (BPD). Simon A. Rego, PsyD, chief psychologist at Montefiore Medical Center and Associate Professor of Psychiatry and Behavioral Sciences at Albert Einstein College of Medicine in New York City, states that the disorder is diagnosed through a clinical interview with a certified mental health practitioner.

What does having a quiet BPD feel like?

If you have reserved BPD, you may have low self-esteem and frequently experience anger, depression, and anxiety. You may also have a history of self-harm, suicidal ideation, or both. With Quiet BPD, you may also have feelings of guilt or shame.

Is Quiet BPD worse than BPD?

Quiet borderline personality disorder can be far more difficult to detect and treat than BPD, but like with many mental health issues, the earlier it is diagnosed and intervention is initiated, the more successful the therapy will be.

Can a quiet person have BPD?

Living with a silent borderline personality disorder can be immensely taxing and incapacitating. It can prevent a person from being able to enjoy their daily life, as they struggle to manage their intense thoughts and feelings.

How common is quiet BPD?

People with quiet BPD may appear to be doing well on the surface, but they struggle internally with feelings of extreme loneliness, humiliation, or self-criticism. An estimated 1.6% of the population is affected by BPD at any given moment. Nevertheless, some estimates place the proportion closer to 6%.

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