Quiet BPD (or quiet borderline personality disorder) is the latest mental health term making the rounds on social media, and it seems to be referring to borderline personality disorder symptoms that are more internal than external. Kind of like how high-functioning depression is used to describe people who don’t necessarily seem depressed, quiet BPD is a label that’s used to describe those who have symptoms of borderline personality disorder, but they’re not outwardly obvious. Or, at least, they’re not outwardly obvious in all areas of a person’s life.
That said, quiet BPD isn’t an actual diagnosis you’d find in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR), which can make all this a little confusing. That’s why we spoke to mental health pros who can explain what quiet BPD might actually be referring to and what to do if you think you have it. Turns out, it’s a little more complicated than you think.
What is borderline personality disorder?
Borderline personality disorder is a mental health condition that involves difficulty managing your emotions, a distorted sense of self, and impulsivity—all of which can negatively impact a person’s relationship with themself and others, according to the National Institute of Mental Health.
When diagnosing borderline personality disorder, mental health professionals typically look out for signs like frequent angry outbursts, patterns of relationship issues, and self-harm or suicide attempts. Because of that, people who have borderline personality disorder are often unfairly described as dramatic, manipulative, angry, and attention-seeking, according to a small study published in Psychiatry Research Communications. Yeah, there’s a serious stigma here.
Borderline personality disorder symptoms can show up in different ways, but all people with the condition experience chronic internal distress, confusion, and emotional dysregulation across multiple areas of their lives, explains Alexander Kriss, PhD, clinical psychologist and author of Borderline: The Biography of a Personality Disorder.
Unlike conditions like depression and anxiety which tend to come and go over the course of someone’s lifetime, borderline personality disorder symptoms tend to remain constant until they’re addressed, he adds.
In order to be officially diagnosed, you have to have at least five of nine symptoms outlined in the DSM-5-TR, which include the angry outbursts, relationship issues, and self-harm behaviors we mentioned above. There can also be symptoms like a persistently unstable sense of self, impulsivity that can be self-damaging, chronic feelings of emptiness, and going to great lengths to avoid abandonment.
Because this is a personality disorder, the symptoms need to be part of an enduring pattern that starts in early adulthood—not something that comes and goes in episodes, like major depression disorder.
So what is quiet BPD?
Quiet BPD isn’t a clinical term or an actual diagnosis, but some people use it to refer to those who have some symptoms of borderline personality disorder without fitting the classic presentation, says Shireen Rizvi, PhD, clinical psychologist and founder of DBT-RU, a dialectical behavior therapy outpatient training clinic at Rutgers University.
As with other non-clinical terms like high-functioning depression or high-functioning anxiety, quiet BPD seems to imply that these symptoms don’t impact people to a noticeable degree, at least from an outsider's perspective. Hence the “quiet” label, explains Lauren Kerwin, PhD, a clinical psychologist who specializes in treating borderline personality disorder.
For instance, instead of the loud, angry outbursts as the DSM-5-TR describes, someone with quiet BPD might direct their rage inward and become extremely self-critical. Or, instead of expressing a deep fear of abandonment by being clingy, a person with quiet BPD might isolate to avoid that feeling altogether, explains Dr. Kerwin.
Plus, the more relevant and pervasive symptoms of borderline personality disorder can be harder to see from the outside, adds Dr. Kriss. Folks who have borderline personality disorder experience high levels of emotional distress, and many of them experience chronic feelings of emptiness, numbness, or dissociation (feeling detached from reality).
They also tend to struggle with their sense of identity and are highly sensitive to criticism. These are all symptoms that exist on the “quiet” end of the borderline spectrum since others wouldn’t necessarily know you’re going through them (unless you say something).
How can you tell if you have quiet BPD?
The only way to know for sure is to seek out a therapist. Regardless of whether you’re experiencing symptoms like intense anger, self-harm, and relationship issues or the “quieter” internal issues like feelings of emptiness and patterns of confusion about your sense of self, seeking professional help enables you to manage symptoms, take care of your mental health, and improve your relationship with yourself and others.
Keep in mind that it’s also possible to have some symptoms of borderline personality disorder without meeting the official diagnostic criteria, so there’s a chance you’re in that boat. If that’s the case, you’ll still benefit from some of the same treatment strategies, says Dr. Kerwin.
Just make sure to look for a therapist with a background in treating borderline personality disorder. There’s still a lot of stigma around this disorder—even among mental health professionals—so looking for someone who has experience helping clients with borderline personality disorder will help ensure that you get the care you deserve, says Dr. Kriss. One way to do that is by searching for a provider through the Borderline Personality Disorder Resource Center directory.
How is quiet BPD treated?
All presentations of borderline personality disorder—quiet or not—can be treated the same way. The most common treatment for borderline personality disorder is dialectical behavior therapy (DBT). Rather than examining your thought patterns and trying to change them like you do in cognitive behavioral therapy (CBT), DBT is all about learning specific skills to help you cope with symptoms. You’ll learn emotional regulation, distress tolerance, interpersonal effectiveness, and mindfulness, says Dr. Rizvi. And all of these techniques can be helpful, even if your symptoms are mostly the quieter ones.
But therapy isn’t one-size-fits-all. If DBT doesn’t sound like the right vibe for you, or you try it and don’t feel like it’s a fit, there are other options. Mentalization-based therapy (MBT) is another fairly common approach to treating borderline personality disorder. It involves learning how to identify and understand what other people are thinking and feeling, since that’s something people with borderline can have a hard time with, explains Dr. Rizvi.
There’s also transference-focused therapy (TFT), which involves exploring social roles and interpersonal relationships through your relationship with your therapist, and schema-focused therapy (SFT), which is all about helping you change unhelpful thought and behavior patterns.
Therapy is the primary treatment method for borderline personality disorder but Dr. Kerwin and Dr. Rizvi agree that, anecdotally, medications like SSRIs or mood stabilizers can help treat anxiety and mood-related symptoms that go along with it. So that’s an option too.
The bottom line: If you’ve been suffering from borderline personality disorder symptoms in silence, know that you’re not alone. And you don’t have to meet some arbitrary (see: noticeable) level of suffering to seek help. There are effective, evidence-based treatments that can help you feel better. In the meantime, there are a whole bunch of resources available through the National Education Alliance for Borderline Personality Disorder.
Wondermind does not provide medical advice, diagnosis, or treatment. Any information published on this website or by this brand is not intended as a replacement for medical advice. Always consult a qualified health or mental health professional with any questions or concerns about your mental health.
