Imagine a person who is captive to a gamut of intense emotions and erratic moods and that those feelings shift within a few hours to within a few days at a time. Such is the life of a person diagnosed with borderline personality disorder (BPD).

Emotions have a major, albeit sometimes indirect, influence on behavior. In most cases, people act in specific ways to avoid undesirable emotions or chase highly favorable emotional outcomes. Many people also correlate their feelings with thoughts, desires, and beliefs. When a person has a diagnosis of BPD, there is overwhelming emotional intensity and instability.

BPD has a broad spectrum of symptoms. People can have different expressions of the condition. Theodore Millon, an American psychologist, named four subtypes of borderline personality disorder:

There is no single subtype worse than the others. The "quiet" borderline personality disorder, on the other hand, is frequently overlooked, misdiagnosed, and misleading.

Understanding the silent and invisible subtype of BPD

People diagnosed with typical borderline personality disorder or quiet borderline have perpetual patterns. Their moods, behavior, and self-perception often sway. They maintain a heightened level of reactivity. So, they often act impulsively, impairing their healthy relationships.

Classic BPD differs from quiet BPD through the externalizing versus internalizing of emotions. There is "acting out" along the borderline personality continuum, and there is the invisible misery of "acting in."

People suffering from depression are more likely to harm themselves than others. They prefer to suffer silently.

They restrain any inkling of an outward show of their anxiety, obsessive emotional attachment, or fear of rejection. Quietly, these individuals direct their hate, anger, and blame inward toward themselves.

People diagnosed with discouraged borderline tend to cloak their inner turmoil with a degree of high functionality. They avoid volatile behavior. But like regular BPD, quiet borderline is not without episodic bouts of anxiety, depression, and anger that can endure for a few hours or a few days.

Common and other notable symptoms of quiet BPD

It is beyond question that if you think you have had experiences like those that a person diagnosed with quiet BPD has, you may feel immense daily insecurity and instability.

Quiet borderline is heterogeneous. Some people have greater or fewer symptoms than others diagnosed with the same condition. As outlined in the DSM-V (Diagnostic and Statistical Manual), some symptoms may include these thoughts and behaviors:

Directs feelings and moods inward, which can be toxic and detrimental, as the undetected symptoms don't show.
Experience social anxiety because being around others creates a burning, internalized susceptibility to humiliation, shame, and hurt by those close by.
Self-isolation is the most proper and effective coping method for social anxiety.
Appears to be high-functioning in the eyes of others because of elusiveness in staving off speculations or implication of impairment by coping sufficiently with symptoms while at work or school.
They find it hard to build confidence and self-esteem within themselves because, with their personal beliefs, values, and preferences changing repeatedly, it's hard to have a healthy sense of self and oppose the self-doubt felt about who they are.
Blaming oneself repeatedly, even when faultless, and constantly feeling oneself as a burden to others—taking derogatory responsibility for any misfortune and disagreements.
Strives excessively to be a people-pleaser to avoid causing distress and works tirelessly to have others like and favor them highly—at the expense of respect and admiration.
One resigns to a life of suffering silently, with the help of social conditioning, ensuring others see only the most positive version of oneself, which could cause alexithymia—frailty in recognition or articulation of one's feelings.
It disconnects from the outer and inner worlds, feeling as if in a dream through derealization, and cannot build connections through depersonalization, which drains authentic intimacy from personal relationships.
Fears of rejection, like a fear of abandonment familiar with regular BPD, isolate and reluctance to start or keep relationships—eventually leading to a self-loathing numbness.
Discouraged borderline personality disorder manifests inwardly. That can make it challenging to name at first. Other symptoms include:
Undetectable mood swings last anywhere from several hours up to several days.

Quiet borderline personality disorder causes and risk factors

The reasons for many mental health conditions are unknown. Quiet BPD is no exception. One of the usual culprits could be a genetic inheritance from a parent.

Another factor contributing to the development of the condition is brain abnormalities, such as changes in some brain regions or improperly functioning brain chemicals like serotonin, which handles mood regulation.

Other contributing factors could be environmental circumstances or obstructions to personality development, like childhood trauma of physical or sexual abuse, neglect, or a personal history of instability in relationships.

Certain risk factors, like eating disorders, substance abuse, anxiety, bipolar disorder, and depression, could also be influential links to quiet BPD development.

Getting treatment for quiet borderline

Sometimes, a person doesn't receive a quiet BPD diagnosis right away. This subtype of BPD lacks the explosiveness typical of classic borderline personality disorder. Undoubtedly, it’s frustrating to not get a proper diagnosis as quickly as you would with more visible and apparent mental illnesses—especially with self-harm possible in the interim.

You may think you're being misunderstood without the proper diagnosis. Or you could feel just as invisible as the "quiet" disorder itself. You're not alone. But many people report feeling as if an enormous weight is lifted from their backs after finally giving it a name.

Having a proper diagnosis of quiet BPD is imperative. Receiving adequate treatment is equally vital. The National Alliance of Mental Illness recommends psychotherapy as the most efficacious treatment.

Several modalities help people diagnosed with quiet BPD control their thoughts, behaviors, and emotions. They include:

Dialectical behavior therapy (DBT) is a specialized form of cognitive-behavioral therapy involving four skills modules divided into two groups. They include change-oriented skills (interpersonal effectiveness and emotion regulation) and acceptance-oriented skills (mindfulness and distress tolerance).
Schema-focused therapy is another cognitive-behavioral therapy derivative that helps change self-defeating life schemas or patterns. A patient uses emotional, behavioral, and cognitive-focused techniques.
Transference-focused therapy is a treatment that aims to reveal the underlying causes of quiet BPD and supply healthier ways to behave and think. Transference refers to the moment-to-moment relationship a patient has with their therapist to change unhealthy self-perception and develop better self-control methods.
Mentalization-based treatment: the process of mentalizing is to make sense of oneself and others, explicitly and implicitly, through mental processes and subjective states. Increased mentalization ability leads to fewer problems with impulsivity, interpersonal interactions, and emotion regulation.

Your feelings and life matter because you matter.

Having quiet BPD can affect all the significant aspects of a person's life—relationships, work, and school, for example. Intervention is necessary if a person hopes to disrupt inverted emotions, reduce self-loathing, and improve depreciated self-worth.

If you feel that you or a loved one has been living long enough with quiet BPD, it may be time to get help. A mental health professional can help you gain the necessary tools, support, treatment, and care for well-deserved healing.

But you don't have to wait for a diagnosis to mend. Healing can start today. First, acknowledge that your feelings matter. Then accept that you don't have to keep your emotions to yourself. You are not alone.

R. Antonio Matta

Do You Have Quiet Borderline?