Quiet BPD: What Is It?
Some psychologists classify a subtype of borderline personality disorder as quiet borderline personality disorder, or quiet BPD (BPD). Individuals with silent BPD may direct symptoms like anger inward, despite the fact that many symptoms of BPD can appear outside (such as violence against others).
Here is everything you need to know about this mental health category, including the warning signals, risk factors, and available therapies.
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Quiet BPD: What Is It?
A mental health disease known as borderline personality disorder (BPD) is characterised by mood swings and trouble controlling emotions. People who have this illness may go through severe mood fluctuations that linger for a long time. According to the National Alliance on Mental Illness, BPD affects 1.4% of individuals in the United States, with women making up roughly 75% of those who receive diagnoses.
The idea that some behaviours may present differently because of “traditional” gender norms is one of the main points of contention surrounding the higher frequency of BPD in women compared to males. Men are typically perceived as being more aggressive, thus in some groups, that behaviour may be more readily accepted.
According to Ernesto Lira de la Rosa, Ph.D., a psychologist in New York City and the media advisor for the Hope for Depression Research Foundation, quiet BPD is not a recognised diagnosis. Theodore Millon, a psychologist, initially established four varieties of BPD, according to him. He adds, however, that there isn’t complete agreement on these classifications.
The “discouraged” subtype of BPD shares the same “feeling of instability in interpersonal relationships, self-image, affect, and impulsivity,” according to Dr. Lira de la Rosa. However, these people may internalise rather than externalise their behaviours.
An profound attachment to one or two significant persons and a persistent sense of vulnerability are further characteristics of quiet BPD.
What Are Quiet BPD’s Symptoms and Signs?
The National Education Alliance for Borderline Personality Disorder notes that, in addition to issues with emotional regulation, other signs of BPD include:
whether it is genuine or imagined, a dread of abandonment
an unsteady pattern of relationships
Self-image instability and insecurity
Impulsive, risky actions like excessive spending, promiscuity, or drug usage
Self-destructive or suicidal behaviour
extreme mood changes
Feelings of emptiness or melancholy that persist
Management of anger difficulties
loss of reality or psychosis brought on by stress
Before a doctor can declare someone to be suffering from BPD, five or more of these signs and symptoms must be present over an extended period of time and in several settings (such as at home, school, and work). The majority of the time, BPD symptoms start to manifest in adolescence or early adulthood.
Dr. Lira de la Rosa points out that since the quiet BPD subtype is not formally classified, the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V), the manual used by mental health professionals in the U.S. to evaluate and diagnose mental illness, does not include any specific symptoms for it.
However, Dr. Millon lists some of the distinctive characteristics of quiet BPD as follows in his book Personality Disorders in Modern Life:
Dependency or avoidance behaviours
Possessive actions
persistent sense of powerlessness and vulnerability
Resentment that persists
a strong clinginess
Depressive episodes
Before seeking assistance or therapy, it is imperative to receive a professional evaluation because quiet BPD is not a recognised classification and because the symptoms of BPD itself can be confused with those of other mental health conditions.
What Might Lead to BPD?
Although BPD has no known cause, there are risk factors that could make you more likely to get the disorder. A few of these are:
traumatic events during childhood: Situational variables, such as abuse, neglect, or protracted exposure to stress as a child, may raise someone’s chance of developing BPD.
Brain development: According to brain scans of BPD patients, problems with brain development, particularly in regions of the brain linked to mood regulation and decision-making facilitation, may be at play. According to research, BPD patients have certain regions that are either undeveloped or overactive.
Serotonin levels that are abnormal: Serotonin, a neurotransmitter linked to mood regulation, may be present in abnormally high levels in people with BPD.
Who Might Develop Quiet BPD?
As was previously said, almost 1.4% of U.S. adults suffer from BPD, but as quiet BPD is not formally recognised, there is insufficient data to say how many people with BPD also have the symptoms of the subtype.
And while new research indicates that men may experience BPD at equal rates, they are frequently misdiagnosed with post-traumatic stress disorder or depression, even though up to 75% of BPD diagnoses are in women.
The Diagnosis of Quiet BPD
Since BPD is an unofficial classification, most mental health professionals can diagnose someone as having it, however quiet BPD may not be apparent during an examination.
According to Dr. Lira de la Rosa, a person needs to exhibit five out of the nine symptoms and go through a series of clinical interviews with a qualified mental health expert in order to be diagnosed with BPD. A mental health professional would also consider a patient’s family, medical, and educational histories, as well as any other information provided by family members and close friends, he continues.
BPD may also coexist with other mental health issues such bipolar illness, depression, anxiety, or post-traumatic stress disorder. As a result, it could be harder to make the right diagnosis and choose the best course of action. A physical examination could also be offered to rule out alternative causes of the symptoms.
A Quiet BPD Episode Can Be Started by What?
Given the intricacy of BPD and the fact that not every person is triggered by the same circumstances, pinpointing the triggers and warning indications of an episode may be challenging, says Dr. Lira de la Rosa. However, the following circumstances may make symptoms worse:
Relationship Problems: A BPD episode may be brought on by circumstances where they feel rejected, criticised, or abandoned.
Loss or Rejection: For some people, experiencing loss or rejection—such as the breakdown of a relationship or the loss of a job—can also set off an episode of BPD.
Intrusive Thoughts: BPD may become more severe if distressing thoughts or pictures suddenly appear, especially if they bring up unpleasant experiences.
It could be good to reflect on earlier episodes and the situations that led up to them in order to comprehend what causes your BPD. These instances can shed light on the triggers of an episode.
Working with a mental health professional can help family members or friends who are dealing with a loved one who has BPD better understand their personal triggers.
Factors at Risk for Quiet BPD
Dr. Lira de la Rosa claims that lash outs, aggressiveness, sex, or drug usage are typical among some BPD sufferers. He observes that anger can frequently be internalised in people who have been diagnosed with silent BPD.
He explains, “We’re looking at the person’s sense of self and impairments in interpersonal functioning. This may manifest as excessive self-criticism, feelings of emptiness, and instability in beliefs, values, and objectives.
According to Dr. Lira de la Rosa, those with silent BPD may have lower empathy levels, high conflict relationships, clinginess, and a fear of being abandoned.
When should you get help? How is quiet BPD treated?
The prognosis for those with BPD is quite favourable with the appropriate treatment. People who seek treatment report that their symptoms are less severe and more infrequent, and they also have a better quality of life.
A mental health expert can assist direct you to the best treatments if you or a loved one is coping with this diagnosis. These may consist of:
Therapy: Therapy enables people to control their emotional dysregulation under the supervision of a qualified mental health professional. According to Dr. Lira de la Rosa, dialectical behaviour therapy (DBT) is the gold standard for treating BPD.
According to him, DBT helps people confront emotional dysregulation, interpersonal issues, and stressful situations. Other therapeutic approaches include mentalization-based therapy (MBT), which helps people understand their feelings and empathize with those around them, and cognitive behavioral therapy, which helps people manage negative thoughts and actions.
Medicine can be used to control certain symptoms, such as anxiety and depression, or concomitant disorders, but there is no medication that can be used to treat the symptoms of BPD as a whole.
According to Dr. Lira de la Rosa, BPD can negatively impact a person’s relationships, relationships with others, and quality of life. If someone is dealing with high conflict relationships, difficulty controlling their emotions, a fear of abandonment, or a sense of emptiness, he advises that person to get counselling. A specialist can provide you with the knowledge and support you need to take the next steps in your recovery if you feel as though you or someone you know has been experiencing the specific symptoms of quiet BPD, despite the fact that the quiet BPD subtype is not recognised by all mental health professionals psychological journey.
