Life can be full of unexpected twists and turns. Sometimes navigating your emotions can feel like you’re riding a roller coaster. While everyone experiences emotional ups and downs, for some people, these challenges can be more intense and persistent. Quiet borderline personality disorder (quiet BPD) is a subtype of borderline personality disorder (BPD), characterized by how individuals manage their emotions internally. People with quiet BPD often direct their emotions inward, rather than expressing them outwardly. This can make their suffering less visible to others, leading to misunderstandings about the depth of their emotional pain.

Unlike the more commonly recognized form of BPD, which might include explosive anger, impulsive behaviors, and intense, unstable relationships that are visibly manifested, those with quiet BPD might appear calm and introspective on the outside, but they experience significant turmoil and instability internally. They may struggle with feelings of emptiness, identity disturbances and fears of abandonment, similar to other forms of BPD. However, they’re more likely to hide these feelings, avoid confrontations, and blame themselves rather than others. 

A compassionate look at recognizing the signs and symptoms

Some key signs and symptoms that may indicate quiet BPD include:

• Chronic feelings of emptiness — If you have a persistent feeling of hollowness or a lack of purpose, these can be hallmark symptoms of quiet BPD. You may have a hard time connecting with activities you used to enjoy or struggle to find fulfillment in your life.
• Self-blame and shame — There is a tendency to internalize fault and blame, leading to intense feelings of shame. This might be in response to real or imagined failures in interactions or personal achievements, often resulting in a harsh inner critic that perpetuates low self-esteem. 
• Social anxiety and social isolation — Just like traditional BPD, quiet BPD is characterized by a pervasive fear of being abandoned/rejected by loved ones. You might withdraw socially to preemptively avoid rejection or simply suffer in silence. 
• People-pleasing tendencies — In an effort to avoid conflict or abandonment, you may prioritize meeting the needs of others over your own. This tendency can come with a personal cost. 
• Emotional dysregulation — For people with quiet BPD, there is a discrepancy between how they feel and how they are perceived by others. Your emotional distress and internal struggles likely go unnoticed much of the time, which can compound any emotional pain you may be experiencing. You might not be fully aware of how effectively you mask your feelings, which can lead to misunderstandings in personal relationships and delays in seeking help. 
• Dissociation — You may detach yourself from yourself or your surroundings to attempt to cope with overwhelming emotions. This can manifest as feeling like you’re on autopilot or observing yourself from outside your body.
• Self-destructive behaviors — Keeping struggles internalized may lead you to turn to unhealthy coping mechanisms. These unhealthy behaviors may include self-harm, substance use or disordered eating. 

It’s important to note that these signs and symptoms can vary from person to person. Some people may experience most or all of these while others only experience a few.

Finding your way with quiet BPD

While there isn’t a cure for quiet BPD, there are a variety of effective treatment options. Up to 50% of clients can achieve remission from quiet borderline personality disorder and its symptoms. An effective treatment plan may include a combination of the following:

• Medication — For people with BPD, medication is typically not a primary treatment focus as it is with some other mental health conditions. But while there are no medications specifically approved for BPD, medications can help manage specific BPD symptoms and co-occurring disorders.
• Psychotherapy — Therapy is typically the main treatment for quiet BPD. Therapy can be done individually or in a group setting. Individual therapy sessions can provide you with a safe environment to explore your unique struggles, develop healthy coping skills and build self-compassion. Group therapy can give you a supportive environment to connect with others who understand due to their similar challenges. It can be incredibly validating and help you practice effective communication skills and learn from others’ experiences. 

Navigating the quiet storm with our Precision Care Model at Lightfully Behavioral Health

The Precision Care Model (PCM) is a unique treatment approach we use here at Lightfully. It’s a framework that’s made up of evidence-based, data-driven components from effective therapies like cognitive behavioral therapy and dialectical behavioral therapy. PCM is a broader approach that helps focus on the underlying processes contributing to your symptoms, rather than just addressing the symptoms themselves. It allows our deeply compassionate, licensed clinical experts to provide you with whole-person-centered care. Our PCM approach can help you:

• Identify core processes — PCM can help you identify the patterns and cycles that are maintaining your emotional distress. For example, your therapist might help you explore how your fear of abandonment leads to you having people-pleasing tendencies, which can lead you to also have feelings of resentment and isolation. 
• Develop emotional awareness — PCM can help you learn how to recognize your emotions before they become overwhelming. This can include learning how to identify physical cues that can be associated with certain emotions. These cues could be recognizing a tightness in your chest or racing thoughts.
• Build distress tolerance skills — Once you’re aware of your emotions, therapy can help equip you with tools to manage them. These tools can include mindfulness exercises, relaxation techniques, or distress tolerance strategies like radical acceptance.
• Work on cognitive restructuring — PCM can help you learn how to challenge negative thought patterns that contribute to your emotional dysregulation. For example, your therapist can help you identify and reframe your tendency to think in black-and-white ultimatums like, “If they don’t like me, it means I’m worthless,” and turn them into more balanced perspectives. 
• Build healthy relationships — PCM can help you focus on learning how to improve your communication and interpersonal skills. It can help you learn how to set healthy boundaries, express your needs assertively, and navigate conflict confidently and constructively. These skills can be especially helpful if you struggle with social anxiety or the fear of rejection. 

Change is possible. When you’re ready to take the first step, reach out to our Admissions Concierge team. We’ll take the next steps together, toward the fullest, brightest version of you.