What Is Quiet BPD? – Forbes Health

Borderline personality disorder (BPD) is a mental health condition often identified by fluctuating moods and difficulty regulating emotions. Individuals living with this condition can experience intense mood swings that may last for extended periods. BPD affects an estimated 1.4% of U.S. adults,  and about 75% of those diagnosed are women, according to the National Alliance on Mental Illness.

There is debate around the higher prevalence of BPD in women vs men, especially around the idea that certain behaviors may manifest differently due to “traditional” gender constructs. For instance, men are traditionally seen as more aggressive, so that behavior may get more of an unconscious pass in certain circles.

Quiet BPD is not an official diagnosis, says Ernesto Lira de la Rosa, Ph.D, a psychologist in New York City and the media advisor for Hope for Depression Research Foundation. Instead, the term refers to one of four subtypes of BPD initially identified by psychologist Theodore Millon, he says, adding though that there’s not a full consensus on these subtypes.

This subtype of BPD (also known as the  “discouraged” subtype) experiences the same “sense of instability in interpersonal relationships, self-image, affect and impulsivity, however, these individuals may internalize rather than externalize their behaviors,” says Dr. Lira de la Rosa.

Quiet BPD is also marked by an intense attachment to one or two significant others, and a constant feeling of vulnerability.

What Are the Signs and Symptoms of Quiet BPD?

In addition to emotional regulation difficulties, the National Education Alliance for Borderline Personality Disorder notes that the symptoms of BPD as a whole can include:

  • A fear of abandonment, whether real or imagined
  • A pattern of unstable relationships
  • Instability and insecurity in self-image
  • Impulsive, high-risk behaviors, such as excessive spending, promiscuity or substance abuse
  • Suicidal behavior or self-harm
  • Intense mood swings
  • Chronic feelings of emptiness or sadness
  • Anger management issues
  • Stress-related paranoia or loss of contact with reality

Five or more of these symptoms and behaviors must be present for a length of time, in a variety of contexts (such as at home, at school and at work) before a professional can diagnose an individual as living with BPD, according to the organization. Most often, symptoms of BPD begin to develop in adolescence or early adulthood.

When it comes to the quiet BPD subtype, because it’s not a formal classification, Dr. Lira de la Rosa notes that there are no specific symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-V), the text mental health professionals use to assess and diagnose mental illness in the U.S.

However, in Dr. Millon’s Personality Disorders in Modern Life, he describes some of the specific attributes of quiet BPD as:

  • Dependent or avoidant tendencies
  • Submissive behaviors
  • Persistent feelings of vulnerability and powerlessness
  • Persistent feelings of resentment
  • Intense clinginess
  • Periods of depression

Because quiet BPD is not a formal classification, and because the symptoms of BPD itself can overlap with other mental health issues, it’s essential to get an expert opinion before seeking help or treatment.

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