Some people use the term “quiet borderline personality disorder” to describe cases of BPD where a person directs their symptoms inward rather than toward other people. However, it is not an officially recognized diagnosis.

A person with borderline personality disorder (BPD) typically experiences unstable moods, behaviors, and self-image. They may have episodes of intense anxiety, anger, and depression.

Some people use the term “quiet BPD” to refer to cases of BPD in which a person internalizes these symptoms rather than directing them at others. However, doctors and mental health professionals do not classify quiet BPD as an official diagnosis.

This article explains what quiet BPD is, how common it might be, and the symptoms a person may experience. It also looks at how doctors diagnose the condition and how they treat it.

Finally, this article looks at coping with quiet BPD, helping someone cope, and getting support.

Female painted with bright paint colors with light and shadowsShare on Pinterest
Yana Iskayeva/Getty Images

Quiet BPD is not an official diagnosis, and doctors and mental health experts do not recognize it as a clinical condition. Therefore, there is a lack of research and credible evidence on what may constitute quiet BPD.

Anecdotally, people refer to quiet BPD as a possible subtype of BPD that does not fit the typical profile of the disorder.

People with quiet BPD may direct symptoms and negative emotions inward, at the self, rather than out toward other people.

Is it a subtype of BPD?

In 2004, psychologist Theodore Millon proposed four possible subtypes of BPD, which include:

  • discouraged
  • irritable
  • petulant
  • self-destructive

Of these four, the discouraged subtype most closely resembles what some people refer to as quiet BPD.

In a 2022 case report, researchers explain that someone with the discouraged subtype of BPD may have characteristics such as:

  • displaying humble behavior
  • avoiding competition
  • being extremely subordinate
  • having extreme attachment to another person
  • experiencing self-doubt and lacking self-sufficiency
  • being insecure
  • feeling shame and guilt

Millon suggests that people with discouraged BPD may become preoccupied with blaming themselves, which may lead to them punishing themselves with self-harm or suicide attempts.

Research from 2017 reviewed studies on other possible subtypes of BPD, including a subtype called high functioning internalizing.

This may also correlate with quiet BPD. People with this subtype may appear to function more effectively than others with typical BPD while internalizing harmful symptoms instead of directing them at others.

However, there is a lack of evidence to suggest the existence of subtypes of BPD, and doctors and mental health professionals cannot officially diagnose them.

Because quiet BPD is not an official diagnosis, there is no way to determine how common it may be or who it may affect.

According to research, BPD may affect 1.6% of the population.

There are no official symptoms of quiet BPD, as it is not an official diagnosis.

Symptoms of typical BPD can include:

  • intense mood shifts
  • emotional distress
  • inappropriate or intense anger
  • thinking in extremes, such as interpreting things as completely positive or negative
  • instability of self-image
  • instability in relationships
  • impulsive and potentially dangerous behaviors
  • fear of abandonment
  • feeling disconnected
  • self-harming behaviors

Someone with quiet BPD may internalize and disguise these symptoms so they appear to be unaffected. They may direct feelings of anger, blame, guilt, and shame inward, which may result in self-harming behaviors.

What might aggravate symptoms?

Certain factors may trigger or aggravate BPD symptoms. According to 2015 research, these may include:

  • rejection
  • abandonment
  • isolation
  • disappointment in others
  • feeling betrayed
  • boredom

A doctor or mental health professional cannot diagnose a person with quiet BPD, as it is not an official diagnosis.

Cases of BPD vary among individuals, and the symptoms may overlap with those of other mental health conditions.

A mental health professional may need to rule out other conditions before they diagnose a person with BPD. They may perform a thorough medical examination and interview a person about their symptoms, medical history, and family history of mental illness.

For a doctor or mental health professional to diagnose a person with BPD, a person must show a pattern of instability in interpersonal relationships and self-image and impulsive behaviors.

These factors must manifest as five or more of the following:

  • frantic efforts to avoid abandonment, either real or imagined
  • a pattern of intense and unstable personal relationships, which shift between idealization and dislike of others
  • unstable or distorted self-image
  • impulsivity in at least two potentially harmful areas, such as substance misuse, reckless spending, and dangerous driving
  • mood instability, which may present as episodes of anxiety or irritability
  • chronic feelings of emptiness
  • difficulty controlling anger, and intense or inappropriate anger
  • episodes of paranoia during times of stress, or severe dissociation, which means feeling disconnected

While a person with BPD may lash out in anger or distrust and reject others because of their symptoms, people have anecdotally described people with quiet BPD as instead internalizing these and other symptoms.

There is no clinical evidence to suggest there are complications specific to quiet BPD. However, complications of typical BPD include:

  • relationship difficulties
  • engaging in dangerous behavior
  • incomplete education
  • substance misuse
  • job loss
  • suicide attempts

How might it affect relationships?

Someone with BPD may have difficulty developing and maintaining relationships. This is because the symptoms of BPD include sudden changes in feelings toward others, problems with anger, paranoia, and mood shifts.

Someone with BPD may also have an intense fear of abandonment, which may manifest in ways harmful to a relationship.

The tendency to interpret situations in extremes, such as all good or all bad, may also affect a person’s ability to navigate relationships effectively.

There is no specific treatment for quiet BPD or any other potential subtype of BPD.

Treatment for typical BPD includes:

  • Psychotherapy: Types of therapy that may be effective for BPD include cognitive behavioral therapy or dialectal behavior therapy.
  • Medications: Doctors do not typically use medication as the main treatment for BPD, but they may prescribe it to treat specific symptoms or other mental health conditions a person may have

Anyone with symptoms of BPD should seek professional treatment and continue to follow through with it.

A person can contact a healthcare professional who can refer them to a licensed mental health professional, such as a psychiatrist or psychologist who specializes in the treatment of BPD.

Loved ones

Having a loved one or relative with BPD can be stressful for caregivers or family members. Family therapy, which involves attending therapy together, can be beneficial to both the person with BPD and their loved ones.

Attending family therapy can help by focusing on the needs of the caregivers or family members and helping them better prepare to care for someone with BPD. It can also help loved ones better understand BPD.

Helping someone cope with quiet BPD

Ways to help a loved one cope with BPD include:

  • encouraging a loved one with BPD to continue with the treatment
  • attending family therapy together
  • learning about BPD and trying to gain a better understanding of the disorder
  • offering emotional support and encouragement, and trying to be patient
  • attending personal counseling or psychotherapy

There are several resources available for people with BPD. These include:

  • BPD World: This dedicated BPD organization provides a list of helplines for people in the United States.
  • National Institute of Mental Health (NIMH): The Help for Mental Illnesses page includes resources such as suicide and crisis helplines and treatment resources for substance misuse and other services.
  • Substance Abuse and Mental Health Services Administration (SAMHSA): The behavioral health treatment services locator is a tool for finding mental health services in specific areas.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.

Find more links and local resources.

Was this helpful?

The symptoms of BPD vary among individuals. While some people refer to quiet BPD as a subtype of the disorder, it is not an official diagnosis. Mental health professionals and doctors do not recognize quiet BPD as a separate disorder.

Anecdotally, people may describe quiet BPD as a type of BPD in which a person directs the symptoms inward instead of acting out at others.

A person with symptoms of BPD should contact a healthcare professional for a diagnosis. Treatment may help a person with BPD manage their condition effectively.