Quiet BPD is a type of borderline personality disorder with symptoms that can be difficult for others to detect. But the minimized presence of obvious signs doesn’t mean that this condition is easy to live with.
At North Atlanta Behavioral Health, we are committed to maintaining a safe and respectful environment where adults with quiet BPD can receive the personalized care they deserve.
Learn more about treatment for BPD in Atlanta or verify your insurance now.
What Is Borderline Personality Disorder?
Borderline personality disorder (BPD) is a mental health condition that is characterized by instability and impulsivity. It is one of 10 personality disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and is categorized as a Cluster B disorder.
In addition to BPD, the other Cluster B conditions are antisocial, histrionic, and narcissistic personality disorders. The DSM-5 says that the common thread among these conditions is that they all cause people to appear “dramatic, emotional, or erratic.”
To be accurately diagnosed with BPD, a person must exhibit at least five of the following nine symptoms:
- Frantic efforts to avoid real or imagined abandonment
- A pattern of intense but unstable relationships during which they alternately idealize and devalue their partner
- Persistent instability in self-image or sense of self
- Impulsivity in at least two areas that can cause considerable harm, such as substance use, reckless driving, spending sprees, unsafe sex, and binge eating
- Recurrent self-harm and/or suicidal behaviors or threats
- Periods of intense dysphoria, irritability, or anxiety that may last from a few hours to a few days
- Chronic feelings of emptiness
- Inappropriate, intense, and/or uncontrolled anger
- Stress-related paranoid ideation or severe dissociative symptoms
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What Are the Signs of Quiet BPD?
Many of the symptoms of borderline personality disorder are easily observable. If someone in your life has a history of intense but unstable relationships, often acts impulsively in ways that can cause great harm, and frequently exhibits outbursts of uncontrolled anger, it’s hard not to notice that something is amiss.
But if your loved one has quiet BPD, you might have a more difficult time realizing that they’ve been struggling with a mental health concern. This isn’t because their symptoms are less severe. It’s primarily due to the fact that their self-defeating emotions are directed toward themselves instead of projected onto others.
Examples of how someone with quiet BPD may experience common symptoms of borderline personality disorder:
- Fear of abandonment: They may have a deep, unrelenting fear of being abandoned, but their inability to express this fear causes them to blame themselves for “deserving” to be cast aside. This fear can also manifest as people pleasing, which is an unhealthy commitment to making others happy at the expense of their own wants and needs.
- Relationship instability: Instead of accusing partners of falling short of their obligations or being otherwise unworthy, they may simply pull away from them without explanation. This habit of ghosting may apply to friends as well as romantic partners.
- Self-harm and suicide: If they engage in self-harm, they may make a concerted effort to hide their behavior from loved ones. If they have thoughts of suicide, they are unlikely to express these thoughts to others, even close friends or trusted family members.
- Emotional numbness: This is primarily an internal symptom, and it is often accompanied by a sense of detachment as well as efforts to withdraw or self-isolate. Unless the withdrawal is abrupt and obvious, it is unlikely to be noticed as a sign of BPD.
- Anger: Instead of manifesting as aggression or violence toward others, their feelings of anger may instead involve intense self-criticism or self-blame.
Other potential signs of quiet BPD include:
- Frequent headaches, stomach aches, muscle tension, or similar physical symptoms that don’t have an identifiable biological cause.
- A tendency toward perfectionism, which may be fueled by the belief that if they meet unrealistically high standards they will prove themselves worthy of love, or at least of not being criticized or cast aside.
- Persistent belief that they are inherently flawed, and that they deserve or are somehow responsible for every bad thing that happens in their life.
It’s important to remember that there’s no entry for quiet BPD in the DSM-5. Thus, even if a person has symptoms like the ones listed above, they still must meet five or more of the criteria from the previous section in order to be diagnosed with borderline personality disorder.
How Is Quiet BPD Treated?
Treatment for quiet BPD often includes a combination of prescription medication and therapy.
The elements that are incorporated into a person’s treatment plan can vary depending on factors such as the type and severity of their symptoms, how these symptoms have affected their life, the quality of their personal support network, and if they have any co-occurring medical or mental health concerns.
Medication
The U.S. Food and Drug Administration (FDA) has not approved any medication specifically to treat the symptoms of borderline personality disorder. But since anxiety, depression, and other co-occurring disorders are so common among people with quiet BPD, medication is often helpful.
Medications that may be included in treatment for BPD include:
- Selective serotonin reuptake inhibitors (SSRIs)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs)
- Tricyclic antidepressants
- Atypical antidepressants
- Benzodiazepines
- Mood stabilizers
- Antipsychotics
Therapy
Comprehensive treatment for quiet BPD can include several types of therapy, including individual, group, and family sessions.
The Mayo Clinic has reported that effective therapies for people with BPD include:
- Cognitive behavioral therapy (CBT)
- Dialectical behavior therapy (DBT)
- Schema-focused therapy
- Mentalization-based therapy (MBT)
- Systems training for emotional predictability and problem-solving (STEPPS)
There is no single medication, type of therapy, or course of care that is right for every person with borderline personality disorder or quiet BPD. This is why it is important to find a treatment provider who will take the time to understand how you have been affected by the condition, then develop a customized plan that reflects your unique history, needs, and preferences.
Find Treatment for Quiet BPD in Atlanta
North Atlanta Behavioral Health offers personalized outpatient care for adults who have quiet BPD, other mental health concerns, and substance use disorders.
Treatment options at our center in Atlanta, GA, include a partial hospitalization program (PHP) and an intensive outpatient program (IOP).
Call 770-230-5699 today to learn more or verify your insurance now.
