> 

Quiet Borderline Personality Disorder: An Overview

Jennie Lannette, Author
Updated on October 30, 2025

Borderline personality disorder (BPD) is one of the best-known and sometimes most disconcerting mental conditions. Many people wonder if they, or someone they know, suffers from BPD. Traditionally, this disorder has been identified through a fairly straightforward set of symptoms, involving problems with emotional regulation and sometimes lashing out at others.

Quiet BPD

However, many people haven’t heard of one specific subtype of BPD, called quiet borderline personality disorder, or quiet BPD. This condition may also be referred to as discouraged BPD, or high-functioning BPD.

Psychologist Theodore Million originally proposed the idea of quiet BPD, along with three other subtypes of borderline personality disorder. These are known as BPD subtypes, which reflect different patterns of behavior and symptom expression. He suggests that people may be suffering from the same internal symptoms or feelings, but that these experiences may manifest in different ways for different people. In quiet BPD, the symptoms present more inwardly rather than outwardly, with unstable emotions and unstable moods being key features that are often internalized. The variability of symptoms means that mood swings or emotional episodes can last from a few hours to days, highlighting the fluctuating nature of quiet BPD (Millon et al., 2004).

Introduction to Borderline Personality Disorder

Borderline personality disorder (BPD) is a complex mental health condition that significantly impacts how individuals manage their emotions, behaviors, and relationships. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), BPD is characterized by a pervasive pattern of instability in interpersonal relationships, self-image, and emotions. People living with borderline personality disorder often experience intense emotions, frequent mood swings, and impulsive behaviors that can lead to self-destructive actions and unstable relationships.

BPD is frequently associated with other mental health conditions, such as major depressive disorder, post-traumatic stress disorder, and various anxiety disorders. These overlapping mental health disorders can complicate diagnosis and treatment, making it essential for individuals to seek help from a qualified mental health professional. The emotional distress and challenges in regulating emotions that come with borderline personality disorder can affect everyday life, leading to difficulties in maintaining close relationships and a stable sense of self. Understanding the clinical features of BPD is crucial for accurate diagnosis and effective intervention.

Understanding Quiet Borderline Personality

Quiet borderline personality disorder, often referred to as quiet BPD, is a unique subtype of borderline personality disorder where emotional distress is turned inward rather than expressed outwardly. Unlike typical BPD, where symptoms such as intense anger or impulsive behaviors may be visible to others, individuals with quiet borderline personality tend to suppress their emotions, leading to significant inner turmoil and emotional instability.

People with quiet BPD may appear calm, composed, or even high-functioning on the outside, but internally they struggle with intense emotions, self-doubt, and chronic feelings of emptiness or shame. This internalization can make quiet BPD difficult to recognize, both for the individual and those around them. Quiet BPD tends to be misunderstood or misdiagnosed, as the emotional pain and distress are often hidden beneath the surface. Understanding quiet borderline requires looking beyond outward behavior and considering the deep, internal experiences that shape a person’s everyday life and relationships.

Signs and Symptoms of Quiet BPD

The signs and symptoms of quiet BPD are often subtle and can easily go unnoticed by others. Individuals with quiet BPD may internalize their emotional distress, leading to persistent feelings of shame, guilt, and sadness that they keep hidden. Self-blame is common, and many people with quiet BPD struggle with self-harm or self-directed anger as a way to cope with overwhelming emotions.

Social anxiety and withdrawal from close relationships are also frequent, as individuals may fear abandonment or rejection but are reluctant to express these fears openly. Instead of seeking support, they may isolate themselves, further intensifying their emotional pain. Difficulty expressing emotions, self-isolation, and avoidance of social situations are key indicators. Recognizing these quiet BPD symptoms is essential for an accurate diagnosis and for providing the right support and treatment.

Diagnosing Quiet BPD

Quiet BPD is not a condition that can receive a formal diagnosis, as it has not been officially recognized under the DSM-5 as of yet. Rather, it is considered one of the ways the condition manifests. Traditionally, BPD is diagnosed if five or more of the following symptoms are identified:

  1. Frantic effort to avoid abandonment, or perceived abandonment, by others
  2. A pattern of intense and changing relationships, alternating between extremes of “loving” or “hating” certain individuals
  3. Struggling with an individual self-identity and experiencing an unstable self-image (Who am I?, What’s important to me?)
  4. Impulsive and self-sabotaging behaviors in at least two areas of life (such as reckless spending, sex, or driving)
  5. Recurring suicidal urges, threats, and/or episodes of self-harm
  6. Frequent or sudden but temporary changes in mood, such as sadness, anxiety, or irritability
  7. Feelings of emptiness or hopelessness
  8. Problems regulating anger, including inappropriate anger and physical or emotional outbursts toward others
  9. Dissociative symptoms or episodes (feeling apart from reality), and/or paranoid worries brought on by stress and triggers

Rather than lashing out or blaming others when there are triggers, individuals with quiet BPD may turn their anger inwards. In contrast, individuals with traditional BPD may experience intense anger that is expressed outwardly. Lo identifies the following symptoms that a person with quiet BPD might experience, in addition to, or instead of, symptoms listed in the DSM-5:

  1. Blaming oneself. Someone with quiet BPD may consciously believe that the way others treat them is their fault. They may blame themselves for any negative feelings that others have.
  2. Hiding feelings. One might keep a lid on any negative feelings in public or even have trouble identifying basic feelings.
  3. Functioning well publicly. Quiet BPD is sometimes called “high-functioning BPD,” because they keep it together on the outside. Inside, things still feel out of control.
  4. People pleasing. This might involve going out of one’s way to help and keep others happy, at the expense of your own well-being and needs.

Causes of Quiet BPD

Experts believe that BPD develops during childhood and is a combination of biological and environmental factors. A family environment characterized by invalidation, maltreatment, or neglect is a significant influence on the development of BPD. Additionally, a family history of mental health issues can contribute to the risk of developing BPD. Certain children are born with a higher vulnerability to trauma and neglect. This sensitivity, combined with traumatic experiences, can lead to the development of borderline personality disorder and highlights the importance of considering various risk factors that increase the likelihood of developing quiet BPD (Cattane et al., 2017).

Researchers are beginning to understand borderline symptoms as they relate to post-traumatic stress disorder, which may also develop in response to trauma. Traumatic incidents can be very straightforward, such as an episode of physical or sexual abuse. However, children may also be traumatized by episodes of neglect, constant invalidation, or emotional and verbal abuse by parents or others.

In a well-known book about borderline personality disorder, I Hate You–Don’t Leave Me, the authors note the effect a cold or withdrawn parent may have on a child. Even when parents aren’t abusive in a physical way, a lack of emotional support for a child may be one factor that leads to BPD (Kreisman & Straus, 2010).

Overlapping Diagnoses

It can be difficult to identify the difference between BPD, particularly quiet BPD, and similar conditions. Often, symptoms of other reactions to trauma may overlap, and individuals may have multiple diagnoses. Other mental health conditions, such as bipolar disorder and anxiety disorder, may also be confused with or co-occur with BPD, further complicating diagnosis and treatment.

Episodes of ongoing trauma in childhood are sometimes described as complex trauma, or complex PTSD. This can occur when children have frequent episodes of trauma, which may include neglect.

Pete Walker, psychologist and author of Complex PTSD: From Surviving to Thriving, identified the experience of emotional flashbacks, which is one possible response to childhood trauma. He writes, “When fear is the dominant emotion in a flashback, the person feels extremely anxious, panicky, or even suicidal. When despair predominates, a sense of profound numbness, paralysis, and desperation to hide may occur (Walker, 2013b).”

These symptoms may seem similar to borderline personality disorder, and specifically to quiet BPD. However, researchers have identified differences between BPD and PTSD. Borderline personality disorder is a mental illness and a mental health disorder, making it important to distinguish it from other disorders. Symptoms of a frantic fear of abandonment and a lack of sense of self are unique to BPD, and are not necessarily present among those with PTSD or complex PTSD (Cloitre et al., 2014).

Why BPD Manifests Differently Between Individuals

Why would BPD symptoms differ from one person to another? It may be that the cause and feelings of the condition are the same, but they are expressed outwardly in different ways. When comparing both BPD subtypes, such as quiet BPD and more classic presentations, the differences often lie in how symptoms are managed and displayed.

As children grow up, they develop coping mechanisms to deal with the environment they find themselves in. In some cases, children may have found that it worked better when they hid their feelings. It may have been emotionally unsafe, or simply unproductive, to lash out or calmly discuss their internal experiences. It served them better to seem okay on the outside while suffering internally, often leading to a chronic feeling of despair or unhappiness that persists over time.

When these children become adults, they may naturally continue the same coping mechanisms. These may or may not continue to work day to day, but they never address the underlying feelings of despair or unhappiness.

Those with high-functioning BPD may also be driven by their past experiences. They may want to prove to others that they can be successful, or may simply not want to live the same life that they grew up in. They can appear very competent on the outside, but feel anything but.

Coping with Quiet Borderline

Managing quiet borderline personality disorder involves addressing emotional, behavioral, and relational challenges through a comprehensive treatment approach. Dialectical behavior therapy (DBT) is widely recommended for quiet BPD, as it equips individuals with practical skills for emotional regulation, distress tolerance, and improving interpersonal relationships. Cognitive-behavioral therapy (CBT) can also be beneficial, helping individuals identify and change negative thought patterns, reduce self-destructive behaviors, and build healthier self-esteem.

Mentalization-based therapy (MBT) is another effective option, focusing on helping individuals better understand their own thoughts, feelings, and behaviors, which can lead to improved emotional regulation and more stable relationships. Working with a mental health professional who has experience treating borderline personality disorder is crucial for developing a personalized treatment plan. With the right support and therapeutic interventions, individuals with quiet borderline personality can learn to manage their symptoms and lead more fulfilling lives.

Helping Someone with Quiet BPD

Supporting someone with quiet borderline personality disorder requires compassion, patience, and a willingness to understand their unique experiences. Creating a safe, non-judgmental environment is essential, as it encourages open communication and allows the individual to express their emotions without fear of criticism or dismissal. Active listening, validation of feelings, and gentle encouragement can help build trust and strengthen your relationship.

Educating yourself about quiet BPD, its symptoms, and available treatment options is also important for providing informed and effective support. Avoiding blame or minimizing their emotional distress can prevent further feelings of shame or guilt. By offering empathy and understanding, you can help someone with quiet borderline personality feel more comfortable seeking help from a mental health professional and taking steps toward recovery. Your support can make a significant difference in their journey toward healing and emotional well-being.

Treatment Options for Quiet BPD

If you or someone you know suffers from quiet BPD, there are steps that may help. Some symptoms may actually improve over time, as you gain more positive experiences in relationships. Meanwhile, you can find support to deal with your symptoms and underlying feelings. Some therapy treatment types are more commonly used than others in addressing BPD, such as talk therapy, which includes approaches like cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT), and is effective for quiet BPD. Additionally, it is important to note that self-destructive BPD is a subtype characterized by impulsive and risky behaviors, including self-harm and substance use, which may require specialized interventions.

Dialectical Behavioral Therapy

Dialectical Behavioral Therapy (DBT) is one of the most popular approaches to treating BPD. Someone with quiet BPD may feel that they are different from others who participate in this treatment. Indeed, the outward symptoms may differ. However, the skills learned in DBT can still help.

Common elements of DBT include the following:

  • Educational groups to learn everyday strategies to manage mood and life complications caused by BPD.
  • Individual therapy with a counselor who can help with identifying thought and behavioral patterns that may be making life more difficult, such as cognitive distortions like black and white thinking.
  • Coaching calls to help individuals practice using skills in difficult moments.

Here are a few of the most popular skills taught in DBT:

  1. TIPP, which stands for temperature, intense exercise, paced breathing, and paired muscle relaxation. This skill involves changing your bodily experience in order to interrupt any emotional symptoms that are overwhelming you. Often, people hold ice cubes or splash their faces with cold water. This has a biochemical effect that can change your mood in the moment. Similar options might include taking a cold shower or going for a run.
  2. PLEASE, which stands for treating physical illness, eating a balanced diet, avoiding addictive substances, sleep balance, and exercising.
  3. HOW/WHAT, which focuses on mindfulness. This includes the following steps one can use in a difficult moment:
  4. Observe thoughts and feelings
  5. Label what you feel
  6. Allow yourself to have the experience or feeling, even if it’s uncomfortable
  7. Don’t judge your feelings or experience
  8. Stay in the moment
  9. Make a choice based on what’s best for you

Through DBT, people learn to better manage and tolerate the strong emotions that come along with quiet and other types of BPD.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is another type of therapy that can be helpful for those with quiet BPD. CBT is technically a part of DBT; however, traditional CBT is structured differently. A cognitive therapist can help you identify thoughts that may be inaccurate but contribute to your feelings of self-blame and emptiness. CBT can also address co-occurring issues such as substance abuse, which often occur alongside mental health conditions like quiet BPD. The experience of having a therapist who is consistent and supportive can also be a way to heal your feelings of neglect as a child.

Bottom Line

Because of the related stigma, many people fear a diagnosis of borderline personality disorder (BPD). Only a qualified mental health professional can make such a diagnosis. Even if you are diagnosed with this disorder, you can still live a happy life. Everyone experiences the world in their own unique way, and you don’t need to compare yourself to others. If you’re already struggling with hidden emotional symptoms, then a diagnosis can be a first step to finding support and beginning to heal your past.

References
Jennie Lannette, Author

Jennie Lannette is a licensed therapist who specializes in trauma, PTSD, and related issues. She has trained extensively in multiple evidence-based treatments. She has a decade of experience in inpatient, community, and private practice settings.

  • This field is for validation purposes and should be left unchanged.

More For You