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Quiet Borderline Personality Disorder: Symptoms, Complications, Causes, Risk Factors, Treatment

Borderline personality disorder (BPD) is a type of mental health condition that is characterized by fluctuations in behavior and mood. People with borderline personality disorder often find themselves struggling with relationships and their own self-image. Most people are familiar with borderline personality disorder, but not many know that there are several subtypes of this condition as well. One such subtype of borderline personality disorder is known as quiet BPD. Quiet borderline personality disorder means that the person who has the condition directs their struggles and challenges more inward so that others do not notice. This makes it difficult to diagnose and treat. Here’s everything you need to know about quiet borderline personality disorder.

What is Quiet Borderline Personality Disorder?

There are four types of borderline personality disorder (BPD) that are recognized. These include: (1, 2)

  • Quiet (discouraged) borderline personality
  • Impulsive borderline personality
  • Self-destructive borderline personality
  • Petulant borderline personality

The term quiet borderline personality disorder can often be misleading. Having quiet BPD means that any behavior changes and mood swings you experience are directed inward instead of directing them toward other people. In other words, instead of acting out, you ‘act in.’ However, acting inward instead of out can make things more complicated for an already challenging mental disorder. People who have quiet borderline personality disorder are likely to direct all these big feelings towards themselves without letting others know or see them. Some of these intense emotions may include: (3, 4)

  • Anxiety
  • Anger
  • Mood swings
  • Fear of rejection or abandonment
  • Emotional attachment
  • Severe self-doubt
  • Rage
  • Self-blame
  • Guilt

Quiet borderline personality disorder is sometimes also referred to as high-functioning borderline personality disorder. Again, this term is also potentially misleading since it indicates that a person with quiet borderline personality disorder might now show their symptoms and are still able to deal with day-to-day situations, including at work or at school. (5, 6)

Symptoms of Quiet Borderline Personality Disorder

Due to the fact that quiet borderline personality disorder tends to manifest inward, this type of borderline personality is difficult to identify in the beginning. Some of the major symptoms of quiet borderline personality disorder include:

  • Withdrawing into self when feeling upset.
  • Suppressing feelings of anger or denying that you are feeling angry.
  • Mood swings that can last from a few hours to even a few days, but no one else is able to witness or feel them.
  • Blaming yourself whenever some conflict arises.
  • Persistent feelings of shame and guilt.
  • Avoiding talking to those who have upset you and cutting them off.
  • Extremely poor self-esteem.
  • Feelings of emptiness or numbness inside.
  • Feeling like you are a burden to others.
  • A habit of pleasing others, even at a cost to yourself.
  • Social anxiety
  • Self-isolation
  • Deep-rooted fear of rejection
  • Having a thing skin and taking everything personally.
  • Feeling detached from the rest of the world and may even feel like you are in a dream world, known as derealization.
  • Fear of being left alone but still pushing people away from yourself.
  • Inability to build connections with others, known as depersonalization
  • Thoughts of self-harm.
  • Suicidal thoughts

It is important to keep in mind that some people with quiet borderline personality disorder may experience only a couple of these symptoms, while others can experience more. (7, 8)

What are the Complications of Quiet Borderline Personality Disorder?

Most people with quiet borderline personality disorder tend to struggle in silence in fear of burdening their loved ones. However, without seeking treatment, the symptoms are only going to worsen over time. Some of the possible side effects or complications that can arise over time from quiet borderline personality disorder if left untreated include:

Higher risk of developing other mental disorders: Quiet borderline personality disorder is known to increase the risk of developing other mental health disorders, including depression, bipolar disorder, social anxiety, substance abuse, generalized anxiety, and eating disorders.

Challenge to maintain work/school schedule: People with quiet borderline personality disorder often find it increasingly difficult to maintain their role at work or in school. If left untreated, quiet borderline personality disorder is going to increase the risk of acting out impulsively, as well as engaging in uncontrolled gambling, drinking, spending, and other risky behaviors. (9, 10)

Difficulty in establishing and sustaining relationships: It can be challenging to build and maintain relationships when you have quiet borderline personality disorder. Some of the symptoms of this disorder can pose further challenges in this area. People with quiet borderline personality disorder are going to find it difficult to connect on an emotional level to others because of the constant emotional turmoil that goes on within them where they are afraid of being hurt but also scared of being left alone. (11)

Possibility of committing suicide and self-harm: Having suicidal thoughts and wanting to cause self-harm may cross the mind. It is important to always talk about such feelings or thoughts. If you think someone might be at immediate risk of hurting themselves or another person, call your local emergency number at once. It is also a good idea to remove any knives, medications, guns, or any such item that can be used to cause harm. Stay with the person until help arrives.

What are the Causes of Quiet Borderline Personality Disorder?

As with most mental health illnesses, the exact cause of quiet borderline personality disorder is not known, but it is believed to be hereditary. One study discovered that the development of personality disorders like quiet borderline personality disorder during childhood has a major genetic link. (12) Adults with borderline personality disorder are believed to have a family history of this condition.

At the same time, though, genetics are not the only known cause of the development of borderline personality disorder in childhood. Studies have found that physical and emotional abuse, along with childhood neglect, can increase the risk of developing personality disorders. Exposure to or a personal history of unstable relationships is also known to contribute to the development of borderline personality disorder. (13)

Changes in the neurotransmitter known as serotonin in the brain have also been linked with borderline personality disorder. (14) However, it is not yet clear whether it is the changes in the brain that causes borderline personality disorder or if these changes occur as a result of the disorder.

Who Is At Risk For Developing Quiet Borderline Personality Disorder?

Some people are at a higher risk of developing quiet borderline personality disorder. There are some risk factors that have been known to influence the development of mental disorders like quiet borderline personality disorder. These include having a history of:

  • Bipolar disorder
  • Anxiety
  • Eating disorders
  • Substance abuse
  • Depression
  • History of neglect or abandonment

Diagnosis of Quiet Borderline Personality Disorder

There are many misconceptions associated with quiet borderline personality disorder, and due to the inward nature of this condition, it is often misdiagnosed as another disorder, especially social phobia or depression. (15)

Even though these conditions are known to occur together, quiet borderline personality disorder is still a separate diagnosis, and only a mental health professional gives you a proper diagnosis. Licensed mental health professionals like psychologists and psychiatrists can diagnose quiet borderline personality disorder by interviewing you and taking into account all your symptoms. They may also ask you to fill out a survey based on your symptoms.

Since there is no medical test for diagnosing quiet borderline personality disorder, but undergoing a medical examination helps rule out other conditions that might be causing your symptoms.

If anyone in your family has a history of borderline personality disorder or any of the other commonly co-occurring conditions like bipolar disorder, depression, anxiety, or eating disorders, you should inform your doctor about the same.

You can also undertake a borderline personality disorder online survey to help you understand your symptoms and take the first step to get a diagnosis of quiet borderline personality disorder. (16)

Treatment of Quiet Borderline Personality Diagnosis

No doubt that it can be challenging to acknowledge the need to talk to someone about your struggles, but you will find a sense of freedom, relief, and validation once you take the decision to speak to a professional about your struggles.

Psychiatric medications, psychodynamic therapy, or dialectical behavior therapy (DBT) are some of the first lines of treatment for quiet borderline personality disorder. (17, 18)

Dialectical behavior therapy helps people with quiet borderline personality disorder learn emotional regulation, interpersonal effectiveness, mindfulness strategies, and distress tolerance. Over time with practice, DBT helps reduce self-destructive actions and thoughts.

There are certain mental health medications as well that your psychiatrist may prescribe for easing some of your symptoms. However, you should not rely only on medications as they may not address the underlying causes of your borderline personality disorder. Medications also work best in combination with psychotherapy.


Quiet borderline personality disorder is not an easy disorder to diagnose. It can take time to identify and diagnose this condition, but the sooner you start to understand your symptoms, the sooner you can decide to seek help from a mental health professional. It is important to recognize that your feelings are valid and they do matter, and it is also perfectly acceptable to share your feelings with others. While you may continue to quietly struggle with your persistent guilt and self-worth issues, everyone deserves to live a happy and fulfilling life. The first step to take towards healing is to visit a mental health professional so that your condition can be diagnosed.


  1. Whewell, P., Ryman, A., Bonanno, D. and Heather, N., 2000. Does the ICD 10 classification accurately describe subtypes of borderline personality disorder?. British Journal of Medical Psychology, 73(4), pp.483-494.
  2. Bender, D.S. and Skodol, A.E., 2007. Borderline personality as a self-other representational disturbance. Journal of personality disorders, 21(5), pp.500-517.
  3. Perseius, K.I., Ekdahl, S., Åsberg, M. and Samuelsson, M., 2005. To tame a volcano: patients with borderline personality disorder and their perceptions of suffering. Archives of Psychiatric Nursing, 19(4), pp.160-168.
  4. Stein, K.F., 1996. Affect instability in adults with a borderline personality disorder. Archives of Psychiatric Nursing, 10(1), pp.32-40.
  5. Torgersen, S., 2005. Genetics of borderline personality disorder. In Borderline personality disorder (pp. 149-156). CRC Press.
  6. Gunderson, J.G., Herpertz, S.C., Skodol, A.E., Torgersen, S. and Zanarini, M.C., 2018. Borderline personality disorder. Nature Reviews Disease Primers, 4(1), pp.1-20. Gunderson, J.G., 2009. Borderline personality disorder: A clinical guide. American Psychiatric Pub.
  7. Yen, S., Shea, M.T., Sanislow, C.A., Grilo, C.M., Skodol, A.E., Gunderson, J.G., McGlashan, T.H., Zanarini, M.C. and Morey, L.C., 2004. Borderline personality disorder criteria associated with prospectively observed suicidal behavior. American Journal of Psychiatry, 161(7), pp.1296-1298.
  8. Svaldi, J., Philipsen, A. and Matthies, S., 2012. Risky decision-making in borderline personality disorder. Psychiatry Research, 197(1-2), pp.112-118.
  9. Ghinea, D., Koenig, J., Parzer, P., Brunner, R., Carli, V., Hoven, C.W., Sarchiapone, M., Wasserman, D., Resch, F. and Kaess, M., 2019. Longitudinal development of risk-taking and self-injurious behavior in association with late adolescent borderline personality disorder symptoms. Psychiatry research, 273, pp.127-133.
  10. Allen, D.M. and Farmer, R.G., 1996. Family relationships of adults with borderline personality disorder. Comprehensive psychiatry, 37(1), pp.43-51.
  11. Coolidge, F.L., Thede, L.L. and Jang, K.L., 2001. Heritability of personality disorders in childhood: A preliminary investigation. Journal of Personality Disorders, 15(1), pp.33-40.
    Bornovalova, M.A., Gratz, K.L., Delany-Brumsey, A., Paulson, A. and Lejuez, C.W., 2006. Temperamental and environmental risk factors for borderline personality disorder among inner-city substance users in residential treatment. Journal of personality disorders, 20(3), pp.218-231.
  12. Hansenne, M., Pitchot, W. and Ansseau, M., 2002. Serotonin, personality and borderline personality disorder. Acta Neuropsychiatrica, 14(2), pp.66-70.
  13. Stanley, B. and Singh, T., 2018. Diagnosis of borderline personality disorder.
  14. Psych Central. 2022. Borderline Personality Test I Psych Central. [online] Available at: <https://psychcentral.com/quizzes/borderline-test> [Accessed 14 May 2022].
  15. Lynch, T.R., Trost, W.T., Salsman, N. and Linehan, M.M., 2007. Dialectical behavior therapy for borderline personality disorder. Annu. Rev. Clin. Psychol., 3, pp.181-205.
  16. Koerner, K. and Linehan, M.M., 2000. Research on dialectical behavior therapy for patients with borderline personality disorder. Psychiatric Clinics of North America, 23(1), pp.151-167.
Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:May 24, 2022

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