Understanding quiet BPD: Why have you hidden your suffering?

The term quiet BPD refers to a type of borderline personality disorder that means you don't fit the mould of having typical BPD symptoms. It is often missed by people, including mental health clinicians. 

Quiet BPD (borderline personality disorder) VS BPD: What's the difference?

People who have quiet BPD can suffer as much as, if not more than, people with 'classic. BPD. You may have a deep fear of abandonment and severe mood swings; you may feel suicidal or empty, and feel disconnected from yourself. However, all these remain hidden underneath an appearance of normalcy.

At the core of quiet BPD is internalised anger: rather than 'acting out'. you 'act in'. Rather than expressing your feelings towards others or seeking help, you hide how much you are suffering to the point of implosion. 

What is it like living with quiet BPD and what are the symptoms?

• You go at length to hide how much you are suffering.
• You rarely get angry at others, only at yourself.
• You don't know what your emotional triggers are, but you suffer from extreme mood swings.
• When there are interpersonal conflicts, you may not express your needs through crying in front of others or tantrums; instead, you isolate yourself and become overwhelmed with feelings of shame.
• You are deeply anxious on the inside when it comes to relationships; you want intimacy but fear revealing your true self would drive people away.  
• You would do almost everything to avoid conflicts. When things happen, you assume you have done something wrong. 
• Under stress, you become dissociated from your feelings and bodily sensations.
• You often feel empty and numb and unsure of who you are, what you like, and your needs. 
• You would never burden anyone with your sorrow. Even when you are with friends, you try to be the listener and not take up any space. 
• When someone upsets you, instead of seeking clarification or confronting them, you immediately withdraw and may end the relationship without speaking to them. 
• You can flip into a black-or-white mode of thinking, especially when you feel hurt.
• You feel you are inherently not lovable. Even when good things/ relationships come your way, you do not believe them or would subconsciously do something to sabotage them. 
• If others know how you truly feel, they would say you are 'too much', 'too sensitive', 'too dramatic' and etc. 

If you are willing to take the first step and allow people who understand your unique personality to get to know you, not just healing thriving is also possible for you. 

What are the possible side effects of quiet borderline personality disorder?

Quiet BPD may increase your risk of experiencing other mental health disorders. This can include:

• depression
• eating disorders
• generalised anxiety disorder (GAD) or social anxiety
• substance abuse (addiction)

Other common issues experienced by those with quiet BPD can include finding it more difficult to establish and maintain relationships, difficulty maintaining school, college, or work schedules. You may be more likely to act impulsively if you do not receive treatment, which can lead to risky behaviours including gambling, drinking, or uncontrolled spending. 

What is under-control/over-control?

The theory of emotional under-control/over-control can potentially explain the differences between classic BPD and quiet BPD. According to this theory, everyone will fit on the spectrum from over-control to under-control. Both extreme ends are detrimental to mental health, whilst in the middle of this continuum is resilience. 

Compared to their 'classic BPD' counterparts, people with quiet BPD may be leaning towards the over-control end of the spectrum.  

People with under-controlled tendencies tend to struggle with emotional dysregulation and impulsivity. They appear dramatic in their behaviours and attract more attention from others. In contrast, over-controlled people keep to themselves, are quiet and in control. Biologically, over-controlled people are extremely threat-sensitive and can notice small details that other people miss. 

Being over-controlled, you may be highly perfectionistic, rigid, self- critical. You may have a severe fear of being out of control and impose all sorts of rules on yourself. You may also be highly critical of yourself and constantly put your own thoughts and behaviours under harsh scrutiny. You find situations without order and structure challenging— for example, small talks or parties. Your avoidance amplifies social anxiety and perpetuates your isolation. You may have social 'contact' via work or necessary activities.

But you do not feel deeply connected with anyone. No one knows the real you beneath a high-functioning appearance. You also tend to over-tolerate distress, which means you do not seek help even when you should. As Quiet BPD is an internalisation disorder, your emotional pain is not felt but absorbed by your body. As a result, you may have somatic symptoms such as migraine headaches, indigestion, IBS and joint pains. 

What therapy may work (better) for people with quiet borderline personality disorder?

You may find materials in traditional Dialectical Behavioural Therapy (DBT) to be irrelevant or even frustrating when you have quiet BPD. DBT, as it is designed for people with BPD, emphasises enhancing distress tolerance and reducing conflicts, but these are not what you need. 

If you have quiet BPD or over-controlled tendencies, you may benefit from specialised treatment such as Radically-Open DBT instead of traditional DBT. 

You may also benefit from working relationally with an attachment-based therapist. Through having an emotionally corrective experience, you get to have a direct experience of safely expressing yourself without being shamed, punished and humiliated. You get to experiment with assertively expressing anger and being spontaneous and playful. Then, you can apply the embodied learning of emotional vulnerability and openness to other realms of your life, start to relax, be self-compassionate, and build deep bonds with other people. 

For many years, you have kept your pain hidden. But if you are willing to take the first step and allow people who understand your unique personality to get to know you, not just healing, thriving is also possible for you. 

Getting support for quiet borderline personality disorder

If you have quiet BPD, seeking help and support can help you to better understand any symptoms or side effects you may be experiencing. Working together with a qualified, experienced therapist can help you to better understand and accept how you are feeling, and find the right methods of help for you.

Find out more about CBT and DBT, or to find a qualified, experienced counsellor with experience with quiet BPD, use our advanced search to find an online or face to face therapist near you.

This article was written by Imi Lo.
Article updated: 14/01/2022