Usually, a diagnosis of BPD is reached by observing outward behaviors. ‘Quiet borderlines’ suffer from many of the same challenges as other borderlines, such as a distorted sense of self, feelings of emptiness and isolation, a fear of abandonment and intense changes of mood.
However, doctors have found it much harder to diagnose as ‘Quiet BPDs’ often internalize their feelings, and their issues may not be immediately apparent. In fact, many people who may have quiet BPD are actually unaware of their disorder. The roots of the disorder are suggested to stem from early childhood experiences. In some cases, it could be a trauma at a young age or an emotional space that left the child feeling they couldn’t share or develop their emotional responses in a healthy way.
So what does it mean to have Quiet Borderline Personality Disorder and how is it different to what we traditionally know about BPD?
The Quiet Borderline tends to internalize, so rather than act out against people, they express their fears and anger at others and direct this towards themselves in a number of ways. Many people could be completely unaware of these behaviors, and Quiet Borderlines are often very good at masking their outward appearances to others. As a defense mechanism, the Quiet Borderline may express their anger or annoyance at someone by becoming cold and emotionally distancing themselves from them, rather than communicate the root cause of their frustration. In these cases, the other individual is often completely unaware that this is happening.
People with Quiet BPD also have a tendency to blame themselves for things that objective observers wouldn’t consider their fault. For example, they may see a friend who is irritated about something entirely unrelated but are convinced that the friend is actually annoyed with them. This is often exhausting for Quiet Borderlines as they will often think very deeply and with great concern about situations like these and their perceptions may not always be accurate.
In fact, many of those with Quiet BPD try to please others around them and try not to ‘make a fuss.’ They crave social acceptance and want to be liked by everyone. A great deal of their self-worth is tied to being validated by others. Often, they will be reluctant to say no to others and to relinquish a role they find a heavy burden (e.g., carrying an unequal share for caring for a relative).
Like other Borderlines, they can share a fear of abandonment and some social situations can induce a fear that if they no longer conform to what is expected of them, they will lose their friendships. This means that Quiet Borderlines often have paradoxical approaches to their relationships that are a massive challenge for them. They distance themselves from getting too close to people to avoid the fear of abandonment yet suffer greatly from feelings of isolation and loneliness. As such, those with Quiet BPD tend to have few close friends, and a great deal of importance is placed on their favorite people.
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This is particularly acute when it comes to romantic relationships, where Quiet borderlines tend not to be as interested in casual romantic relationships but find the everyday stresses of long-term relationships particularly acute, as the level of intimacy builds up a potential fear of abandonment and isolation. As such, many quiet borderlines withhold their ‘true self’ from their partners initially.
Depression, Self-harm and Suicidal Thought
Depression is sometimes described as anger turned inwards. In the case of Quiet Borderlines, this particularly applies. As they don’t wish to confront others and are wary of the effects of potential fallout, they will often take their anger out on themselves in many destructive ways. As well as this, a combination of factors can lead to depressive phases and longer-term feelings of depression. Quiet Borderlines may suffer from sleep issues and poor nutrition which creates a vicious cycle that combines with existing feelings of depression. Quiet Borderlines are also at a higher risk of developing substance abuse issues.
Often this will create a perfect storm where quiet borderlines will have suicidal thoughts or ideations. Quiet borderlines, in particular, may not express this openly to friends or family and as with many other aspects of the condition, will carry this burden and suffer in silence.
Advice for treatment is broadly similar to guidelines given to anyone with a BPD diagnosis. As mentioned in this article;
Borderline Personality Disorder is usually treated with a combination of medications and therapy. Many psychiatrists will prescribe mood stabilizers, anti-depressants or anti-psychotics. Several types of treatment are recommended for BPD such as cognitive behavioral therapy, dialectic behavioral therapy, group therapy, and general psychotherapy.
The prognosis for borderline personality disorder is that it is a lifelong condition. Although many patients may find complete remission, treatment is generally aimed towards coping with and managing symptoms. The length of time required to reduce BPD symptoms varies significantly from person to person. However, many therapists report that it may take months to years to see a reduction in symptoms.
Awareness of the disorder is growing, and there are many forums and groups on the internet now that can offer support and guidance. Many people are able to manage the disorder with the right support and are able to share their experiences to help others.