While no medication is FDA-approved specifically for Borderline Personality Disorder (BPD), doctors often use antidepressants (SSRIs/SNRIs), mood stabilizers, and atypical antipsychotics off-label to target core symptoms like depression, anxiety, impulsivity, and mood swings, with the goal of improving daily functioning, says Verywell Mind and Charlie Health. For quiet BPD specifically, medications address internalizing symptoms like emotional dysregulation and emptiness, often with drugs like SSRIs (Zoloft, Prozac) for mood, mood stabilizers (Lamictal, Depakote) for instability, or antipsychotics (Seroquel, Abilify) for anxiety and paranoia.
Dialectical behaviour therapy is the most favoured therapy option for people with a high-functioning BPD diagnosis. This therapy method offers people with quiet BPD a comprehensive treatment approach, including individual therapy, phone coaching between sessions, and group therapy focusing on skill building.
Common BPD medications include antidepressants (Prozac, Zoloft, Effexor, Wellbutrin), antipsychotics (Abilify, Seroquel, Risperdal, Zyprexa), mood stabilizers/anticonvulsants (Lithobid, Depakote, Lamictal, Tegretol), and anti-anxiety drugs (Ativan, Xanax, Klonopin, Buspar).
Quiet borderline personality disorder can be much more difficult than BPD to both diagnose and treat, but as with many mental health conditions, the earlier it's diagnosed, and intervention is started, the more successful treatment can be.
Having Quiet BPD means you 'act in', rather than act out. You may not have stereotypical BPD symptoms such as frequent anger outbursts – instead, you suffer in silence. You may appear calm and high functioning, instead of 'exploding', you implode and collapse from within.
Childhood Trauma:
Individuals with unresolved adverse early experiences or trauma are more vulnerable to Quiet BPD. Due to emotional neglect or exposure to abuse, many internalize pain and anger instead of expressing them outwardly.
With other forms of BPD, a person will typically experience very intense negative emotions, such as anger, shame, sadness and guilt, which they outwardly display. For someone with quiet BPD, while they still experience these intense emotions, they tend to do so internally. This can cause them to lash out at themselves.
Discouraged Borderline (Quiet BPD): Also referred to as the high-functioning BPD (quiet borderline), this category of BPD makes one heavily dependent on others and practice avoidance. They are incredibly loyal and humble. However, this may make them clingy.
Quiet BPD often overlaps with or is misdiagnosed as depression, social anxiety disorder, or complex PTSD due to its internalized symptoms. Unlike these conditions, however, quiet BPD involves persistent instability in self-image, relationships, and emotional regulation.
Symptoms of BPD Splitting Behaviours
People may quickly alternate between idealising and devaluing people, situations, and themselves. This can lead to unstable relationships, rapid mood swings, impulsive behaviour, and difficulty tolerating ambiguity.
How Is Quiet BPD Diagnosed? Quiet borderline personality disorder (BPD) is not a recognized subtype in terms of diagnosis; rather, it's a term that refers to people who meet the criteria for diagnosis of borderline personality disorder but who don't fit the typical profile.
Due to high comorbidity of BPD with addictive disorders, use of substances with high dependence potential should be avoided if possible. The use of unsafe drugs with risk of overdose (tricyclic antidepressants [TCAs], monoamine oxidase inhibitors [MAOIs]) should be avoided.
Over time, you may find that quetiapine makes you: feel calmer and less upset. able to concentrate better and think more clearly. able to get things done and stay focused.
Stronger evidence exists for the use of the mood stabilizers topiramate, lamotrigine and valproate semisodium in BPD. Topiramate and lamotrigine have both been shown in small RCTs to be effective in the treatment of symptoms of aggression in BPD [Nickel et al.
Borderline personality disorder usually begins by early adulthood. The condition is most serious in young adulthood. Mood swings, anger and impulsiveness often get better with age. But the main issues of self-image and fear of being abandoned, as well as relationship issues, go on.
How Quiet BPD Affects Daily Life. Living with Quiet Borderline Personality Disorder often involves an ongoing emotional burden. Persistent self-criticism erodes self-esteem and leads to exhaustion. In the workplace, perfectionism and fear of failure may cause burnout or missed opportunities.
Key Takeaways. People with BPD often have a "favorite person" to provide support and comfort during emotional upheaval. Being a favorite person means setting healthy boundaries to maintain a balanced relationship. It is important to communicate clear boundaries and challenge any violations to avoid an unhealthy dynamic ...
Triggers that Can Lead to an Episode of Quiet BPD
Emotional Instability is a common trigger for teens and young adults with quiet BPD. Their vulnerability to intense emotions can cause them to experience an episode characterized by mood swings, irritability, and difficulty regulating their emotions.
People with BPD often worry about how they look to others, so they may lie to conceal not meeting someone's expectations, like a boss or a partner. They might think their lies are harmless and may not catch up to them, which, as we've probably all experienced, some lies do and some don't (catch up to us).
Quiet BPD often comes from a deep fear of being abandoned. People may push others away to protect themselves, then feel terrible afterward. They might cry in private, blame themselves, and feel worthless. Covert narcissism, on the other hand, is often tied to a fragile sense of self-worth.
The Main Symptoms of Quiet BPD
Emotional Suppression: Those with quiet BPD tend to bottle up their emotions, keeping their inner turmoil hidden from the outside world. They may experience deep anger or sadness but prefer to internalize these feelings instead of expressing them outwardly.
Quiet BPD and Friendships
Quiet BPD may also prevent someone from forming and committing to friendships because they do not have the emotional capacity to have healthy boundaries or navigate friendships.
BPD Meltdown
During a meltdown, people may experience extreme mood swings, impulsivity, and difficulty calming down. Understanding how BPD contributes to meltdowns is crucial for developing coping strategies and providing support to manage and navigate these overwhelming emotional experiences.
Curiosity – Being extra sensitive and connection emotions, senses and surroundings allows for greater curiosity in the minds of those with BPD. Bold – Impulsivity is a BPD trait that can be positively linked to being bold, courageous and having the ability to speak one's mind.
Symptoms - Borderline personality disorder