Understanding High-Functioning Borderline Personality Disorder

How is Borderline Personality Disorder Diagnosed?

Borderline personality disorder is diagnosed through assessments and questionnaires. In addition, individuals may also be asked about their childhood or other periods in their lives to help clinicians gain an accurate diagnosis. Due to the stigmatization from society, providers avoid diagnosing until sufficient information and criteria are present.

Signs of High Functioning Borderline Personality Disorder

In general, when looking at borderline personality disorder, those diagnosed tend to exhibit challenges with regulating their emotions. While not a formal diagnosis, in individuals with "high-functioning" borderline personality disorder, or “quiet” borderline personality disorder, this is not always as prevalent or present. They may engage in more self-harm and self-destructive behaviors and work hard to hide how they are truly feeling from others.

The following are a few characteristics of high-functioning borderline personality disorder:

Feelings of emptiness- This can present in several ways including a shift in self-image and can depend upon who the person is with.

Fear of rejection- This is the fear that others, especially those deemed as serving important roles in one's life, may leave them.

Mood instability- This can present as going from being happy to suddenly sad.

Intense feelings of shame or guilt- These mood swings often stem from past behaviors and feeling bad about how the individual may have treated themselves or others.

Those with high-functioning borderline personality disorder tend to ruminate on thoughts and experiences. They tend to replay situations in their mind over and over, thinking about how the situation may have affected themselves or others, or how the situation could have been different

How Can Those With Borderline Personality Disorder Live Fulfilling Lives?

Many people who have a diagnosis of borderline personality disorder are highly functioning. They can hold jobs and able to fulfill duties in their personal life such as responsibilities to others and around the house. Many times, those with high-functioning borderline personality disorder may not show certain symptoms such as emotional dysregulation unless they are in specific situations.

Treatments for BPD that those with high-functioning BPD can better manage their day-to-day lives:

Individual therapy with a licensed mental health professional - One-on-one therapy once a week to better explore symptoms can be helpful. This can also be a great way to better explore past trauma or other neglectful situations that may have led to the development of those characteristics. In addition, it can help one to better understand how certain patterns may be negatively affecting their functioning and relationships.

Group Therapy- This can be a great option for those coping with quiet BPD as it can help individuals see how others with the same diagnosis may also be struggling to cope with intense emotions. In addition, a group setting can help to build a sense of support and make individuals feel that they are understood and are not alone. This modality can also be beneficial in helping individuals learn from others and what might be working for them.

Support from family and friends- Opening up to a family member about borderline personality can be scary. Individuals diagnosed with this may worry about how friends or family may react or treat them. They may fear abandonment because of the diagnosis. While it can be worrisome, a strong support network is critical in the outcome of borderline personality symptoms.

Implementation of regular self-care techniques- For every person, self-care looks different. For some, it may include regular massages, trips to the spa, or treating themselves to a restaurant they like. For others, it may look like a regular exercise regimen, implementing boundaries in relationships, or healthy sleep hygiene.

How is Borderline Personality Disorder Treated?

Currently, there are no medications that have been approved for treating borderline personality disorder. Many individuals may be prescribed medications to treat co-occurring disorders such as anxiety and mood disorders. Through psychotherapy, individuals can help better manage BPD symptoms.

Psychotherapy, also known as talk therapy, can be effective in helping individuals increase self-awareness of how experiencing intense emotions and behaviors may affect themselves and others. Dialectical behavioral therapy (DBT), is the most effective way of treating borderline personality disorder. DBT can help individuals increase healthy coping skills to better manage dysregulation in their emotions.

DBT focuses on increasing one's ability to be mindful and present and managing distress tolerance. At Clarity Clinic in Chicago, we have a variety of well-experienced clinicians and medical providers who are here to support you and answer any questions or concerns you may have.