The Underdiagnosed (and Misunderstood) Type of Borderline Personality Disorder

Borderline personality disorder (BPD) is a frequently overgeneralized condition.

Stereotypically, individuals with BPD are seen as impulsive and moody with outbursts of anger; however, while impulsivity and intense emotions are possible symptoms of BPD, they are not applicable to all. There are 256 possible representations of BPD, and stereotyping individuals with the disorder marginalizes those who exhibit these “stereotypical” symptoms. It also further silences those who do not present in a way seen as “typical” of BPD.

There are four types of borderline personality disorder: discouraged, impulsive, petulant and self-destructive. I am a survivor of the underdiagnosed and often misunderstood discouraged (or quiet) borderline personality disorder. My struggle with this disorder has been deeply internal and invisible to those around me, including medical professionals. Due to the invisible way this disorder presents itself, I have been misdiagnosed and underdiagnosed for numerous years. It has only been within the last few months of treatment that I have been able to fully explore and understand myself and how this disorder affects me.

My experience with discouraged borderline personality disorder is I often have extreme emotions, but they are an internal experience. On the outside, I present as though I am calm and collected. Ever since I was a child, I have been criticized for being too sensitive when showing any emotion, and I learned to internalize my feelings. It is because of this that instead of lashing out or expressing my intense emotions, I turn my attention towards myself, which leads to self-harm, self-punishment and extreme self-criticism.

My self-punishment has contributed to my struggle with multiple eating disorders, as well as my unstable self-image and poor self-esteem. Most days it feels like I am at war with myself because I am constantly fighting my emotions, my sensitivity to criticism and my self-hating thoughts. But on the outside, I present as a high achiever, appearing calm and confident. When I experience strong emotions, I turn them towards myself so I won’t be criticized for expressing them, which is something I have learned throughout my childhood. I also experience instability and intensity in my relationships with others because I struggle with idolizing and villainizing individuals on a moment to moment basis, particularly in romantic relationships.

Upon being diagnosed with discouraged (quiet) borderline personality disorder and undergoing dialectical behavior therapy, I find I am better able to identify when I am experiencing strong mood swings as well as villainizing and idolizing others, but I have also found that I will beat myself up when I experience these symptoms because I am afraid of hurting others and being criticized or rejected. Living with discouraged (quiet) borderline personality disorder is a daily, silent battle I face, and it makes it harder knowing that those around me don’t see my struggle and that explaining it to them is near impossible. As a social worker, I have experienced the stigma surrounding BPD in the mental health field, and how often those who are seeking help for BPD are overlooked, misunderstood and/or criticized. My personal experience has informed my practice with individuals who struggle with BPD, but there is still so much misunderstood about this disorder, and the individuals it affects.

Now, I’d like to play a game with you. Imagine you have been diagnosed with a condition and are seeking treatment; however, when you seek out different doctors to try and find one who will treat you, you are met with professionals who either refuse to work with you based on the fact that you have this condition, or they assume you have one type of the condition when you actually have the other type of the condition and overgeneralize your symptoms without considering your personal story or case.

Now, let’s translate this story to someone who is seeking treatment for BPD in a field that often overgeneralizes and stigmatizes the disorder. Imagine how triggering this criticism of BPD is when a fear of rejection and criticism is one of the symptoms of BPD and amplifies this emotion of fear. Finding help and understanding is so difficult when many professionals are not educated on the causes or types of BPD, and many adhere to the stereotypical, manipulative image that is present of individuals who struggle with the disorder.

If you struggle with BPD, I implore you to share your story and to educate others on your experience so we can increase understanding and empathy. If you don’t struggle with BPD, but also don’t know much about it and/or work in the mental health field, then please do listen to the stories of those who struggle with BPD and increase your understanding. It only takes one person to make a meaningful change… and the change of further understanding can save a life