High functioning borderline personality disorder (BPD) is a lesser-known subset of the mental health condition characterized by unstable moods, behaviors, and relationships. The “high functioning” aspect comes from how individuals exhibit these symptoms. Spotting high functioning borderline personality disorder may be harder, and treating it is complex.
Understanding High Functioning BPD
Emotions are typically externalized in traditional borderline personality disorder. Individuals with this diagnosis may have impulsive behaviors, experience intense anger, and undergo frequent mood swings that drastically affect how they interact with others. As a result, maintaining stable relationships can be difficult due to their emotional and behavioral state.
High functioning borderline personality disorder differs because individuals tend to internalize their struggles and imbalance. Common ways this manifests include self-blame, self-isolation, and even self-harm. Instead of having external mood swings, they keep their shifts in mood internal. Individuals with high functioning BPD are more likely to suppress their feelings, making it harder for loved ones and clinicians to notice that something is wrong.
The Main Symptoms of High Functioning BPD
To dive deeper, common symptoms of high functioning borderline personality disorder include:
- Emotional Suppression: Those with high functioning 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.
- Fear of Abandonment: This fear can be so intense that individuals might shy away from close relationships entirely, trying to avoid the pain of rejection. They may be reluctant to form meaningful bonds, always fearing the heartbreak of being left behind.
- Unstable Self-image: People with high functioning BPD often grapple with a changing sense of self. One day they might feel capable and self-assured, while the next, they may see themselves as inadequate or unworthy.
- Impulsive Behaviors: While not as outwardly visible as in typical BPD, those with high functioning BPD might engage in impulsive behaviors, often aimed at themselves. These actions can include anything from reckless driving to binge eating or self-harm.
- Chronic Feelings of Emptiness: This symptom often appears as a deep sense of isolation or loneliness, even when surrounded by others. People with high functioning BPD might feel disconnected or detached, struggling to find meaning or fulfillment in life.
- Dissociation: When stressed, individuals with high functioning BPD may experience dissociation, feeling as though they are detached from themselves or their surroundings. They might describe it as watching their life unfold from a distance, like viewing a movie.
Knowledge leads to better understanding and recognition of high functioning BPD. This, in turn, leads to better treatment and support for those with a diagnosis.
Diagnosing High Functioning Borderline Personality Disorder
High functioning borderline personality disorder is identified based on criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). To receive a diagnosis, a person must meet at least five of the following nine symptoms:
- Making frantic attempts to avoid real or imagined abandonment.
- Having a pattern of unstable relationships that swing between idealizing and devaluing others (often referred to as “splitting” or black-and-white thinking).
- Struggling with an unstable sense of self or fluctuating self-image.
- Engaging in impulsive or risky behaviors.
- Experiencing frequent thoughts of self-harm or suicide.
- Undergoing intense mood swings and experiencing strong emotional reactions.
- Feeling persistently empty inside.
- Dealing with overwhelming or uncontrollable anger.
- Experiencing dissociation, where you feel detached from yourself or as if you’re observing your life from outside your body.
With this condition, individuals direct their symptoms inward, making them less noticeable to others. Because of this inward focus, doctors often misdiagnose high functioning borderline personality disorder as conditions like depression, social anxiety, or even autism, or it may take longer to identify due to the lack of more recognizable outward symptoms.
While many clinicians expect individuals with BPD to present as angry or explosive, those with high functioning BPD suffer in silence, hiding their pain behind a calm exterior.
What Causes High Functioning BPD?
A high functioning borderline personality disorder diagnosis leads many to wonder why they have the condition. A diagnosis of high functioning BPD depends on genetics, childhood development, and the presence of co-occurring mental health conditions. Individuals are more likely to receive a diagnosis if they have a personal or family history of mental health conditions. Experiencing abuse, abandonment, or other trauma during childhood also increases the likelihood of a diagnosis.
However, there is no definitive way doctors and researchers can determine what makes someone develop high functioning borderline personality disorder instead of typical BPD. That varies from person to person.
Treatment for High Functioning Borderline Personality Disorder
Often, clients with BPD have already been to treatment several times to deal with urges of self-harm, suicidal ideation, and attention-seeking behaviors. At Alter Behavioral Health, we use proven techniques to help these clients live fuller lives with fewer debilitating symptoms.
Some of the treatment modalities we use for high functioning borderline personality disorder include:
- Dialectical Behavioral Therapy (DBT)
- Cognitive-Behavioral Therapy (CBT)
- Medication Management
- Solution Focused Therapy
Each client is different, and what works for one person may not work for another. We use research-backed treatment methods to ensure clients with high functioning BPD get the right care they need to live a balanced life. If you or someone you know is exhibiting signs of high functioning borderline personality disorder, give our admissions team a call. We have the tools needed to help you or your loved one get their condition managed and stabilized.
About Alter
Alter is a behavioral healthcare provider that specializes in evidence-based clinical treatment approaches. We provide a wide range of programs for adults and families experiencing mental health conditions including schizophrenia, depression, borderline personality disorder, anxiety, substance abuse, and more. This is done through client-centered care for a full-continuum of treatment. We serve the entire U.S. population from our revolutionary locations throughout sunny Southern California. Whether an individual needs 24/7 care or wants an outpatient program – we are there to guide every step of the journey. For more information, give us a call at (877) 613-9776 or visit our website at alterbehavioralhealth.com.
