Ask About BPD
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Ask About BPD: BPD Types

Original Question: I’ve heard there are types of BPD, like low functioning, high functioning, and translucent. And within these types there’s the “acting out BPD” and the “quiet BPD.” Exactly how many types are there and what are they? What are the differences?

 

It has been said that there are 256 possible combinations of the symptoms that make up BPD. Due to the extreme variance between what causes a person’s BPD (what type of trauma/trauma duration and severity, what kind of environment the person grew up in) it’s hard to know how their experience of BPD will manifest.

Individuals with BPD will fit into different subtypes, ways of functioning, schema modes, and coping styles. They may also switch between a myriad of them throughout their lives. No one will ever fall neatly into any category completely. This is partly due to stressors and the environment we’re in and it’s also due to the experience of identity ambivalence in those of us with BPD.

Theodore Millon came up with the following subtypes and said that a person can fit one, none, or more of what’s listed below. His work was done during a previous edition of the DSM (Diagnostic and Statistical Manual of Mental disorders.) The DSM is the standard classification of mental disorders used by mental health professionals in the United States. Being written for clinical use, the language is a bit shaming, so I’ll do my best to convey it from a modern approach standpoint.

Petulant:

The word petulant means to be moved to or showing sudden, impatient irritation, especially over some trifling annoyance.

  • Rooted mostly in anger, jealousy, and resentment.
  • Outward appearance: an individual who complains a lot, is overly critical, irritable, impatient, as well as unpredictable.
  • Can/will often switch between intensely needing others and pushing them away.
  • Deep feelings of inferiority
  • Prone to outbursts of intense anger, similar to what you’d see in a person with Intermittent Explosive Disorder.
  • Generally, through no fault of their own, are sullen, pessimistic, easily slighted, restless, and often stubborn and/or defiant.

Discouraged:

  • Share traits with people that have Dependent Personality Disorder and/or Avoidant Personality Disorder.
  • Tend to be depressive, prone to self harm (cutting, eating disorders, substance use, etc.)
  • May also have a large amount of suppressed anger dwelling beneath the surface.
  • Are submissive, feel hopeless, vulnerable/in constant jeopardy, loyal, and humble.

Impulsive:

  • Often share traits with Histrionic Personality Disorder and/or Antisocial Personality Disorder.
  • Charming outward expression.
  • Engage in things like impulsive sex, gambling, or dangerous driving, etc.
  • Behaviors are often interpreted as “attention-seeking” (acting out hoping someone will see the cry for help) by professionals.
  • Tend to be capricious, distractible, seductive, and intensely afraid of losing those closest to them.
  • Often can become gloomy, agitated, and irritable.

Self Destructive:

  • People who fall under this category are often consumed by self-hatred.
  • Are particularly prone to self-harm (cutting, eating disorders, substance abuse, etc.)
  • Engage in self-neglect as well.
  • Are inward-turning, and may suffer from characteristics categorized as depressive and/or masochistic.

Casanova Disorder – BPD in Males:

It was once thought that BPD was mainly a woman’s disorder, but recent research has shown that BPD occurs equally in men and women. The difference is how it manifests in their daily life. Although men can exhibit behavior that falls into any or all of the above categories we have discussed this is one that is particular to men.

The term, “Casanova Disorder,” refers maladaptive behavior that is rooted in being addicted to love, seduction, and sex. Due to stigma and socially acceptable male behavior, most people are unaware it exists.

Those that struggle with Casanova type BPD are often searching for adoration, unconditional love, and affection they never received growing up.

As with anyone struggling with BPD, male individuals with BPD also must exhibit 5 of the 9 criteria for BPD.

Differential Signs and Symptoms:

  1. Mood swings: All people with BPD experience mood swings but the ones in men are often more explosive and include more overcompensation.

He can go from depressed to being overly affectionate to being arrogant and haughty then back to feeling depressed in a matter of hours.

  1. Relationships: Obsessed with love; quickly claim to love someone; relationships usually don’t last long due to fears of intimacy and abandonment; relationships are often turbulent; are “all about the chase;” often addicted to sex as physical intimacy is confused with emotional intimacy; are addicted to love yet afraid of it simultaneously; once they find a partner their deep-seated fears come out.
  2. Self-esteem: There is a tendency towards narcissism: outwardly appear to be bold and daring but those are just covers for a deep well of insecurity; they are overly sensitive to criticism; suspicious, distrustful, and jealous due to these deep fears of being unlovable; low self-esteem often comes from the mother/caregiver not providing adequate emotional support as a child.
  3. Impulsivity: Substance abuse: as with a lot of cases of BPD, substance abuse is often part of it due to lack of coping skills; recklessness: gambling, driving recklessly, promiscuous sex, etc.; anger outbursts: are common in BPD and in men can come out as intimate partner violence or bar fights.

Daily Functioning

These subtypes affect the daily actions and interactions of a person with BPD. This leads to an expression of BPD categorized by high functioning, low functioning, and translucent/transparent styles Note: These styles aren’t designed by a professional of any type but can still be applicable. I found them at: https://beyondtheborderlinepersonality.wordpress.com/category/high-functioning/

High Functioning:

  • High functioning borderlines are able to participate in life in a more complete and “normal” way.
  • They are able to maintain daily function by keeping things tucked away.
  • They have regular relationships with people, hold jobs, and generally seem to be productive.
  • It’s the same as low functioning, just with a different façade.
  • Basically, high functioning people are better at masking the symptoms that plague all of us with BPD.

Low Functioning:

  • Someone who falls under the low functioning umbrella is what a stereotypical expression of BPD would look like.
  • The person’s life is seen as a mess. They struggle to take care of themselves, and experience the most constant and extreme mood swings.
  • Often struggle to have relationships with any another person.
  • People who are at a low level of functioning are hospitalized more often because they tend to need someone around them 24/7 to help with self-care.
  • Treatment of individuals in this category is a challenge because they’re already so far down and in so much pain, but it’s not impossible if you find the right treatment team.

Transparent:

  • People in this group are a mix between high and low functioning, and extraversion and introversion. They appear one way in public but when relaxed around family and friends they’re totally different.
  • A person could be either high or low functioning due to the constant conflicting feelings.
  • As the source listed above mentions, it’s sort of a Dr. Jekyll and Mr. Hyde thing happening, and both of those two feel everything at the same intensity level.
  • They’re hard to spot, and won’t generally tell anyone about their problems unless a major emotional event has occurred.

Acting Out – Extroversion

Someone who is “acting out” turns his or her pain outward. This is the more “typical” presentation of BPD. Extraverted borderlines are louder and generally more vocal about their problems or their problems are easier to spot, it seems. It can include things like getting into lots of fights or truancy. It can include self harm but usually acting out is in a bigger way.

Acting In- Introversion

Someone who is “acting in” turns his or her pain inward. Acting In includes self harm like cutting, burning, eating disorders, or substance use. This is considered an atypical presentation of BPD. Many introverted borderlines will be misdiagnosed because they don’t “seem like” they have borderline because it they do not look like the “classic” representation.

As we can see there are as many types, or expressions, of BPD as there are people who experience the disorder. As we move through different stages of our life we will experience these different types and subtypes of the disorder. With the proper treatment we can learn to identify what behaviors we are engaging in and how to minimize their affects on our daily life.

 

 

 

6 Comments

  1. This is very interesting. I had heard about the petulent/discouraged/impulsive/self-destructive types and had heard about low-functioning/high-funcitoning BPD. However, I generally don’t believe in functioning levels within mental illness, because functioning is really a sliding scale not a dichotomy. Besides, everyone with a mental illness has to have significant impairments in functioning or they won’t be diagnosed with it. As an example, I think I am high-functioning in that I can be in a healthy relationship, but I am low-functioning in that I self-injure a lot nd can’t hold down a job. My GAF score is 40 (GAF = global assessment of functioning, we still use DSM-IV here), but in the one area where even the most high-functioning borderlines struggle (relationships), I do relatively okay.

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    • Kayla Fantauzzo says

      I personally don’t like the black and white view of high and low functioning either but I wanted to touch on it cause the original question contained it. You’re right though, it’s much more fluid than people realize. 🙂

      Like

  2. Great article. Really helped in understanding the different types. I found myself, of course, in so many of these but hey, don’t most living with BPD do?

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  3. Pingback: Ask About BPD: BPD Types | Off The Beaten Pathology

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