Understanding High Functioning Borderline Personality Disorder
Borderline personality disorder (BPD) is a serious mental health condition marked by difficulty regulating emotions and thoughts, unstable personal relationships, and a fragile self-image. People with BPD also tend to be impulsive and reckless.
What is High Functioning BPD?
High functioning BPD refers to people who are able to manage jobs, relationships, and responsibilities despite their BPD symptoms. They often appear to be doing well on the outside, making their inner turmoil especially difficult for others to detect or understand.
Signs of High Functioning BPD
Those with high functioning BPD typically experience the following core symptoms:
- Intense but short-lived emotional episodes
- Unstable self-image and sense of self
- Impulsivity and risk-taking behavior
- Intense fear of abandonment, even by those closest to them
- Difficulty maintaining close relationships
They are able to mask these symptoms from most people and superficially hold life together despite inner chaos.
Testing for High Functioning BPD
Diagnostic Process
Getting an accurate BPD diagnosis starts with an evaluation by a mental health professional like a psychologist or psychiatrist. They conduct an interview asking about past and current symptoms.
Borderline Personality Disorder Questionnaires
Validated screening questionnaires help clinicians evaluate if symptoms align with BPD criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Commonly used BPD screening tools include:
- McLean Screening Instrument
- Borderline Symptom List
- Standardized Assessment of Personality
- Personality Assessment Inventory
These questionnaires help quantify BPD traits so borderline personality disorder testing is more accurate and consistent across evaluations.
Co-occurring Conditions Screening
Since over 75% of people with BPD also meet criteria for another mental health condition, evaluation aims to uncover any co-occurring disorders too.
Common co-occurring conditions include:
- Depression
- Anxiety
- PTSD
- Substance abuse
- Eating disorders
- Bipolar disorder
Testing for these helps personalize treatment plans to meet each individual’s needs.
Challenges Diagnosing High Functioning BPD
Hiding Inner Pain
Unlike lower functioning BPD, those with high functioning BPD conceal their symptoms and inner suffering very well from the outside world.
They are often viewed as very charming, intelligent, and likable. Few suspect their profound emotional pain and struggle maintaining stability.
Downplaying Symptoms
During psychological evaluations, those with high functioning BPD also tend to minimize and fail to disclose the full extent of their symptoms and challenges.
One study showed 47% of people diagnosed with BPD did not report symptoms that clearly fit DSM criteria during assessments.
This makes identifying high functioning BPD much more difficult.
Appearing Highly Functional
Since they manage to hold jobs, maintain relationships, and avoid legal issues or hospitalizations, those with high functioning BPD do not display many typical red flags for BPD.
Their ability to function well superficially further obscures their internal suffering and need for treatment.
Dangers of Undiagnosed High Functioning BPD
Worsening Symptoms
Failing to identify and treat high functioning BPD early on increases odds that symptoms and challenges intensify over time.
As responsibilities and relationship demands grow with age, their limited coping capacity becomes exhausted.
Unstable Relationships
The instability, emotional deregulation, and hypersensitivity inherent in high functioning BPD takes an extreme toll romantic relationships.
Partners suffer confusion, loneliness, resentment over time, leading to break ups and divorce.
Addiction Risk
Seeking to numb their emotional agony and self-loathing, many with undiagnosed high functioning BPD turn to substance abuse and addiction.
This only worsens life chaos and risk of tragedy like overdose or suicide.
Suicidality
The combination of excruciating inner anguish and desperation for relief puts those with high functioning BPD at very high risk for suicide.
Approximately 70% attempt suicide and 10% eventually take their own lives through suicide.
Getting Testing and Treatment
Finding a Therapist
Seeing an experienced mental health professional that specializes in BPD and uses proven treatment approaches provides the best chances of recovery.
The most effective treatment is Dialectical Behavior Therapy (DBT) designed specifically for borderline personality disorder.
Committing to Treatment
While therapy and treatment are challenging, it offers real hope. Work closely with your treatment providers and lean on support systems to make the process easier.
Medications may help relieve certain symptoms but cannot eliminate BPD on their own.
Practicing Self-Care
Making lifestyle changes reduces stress so you can function your best, even with BPD. Prioritize proper sleep, nutrition, exercise, and mindfulness practices.
Take things one step at a time and celebrate small victories.
High Functioning BPD Relationship Impact
Communication Breakdown
Frequent emotional escalations along with fear of judgment or abandonment lead those with high functioning BPD to shut down, stonewall, or lash out at romantic partners.
This breakdown in communication breeds isolation within the relationship.
Confusion and Uncertainty
The unpredictable mood swings leave partners feeling perpetually confused, lonely, and like they are "walking on eggshells."
They cannot rely on intimacy or support from their loved one with BPD.
Emotional Exhaustion
Trying to stabilize their partner's emotions and preserve the relationship eventually takes an extreme mental and emotional toll.
Partners often sacrifice their own needs and develop anxiety, depression, low self-worth.
Erosion of Trust
Dealing with repeated cycles of accusations, unstable perceptions, and threats to leave from their BPD partner destroys any sense of trust.
They learn promises and declarations of love cannot be taken seriously.
Supporting Your Partner with High Functioning BPD
Validate Their Feelings
Rather than arguing or minimizing their emotions during conflicts, validate what they feel without judgment. This helps them feel heard and deescalate meltdowns.
Practice Patience
Remain calm, patient, and consistent with your care despite the pushes and pulls. Avoid reacting defensively or making threats you cannot follow through on.
Prioritize Self Care
You must care for your own needs first before helping your partner. Stay connected with friends, keep up healthy routines, and speak openly with your partner about establishing boundaries.
Get Educated on BPD
Read books, join forums, or attend counseling together to better understand BPD. This minimizes feelings of frustration, resentment, and enables you to respond in healthier ways.
Encourage Their Treatment
While you cannot force your partner into treatment, you can explain your concerns coming from a place of care and support. This motivates them to get help and stick with it.
Deciding Whether to Stay or Go
Weighing the Impact on Your Wellbeing
Take time for honest self-reflection - is the constant anxiety, loneliness, and sacrifice of needs outweighing happiness, fulfillment, feelings of worth within the relationship?
Considering Your Partner's Progress
Have they actively committed to treatment like DBT therapy and working to improve communication? Or do they deny problems and refuse help? This factors heavily into possibilities for change.
Learning Ways to Cope
Educate yourself on high functioning BPD using resources like seminars, books, and support groups. This equips you with tangible skills for managing challenges.
Speaking Openly as a Couple
Have candid conversations about your experiences and feelings as a couple. This helps you assess if you both remain equally invested in maintaining the relationship.
Set clear expectations around communication, support needs, and relationship boundaries.
Finding Hope and Healing Together
Despite the struggles of high functioning BPD, you both can absolutely build a healthy, mutually fulfilling relationship through compassion, education and commitment to managing symptoms.
This offers hope to persevere through the darkest, most lonely times. Have faith in treatment and keep moving forward together one day at a time.
FAQs
What is the most accurate test for borderline personality disorder?
There is no single definitive BPD test. Diagnosis involves clinical evaluation by a mental health professional using validated screening tools and criteria in the DSM-5. Commonly used questionnaires include the McLean Screening Instrument, Borderline Symptom List, and Standardized Assessment of Personality.
Can someone with high functioning BPD hold down a job?
Yes, those with high functioning borderline personality disorder are able to maintain employment, relationships, and meet life responsibilities even while struggling internally with BPD symptoms like emotional dysregulation, unstable sense of self, and fears of abandonment.
Does everyone with BPD attempt suicide?
No, but a considerable number do. Around 70% of those with BPD will attempt suicide at least once and up to 10% will die by suicide. This demonstrates the extreme emotional anguish and impulsivity underlying borderline personality disorder.
Are there online self-assessments for borderline personality disorder?
Yes, there are several free online borderline personality disorder tests that help screen for BPD traits. However, they should not replace full clinical evaluation by a qualified mental health expert. Bring any positive screens to your doctor or mental health provider for proper diagnosis.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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