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Subtypes of Borderline Personality Disorder

The good news is there is hope. BPD is treatable. However, it is useful to know if you fall into a subtype in order to better communicate with your mental health professional. You may not know where you fall, and you may not fall into one of those categories–that’s okay. What’s important is that you understand your diagnosis, in order to improve the outcome of treatment.

According to Wikipedia, psychologist Theodore Millon identified four subtypes of borderline personality disorder (BPD).  They are:

  1. discouraged borderline–includes avoidant, depressive or dependent behaviors
  2. impulsive borderline–includes antisocial or approval-seeking behaviors
  3. petulant borderline–includes passive-aggressive behaviors
  4. self-destructive borderline–includes depressive or self-destructive behaviors

A person with BPD may have none, one, or more than one of these subtypes. I believe I fall under the discouraged and self-destructive subtypes.

Discouraged borderline

Subtypes of Borderline Personality DisorderThis is a person who believes that no matter what, they just can’t win. Consequently, he or she may avoid people, believing they will not want to be around him/her.  The other extreme is he or she may be overly dependent on other people, hoping to find some sense of self-worth from them. This person may also suffer from symptoms of depression.

This person is operating in an Abandoned Child mode. He or she believes that he or she is unworthy of love and affection. He or she believes no one will want anything to do with him/her, and behaves accordingly. This may include frantic efforts to avoid the end of or disturbance of any relationship, black-and-white thinking, or unstable sense of self.

Impulsive borderline

I’ve dealt with this kind of person before, and it’s not a pleasant experience. This is what mental health professionals usually mean when they say “borderline”. This type of person is in constant conflict with society. Bouts of violence are not uncommon. This person does not think before acting, and the result is chaos for everyone involved. This person may have antisocial personality disorder as a co-occurring diagnosis.

This person is operating in an Abandoned Child mode–a plea for attention, any attention–as well as an Angry Child mode. The Angry Child believes that other people deserve to be punished for his/her pain, and behaves accordingly. This type of person with BPD may have poor impulse control, abuse substances, or self-harm.

On the other extreme, he or she may seek approval at any cost. In a way this is just as damaging as bouts of self-injurious behavior. He or she may not care about himself/herself; it’s all about what the other person thinks. This often results in extreme efforts to avoid disapproval and abandonment.

Petulant borderline

This is a passive-aggressive person. He or she will injure himself or herself–either physically or emotionally–in an attempt to get needs met. This person has an unstable sense of self, a frantic fear of abandonment, and inability to express his or her needs.

This person operates in an Angry Child mode.  He or she is angry and will hurt friends and family as a result. He or she often does not recognize the anger–the world is the problem, not him/her. He or she does not know how to express his/her needs in a healthy way, so relationships seem to be a game of “If you really loved me” or “You should know what I want”.

Self-destructive borderline

This is the popular cultural image of a person with BPD; “Goth” or “emo”. This person often suffers from depression as a co-occurring diagnosis and is a self-injurer. Oftentimes, just these two criteria–emotional instability and self-injurious behavior–are enough to merit a diagnosis of BPD (in spite of the DSM-IV mandating a diagnosis of BPD if five of nine criteria are met). This is a person who feels that no one cares, and reacts by not caring about himself or herself.

This person operates in an Abandoned Child mode. Since he or she does not feel loved, he or she reacts in self-destructive ways in an attempt to feel something instead of nothing. He or she lives in terror of abandonment, is self-loathing, and has no idea who he or she is inside. Thoughts of self-injury–or actions–are a given in this type.

The good news about BPD

The good news is there is hope. BPD is treatable. However, it is useful to know if you fall into a subtype in order to better communicate with your mental health professional. You may not know where you fall, and you may not fall into one of those categories–that’s okay. What’s important is that you understand your diagnosis, in order to improve the outcome of treatment.  There is hope–even if you feel like you’re the worst insert-subtype in the history of psychiatry.

29 thoughts on “Subtypes of Borderline Personality Disorder”

  1. My daughter was diagnosed with BPD at 18 after developing a myriad of mental health issues from the age of 8, i.e. severe cutting, suicide attempts, multiple hospitalizations. When she was in grade school I was so puzzled by her behavior and tried to control her with physical restraint which was totally ineffective. Without thought or premeditation, I developed a communication style with her that periodically had a calming effect and kept my family intact with my 3 kids and my Dad.

    After she graduated from high school – she tried college for a year and was miserable – back and forth to the hospital and finally arrested when she began destroying things in my home. She spent a night in jail and received diversion. A few weeks later she crawled into my bed at 2am and told me she wanted to check into Menninger’s.

    This was the beginning of a 15 month treatment program – 3 months at Menninger and 12 months in a program in Calif – Optimum Performance Institute. Both of these organizations helped my daughter create a life for herself. She has graduated from college has a job and best of all I can talk with her about most things without triggering a BPD anger episode. Her BPD created a very strained relationships with her sister—which has now been mended. The only med she takes is for sleeping so she sees a psychiatrist and a therapist trained in DBT occasionally. It took about 15 years, but I feel she is as cured as she can be and has developed the skills to deal with her disorder.

    My message is that you have to connect with people who understand BPD and who can treat and support you for a significant period of time. It was essential that my daughter was involved in 15 months of residential treatment. 10 stupid days with an abundance of meds in a psychiatric hospital was exactly the wrong treatment. Much of this was precipitated on my daughter because psychiatrists are reluctant to diagnose BPD in kids – this was a real disservice to my daughter.

    Another important facet of my daughter’s continuing recovery is that she is a “planner” and always sets goals for herself. Early in her treatment the psychiatrist at Menninger’s told me this was a very hopeful sign. When she was 10 she was scheming about some new pet, goat, horse idea and I joked with her by asking “could you just stop dreaming up things for 24 hours.?”! She replied in the most serious tone – ‘I’m always happiest when I’m planning new things.” Little did I know that this thought process of her would pull her through so many very dark days.

    1. Wow. Reading your comment as an avoidant borderline, I felt touched by your story. Thanks for the extra hope I’m now feeling.

  2. I was diagnosed borderline no 4 or thereabout at no 9 I would have to be hospitalised I never found what no 4 means any ideas as I’m still searching but can’t find any answers

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