Subcategories of People with BPD

People with the same BPD diagnosis can act quite differently. Researchers have been trying to categorize them for decades. One "real world,” subjective way is to divide them into three groups: 


  • Lower-Functioning/Conventional
  • Higher-Functioning/Invisible
  • Combination (a mixture of both styles)

No category is "better” than the other. Each category has four dimensions: coping techniques, co-occurring mental health issues, functioning, and impact on family members.

Mostly Lower-Functioning Conventional BPsMostly Higher-Functioning Invisible BPsCombination
Coping Techniques Self-harm and suicidal thoughts Criticism and blame of others far beyond the norm Anger, rages common to both
Willingness to Obtain Help Hospitalized or day/outpatient treatment Refuses help or attends therapy only when threatened More outpatient than inpatient
Co-occurring (Concurrent) Mental Health Issues Eating Disorders, Bipolar, or others that frequently bring them into treatment Narcissistic Personality Disorder, invisible to clinical community Substance abuse, depression common to both
Functioning Lower: May be disabled or often loses jobs Higher: usually employed and job performance doesn’t suffer Problems with coworkers may be common to both
Typical Family Member Challenges Finding and paying for treatment; parents often overburdened; exhaustion and burn-out Trying to convince the BP to get treatment, bewilderment, PTSD, losing confidence and self-esteem Difficulty setting limits common to both

You can find the full description and chat in Randi Kreger’s book on pages 37-40 in The Essential Family Guide to Borderline Personality Disorder: New Tools and Techniques to Stop Walking on Eggshells

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