Low -vs- High Functioning BPs

What’s the Differences? What is the difference between "high functioning" and "low functioning" BPs? For instance, someone said cutting indicated low functioning. What about job instability, raging, or promiscuity, for examples?

While those with BPD come in all ’shades’, there are two extremes of the continuum, which are often designated ’low functioning’ or ’high functioning’. Disclaimer: The management states: Please know that the following information is to be taken as general information only and not an indictment of any of the professions listed. ;-)

Indicators of low functioning BPD: cutting and other self mutilation, excessive risk taking, which may include numerous and near fatal traffic accidents, extreme addictions, and sex addiction (for example getting caught by police on several occasions in public places, promiscuity at an early age), heavy duty involvement with psychiatric institutions and frequent hospitalization, successive non completed suicide attempts, inability to maintain employment, extreme instability in personal relationships, assaulting others, beginning pre-puberty or early adolescence and often early and prolonged involvement with criminal justice system and prisons. Most of the children seen in group homes and psychiatric institution with a history of the above, including cutting and self mutilation are female more often than male and may have a diagnosis of one of the personality disorders.

Raging appears to be a behavior of all those with BPD traits, all across the continuum. The intensity may vary some, but it is a constant. It may be more problematic with low functioning, as they have less inhibition control and are more prone to rage in public and in front of many witnesses. Both low and high functioning borderlines can be extremely physically dangerous, even if they have not acted out in this way before.

High functioning are the ones who "fool everyone" into thinking that they are ’Mr. or Ms. Wonderful’, and reserve the extreme BPD behaviors for their partners or children. On the surface they appear to function well in the majority of areas their lives. They are frequently psychiatrists, social workers, clinical therapists, or otherwise involved in the caring industry. A second sub-set do very well in the military/prison system or customs where they are in control of those around them, in positions like: military officers, police officers, prison guards or customs officers.

These careers can and often do offer lots of rewards and reinforcement for black and white thinking, splitting, and an excessive need for power and control over others. The criminal or the speeder is the ’bad guy’ and they (BPD) are therefore ’the good guy’. What they do is ’right’, therefore they are ’good people’. These professions offer lots of positive reinforcement for BPD behaviors and patterns as well as places for excessive control over others to be tacitly or actively rewarded.

High functioning may rage only in front of their significant other. In fact many keep it so well hidden that Non’s are not believed when they tell friends and family what is happening. Job instability may or may not be present in high functioning, but is usually found in low functioning. Those who are high functioning may choose professions where their behavior will be rewarded or seen as ’normal’ in the context of that profession. They mask their problems better, and are very good a moving from place to place in a ’logical’ or ’justified’ manner.

If the BP in your life fools everyone but you and maybe one or two others, they are usually high functioning. Those who are truly low functioning are obviously very disturbed and families get a lot more support from their communities than those who are high functioning. There is some debate among many therapists that high and low are actually two separate illnesses, linked by similarities of behaviors and attitudes.

The new version of the DSM may vary the ’label’ towards another framework called ’dyslymbia’, which presupposes that BPD is caused by a combination of life trauma along with a predisposed or genetic lack of some neurotransmitters (such as serotonin) within the brain. The word is still out on which way that one will go. I’m not all that much up on this new information yet, and doing more research for yourself is advised.

Hope this is of help.

Respectfully

Deedee