Internalizing and Borderline Personality Disorder (BPD)

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Internalizing means keeping your feelings or issues inside and not sharing your concerns with others. Internalizing is a symptom of several mental health disorders, but is frequently seen in borderline personality disorder (BPD), an illness characterized by extreme mood swings, erratic changes in self-image and behavior, and impulsivity.

Frequent internalizing is often linked to low self-esteem, loneliness, self-harm, and social isolation. Internalizing emotions can make you feel alone, depressed, misunderstood, and without anyone to relate to. People who have developed a pattern of internalizing often magnify and intensify their issues, causing them to feel attacked or alone, leading to outbursts, conflict, and/or suicidal ideation. ​

If you or a loved one are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

Internalizing in BPD

Usually, when we think of someone with BPD, we may picture someone with intense emotions and reactions. A typical person with BPD may get angry quickly, go into rages, and often has very tumultuous personal relationships.

However, instead, many people with BPD also internalize their feelings. While they still meet the diagnostic criteria for BPD outlined in the Diagnostic and Statistical Manual of Mental Illnesses (DSM-5), they may handle and display their symptoms differently than others. 

People with borderline personality disorder who internalize often aim to hide how much pain and sadness they are in. This maladaptive coping mechanism can cause them to spiral emotionally, leaving them to feel like they don't fit in, belong, or have meaningful connections to the outside world.

Those who internalize are often viewed as introverted, withdrawn, cold, and more stoic than others with BPD. They may spend a lot of time trying to control or rationalize their emotions but end up feeling out of control, which often makes their symptoms feel even worse.

Many with BPD may feel confident about themselves one day and feel incompetent the next. The intensity of this cycle tends to worsen for people who internalize because they feel they can't share their insecurities with friends or loved ones. 

Recovery

While BPD can be a debilitating, lifelong mental health disorder, it can be effectively managed with treatment. It is possible to break the habit of internalization and manage BPD symptoms in a healthier way. The first step is to find a therapist who specializes in treating borderline personality disorder.

BPD is often treated with psychotherapy. Cognitive-behavioral therapy and dialectical behavioral therapy are two common forms of psychotherapy used to successfully treat internalizing emotions and BPD.

In therapy, you will learn how to stay in the moment and will begin to challenge your thoughts of yourself and others. You will learn problem-solving and coping skills to help you manage intense feelings and urges, improve relationships, and prevent impulsive or destructive behaviors. Learning to share your vulnerabilities with others can help rebuild connections with loved ones—and help you heal.

In addition to therapy, your doctor may also recommend medications to treat your symptoms. While no medication has been approved to treat BPD specifically, some physicians opt to prescribe medication to help control comorbid anxiety, depression, and/or suicidal thoughts.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

A Word From Verywell

If you have borderline personality disorder and are struggling with internalizing emotions, it's important to see a therapist specializing in BPD. By outlining concerns, pinpointing common triggers, and learning new coping mechanisms, your internalization and other symptoms of BPD can be better managed, which can help improve your relationships with others—and yourself.

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Article Sources
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  1. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Illnesses, Fifth Edition. Arlington, VA, American Psychiatric Association. 2013. 

  2. National Institute of Mental Health. Borderline Personality Disorder. Updated December 2017.

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