Borderline Personality Disorder With Atypical Traits in a 30-Year-Old Female: A Case Report

TL;DR

A 30-year-old woman with a history of trauma and PTSD showed atypical traits of borderline personality disorder, including high functioning and no self-harm.

Contribution

The paper presents a rare case of high-functioning internalizing borderline personality disorder with atypical features.

Findings

The patient displayed mature defense mechanisms like sublimation and altruism.

She showed strong occupational functioning and maternal caregiving behavior.

The case is classified as a high-functioning internalizing subtype of BPD.

Abstract

In this paper, we report an atypical presentation of borderline personality disorder (BPD) in a 30-year-old female with a history of childhood molestation and trauma and a prior diagnosis of post-traumatic stress disorder (PTSD). The patient was hospitalized due to anxiety, depression, and guilt over her relapse into alcohol use disorder. During her hospital stay, we diagnosed her with BPD based on psychiatric examination, clinical interviews, and patient history. While the patient exhibited some of the typical characteristics of BPD, such as an instability of interpersonal and romantic relationships, there were numerous findings that were atypical of BPD. These include a demonstration of mature defense mechanisms such as sublimation and altruism, high levels of occupational functioning, strong maternal caregiving behavior, and no history of self-harm. Further analysis of the patient’s personality traits helped us identify that this presentation could be best characterized as a high-functioning internalizing subtype of BPD as identified in prior literature.