Borderline Personality Disorder in Men: Signs, Symptoms & Treatment
Borderline personality disorder (BPD) in men is diagnosed less frequently than it is in women. Unfortunately, this means much of the information you’ll find about BPD is focused on how it shows up in women. But men may experience BPD slightly differently from women. One reason for this is the different gender norms that influence men’s and women’s emotional lives. Boys sometimes learn to hide sadness and fear, or that anger is acceptable but vulnerability isn’t.
Pressures of masculinity may also prevent men with BPD from seeking help for their mental health. This might explain why men receive fewer diagnoses of borderline personality disorder. There is still a great deal of effective support out there for men with BPD. To help men and their families understand BPD and how to access that support, this page will cover:
- What borderline personality disorder is, and where the diagnosis came from.
- BPD symptoms in men.
- The causes of BPD, including childhood trauma and genetics.
- Why men receive fewer BPD diagnoses than women.
- Self-support strategies and treatment options for male borderline personality disorder.
What Is Borderline Personality Disorder?
Characterized by instability in relationships, rapid mood changes, and fear of abandonment, borderline personality disorder (BPD) is a mental health condition that affects one’s sense of self and others.[1]
BPD’s name was coined when psychiatrists in the 1930s noticed some people showed symptoms of multiple conditions but not enough to be diagnosed with any single one. Instead of being mostly psychotic or anxious, they were thought to be on the “borderline.”[1] The name has stuck, even though it doesn’t describe the condition very well.
This is still true today, with BPD often co-occurring with:
- Depression.
- Anxiety.
- Post-traumatic stress disorder (PTSD).
- Eating disorders.
- Psychotic conditions.
These overlaps can make diagnosis difficult and even call into question the diagnosis of BPD itself.[1]
For example, borderline personality disorder is often associated with childhood trauma. Many experts suggest that BPD could be a delayed PTSD response and that it should be regarded as such.[1][2] This debate is ongoing, and there are researchers and clinicians who believe BPD should be reclassified entirely.
Symptoms of Borderline Personality Disorder in Men
The core symptoms of BPD are the same for both men and women. However, the condition does seem to present differently in males and females. For example, men with BPD are more likely to experience intense anger, antisocial behaviors, interpersonal aggression, and substance abuse, perhaps because these expressions are often more socially accepted in men.[3][4]
With BPD in men, symptoms tend to be outward-focused. These are in contrast with the more inward-focused BPD symptoms commonly reported by women, such as feelings of emptiness and sadness.[5][3]
Nevertheless, many men will still experience these inward-focused symptoms, even if they lead to different behaviors or coping mechanisms. A man might feel intense emptiness but express it through drinking instead of talking about it. The sadness is there, but it just looks different from the outside.
Instability in Relationships
Relationships can be unstable for men with BPD for several reasons. One is that they’re more likely to experience feelings of emptiness and therefore find it difficult to be alone. This may mean that they heavily invest in friendships and romantic relationships to feel fulfilled.[6] They might move very fast in relationships, or become intensely attached to someone they’ve just met.
Additionally, BPD can cause someone to amplify normal annoyances and disappointments in relationships. They can misinterpret and exaggerate other people’s intentions and actions, feeling that they are more grievous than they actually are.[6] For example, a friend running late or a partner not texting back straight away becomes proof they don’t care.
At the root of many BPD relationship problems is a fear of abandonment. This may stem from childhood experiences, which make men:[6]
- Scared of rejection.
- Desperate for social acceptance.
- Frequently lonely.
If a parent left, or was emotionally unavailable, or was inconsistent in their love, the child learns that people leave. That lesson then stays with them into adulthood.
Simultaneously, people with BPD often idealize their relationships because they deeply hope they will soothe their internal insecurities and fears. Family members, friends, and romantic partners may feel that someone with BPD absolutely adores and cherishes them, only to be villainized at a later date. This back-and-forth is due to feelings of love and disappointment being amplified.[6]
Instability in Mood
As we’ve described, men with BPD will experience extreme reactions and fluctuations in their emotions towards people. This pattern also applies to the rest of their lives, whether it’s towards themselves or experiences at work. Typical emotional symptoms include intense:[6]
- Anger.
- Emptiness.
- Sadness.
Emotional dysregulation in men with BPD often looks like anger. When emotions feel unbearable, alcohol and drugs offer temporary relief. Many men with BPD develop substance problems as a way of managing feelings they don’t know how to handle any other way.[6]
Self-Harm and Suicidality
Suicide and self-harm can be a nonverbal way of expressing distress and a need for help. Men with BPD may use self-harm as a way to combat intense feelings of hurt, anger, or emptiness, and they’re more likely than average to attempt suicide.[6]
Self-harm might also be a way to feel something when emotions become numb, or to punish oneself for perceived failures. Men are less likely to talk about self-harm, which means it often goes unnoticed.
Transient Psychosis
When they experience extremely high levels of stress, men with borderline personality disorder can sometimes experience symptoms of psychosis. These can be visual and auditory hallucinations or delusions, which are distorted beliefs about the world, themselves, and others.[1][6]
Crucially, however, psychosis in BPD is transient and will pass when stress levels decrease. Temporary psychosis does not mean that someone has schizophrenia.[1]
Independence and Grandiosity
One key difference between men and women with BPD is that their internal motivations result in different stressors. For example, research finds that men with BPD are significantly affected by the stress of losing employment, while for women with BPD, it is relationship problems.[3]
The researchers suggested that while women are motivated more by relationships and connection, men tend to report a high need for independence. This may explain why a loss of employment affects men with BPD so strongly.[3]
In addition, research finds that BPD in men often overlaps with narcissism, a personality disorder that is more common in men.[5]
Narcissistic personality disorder is often a response to emotional neglect or enmeshment in childhood. The ego forms an extremely strong sense of confidence to protect the child from low self-worth. Male borderline personality disorder may present as narcissism, which shows up as grandiosity and entitlement, despite a low sense of self-worth underneath.[5]
What Causes BPD in Men?
Although many people with BPD have grown up in stable and caring families, childhood deprivation remains one of the main risk factors for this condition. Growing up with neglect, abuse, and instability in relationships with family members creates conditions that are more likely to result in BPD.[1][6]
Research into men with BPD found that many reported that their caregivers in childhood would respond to their emotional distress with rejection or punishment, which are types of emotional abuse.[3] When a child cries and gets yelled at, he learns that his emotions are wrong. When he’s scared and gets ignored, he learns that no one will help. These lessons can shape how he relates to emotions for the rest of his life.
Genetics can also be at play for men with BPD. They could have a predisposition to struggle with regulating mood and anxiety levels or be more vulnerable to stress than the average person. This is found in scientific studies that examined the brains and stress responses of people with BPD.[6]
Is BPD Less Common in Men?
Between 1-2% of people in the US will receive a BPD diagnosis, but three times as many women are diagnosed.[6]
Experts suggest that this difference isn’t due to men being less biologically prone to BPD but because we view men and women differently.[2] For instance, if someone has suffered historical abuse, women may receive a BPD diagnosis, while men may be diagnosed with PTSD.[2]
However, girls are more likely to be sexually abused in childhood than boys, and sexual abuse is most commonly linked with BPD compared to other types of abuse.[4] This could be a further explanation for why more women are diagnosed with BPD.
Another reason for the discrepancy is that women might be more likely to seek help for their mental health than men.[4] This suggests that equal numbers of men and women could be experiencing BPD, but men are living without professional support.
Mission Connection is here to help you or your loved one take the next steps towards an improved mental well-being.
Men’s Mental Health: Treating Male Borderline Personality Disorder
Support for male borderline personality disorder can take many forms, but it’s essential that any mental health treatment understands the key features of BPD. We will explore three types of therapy, each with its own focus for treating BPD, though there are many therapeutic approaches that can be useful.
We’ll also explore the self-support strategies men can try alongside professional treatment to manage the symptoms of borderline personality disorder:
Counseling and Psychotherapy for Borderline Personality Disorder in Men
Counseling approaches for men with BPD include:
- Mentalization-Based Therapy: Many aspects of BPD come under the umbrella of problems with mentalization. Mentalization means understanding that other people have their own thoughts, feelings, and motivations, and that you can’t always know what they are.
Sense of self, impulsivity, relationship problems, and emotional dysregulation in men all connect with mentalizing, an ability that develops in childhood. Mentalization-based treatments aim to improve someone’s ability to mentalize.[7]
This involves developing an attachment to a therapist and openly talking about the dynamic that arises between you. The therapy will teach a perspective of “not knowing” what another is thinking, cultivating patience, accepting different perspectives, and challenging negative assumptions about what other people are thinking. This approach supports people with BPD to navigate future relationship difficulties.[7]
- Dialectical Behavior Therapy (DBT): Emotional regulation, stress tolerance, interpersonal skills, and mindfulness are at the center of DBT. Similar to CBT, DBT provides practical skills to cope with distressing events, communicate in relationships, and regulate intense emotional reactions. Underneath this work is the idea that people deserve to have a positive relationship with themselves and that they’re capable of positive change. DBT was originally developed for BPD, and it has strong evidence for reducing self-harm and suicidal behavior.
- Trauma-Focused Therapy: As explained, men with borderline personality disorder are highly likely to have experienced trauma in their lives. Trauma-focused therapy helps men with BPD make sense of their experiences and how they’re impacting them in the present. Many trauma-focused therapies will also provide helpful coping skills like regulating the stress response and challenging the core beliefs that childhood trauma often imposes.
Men with BPD may also benefit from certain medications or short inpatient stays. These more intensive approaches can help stabilize men in crisis and reduce the intensity of symptoms. There’s no single medication for treating BPD, but mood stabilizers and antidepressants can get certain symptoms under control.[8]
Self-Support for Borderline Personality Disorder in Men
Though it’s essential that men with BPD receive professional mental health treatment, there are several things they can do alongside it to manage symptoms in daily life. For example:[3]
- Learning to seek support before reaching a crisis point.
- Having someone other than a romantic partner who you can rely on for emotional support.
- Practicing good self-care with exercise and nutrition.
- Learning a mindfulness practice to be in the moment and reduce stress levels.
- Learning to recognize unhelpful and harmful thinking patterns.
- Practicing pausing before acting on strong emotional impulses.
- Refraining from alcohol, drugs, and other activities that worsen mental health.
Flexible Treatment That Works Around You
Available from anywhere in California, Virginia, and Washington!
See our Locations
Find Therapy for Borderline Personality Disorder in Men With Mission Connection
BPD is an incredibly disruptive and distressing mental health condition that affects daily life, work, relationships, and identity. Alongside the symptoms of BPD, many men may live with unprocessed traumatic memories and pressures not to seek help.
At Mission Connection, our team of licensed mental health professionals goes beyond traditional treatment and provides life-changing care. We offer several options for effective outpatient treatment, including in-person programs at our locations in California, Virginia, and Washington, virtual telehealth, and a hybrid program that combines in-person and virtual care.
We create a personalized, structured care plan for every patient that consists of evidence-based therapies (CBT, DBT, and trauma-informed approaches) and medication management (when appropriate).
Mission Connection is Joint Commission-accredited. We also accept most major insurance providers, so that your recovery is not hindered due to financial issues.
If you’re looking for treatment for BPD in men, get started online or call us at 866-833-1822 to find out how we can support your long-term recovery. Our compassionate team is available 24/7 to answer your questions and provide guidance with no obligation.
