Borderline Personality Disorder (BPD) in Men

Borderline personality disorder (BPD) is a mental health disorder characterised by extreme emotions, a debilitating fear of abandonment, patterns of unstable and intense relationships, and more [2]. Due to societal expectations for men to suppress their emotions, BPD can often manifest as angry outbursts, aggression, and impulsiveness. 

BPD is challenging to navigate for those who suffer from it, causing a chaotic and difficult-to-manage inner world. This often makes day-to-day life challenging and can create strained, volatile relationships for the person suffering from it. 

This disorder is also understudied, with studies that do exist being more geared towards females, or involving both female and male BPD being studied the same way [1]. This is an issue as men often display symptoms of BPD differently than women, mainly as a result of unhealthy social norms for men to be “less emotional”.

However, the good news is that BPD in men is treatable with talk therapy like CBT and DBT, and other complementary therapies such as art therapy and medication. If you or a loved one are struggling with BPD, help is available. 

Signs and Symptoms of BPD in Men

BPD in males shows up differently than in women. Men are more likely to struggle with anger and impulsivity, in contrast to women, who are most likely to experience more mood swings and self-harming behaviors. 

Men with BPD are also more likely to become addicted to drugs or alcohol, while women are more likely to suffer from co-occurring mood or eating disorders. 

Because men with Borderline Personality Disorder often feel pressure to be less emotionally expressive due to societal expectations, the signs and symptoms of BPD can also be more challenging to detect. They are less likely to seek help, resulting in fewer diagnoses. However, there are common symptoms that men with BPD experience, sometimes silently, which can indicate the presence of this disorder. 

Symptoms of BPD in men include:

Extreme fear of abandonment or rejection

People with BPD often have an overwhelming fear of being left, which can lead to clinginess, frantic efforts to keep relationships, or extreme distress over perceived rejection.

Unstable and intense relationships

Relationships tend to be highly emotional and volatile, with individuals alternating between idealizing (putting someone on a pedestal) and devaluing (seeing them as terrible) a person, often leading to frequent conflicts and breakups.

Identity crisis

A shifting self-image causes people with BPD to struggle with who they are, what they want, and how they see themselves, leading to frequent changes in goals, values, or personal interests.

Impulsive behaviors and risk-taking

Many engage in reckless behaviors like substance abuse, binge eating, unsafe sex, or impulsive spending, often as a way to cope with emotional distress.

Mood swings

Emotional states can shift rapidly within hours or a day, moving from deep sadness to irritability, anxiety, or intense happiness without an apparent external cause.

Feelings of emptiness

Many with BPD experience a chronic sense of inner void or numbness, leading them to seek external validation or engage in risky behaviors to feel something.

Inappropriate anger and aggression

Anger in BPD can be explosive, difficult to control, and often disproportionate to the situation, leading to outbursts, verbal aggression, or even physical altercations. This is particularly common in Borderline Males. 

Paranoid thoughts and dissociation 

During stress, some individuals may experience brief paranoia (believing others are against them) or dissociation (feeling disconnected from reality or their own identity), which can make situations feel surreal or dreamlike.

While these symptoms can be intense and often debilitating for those struggling with BPD, treatment is often effective in managing it. Many individuals with BPD who receive treatment can live a full, stable life. 

Somatic Illness

People with BPD often experience physical symptoms potentially as a result of high cortisol (stress hormone). This causes physical distress such as obesity, diabetes, gastrointestinal disease, cardiovascular disease, hypertension, chronic pain, infertility, and sexually transmitted infections [7]. 

Post-Traumatic Stress Disorder (PTSD) and Borderline Personality Disorder

Studies show that up to 80% of people diagnosed with BPD will also experience PTSD symptoms. While separate disorders, PTSD and BPD share many traits. Individuals who experience traumatic events such as physical, sexual, or emotional abuse in childhood are at risk of developing PTSD and BPD simultaneously [3].  

The combination of these two disorders is tough to navigate, increasing the severity of both PTSD and BPD symptoms, as well as reducing the effectiveness of treatment. However, proper treatment such as DBT talk therapy administered by a licensed clinician can still make a considerable impact on quality of life for those struggling with both of these disorders. 

How are PTSD and BPD the same?

PTSD and BPD share the following similarities:

• Linked to a history of trauma: Both PTSD and BPD often stem from traumatic experiences, particularly childhood trauma, which shapes emotional and behavioral patterns.
• Difficulty regulating emotions: Individuals with PTSD and BPD struggle with intense emotional responses, frequently experiencing mood swings, anxiety, and emotional outbursts.
• Difficulty controlling impulses and risk-taking: Both disorders can lead to impulsive behaviors, such as self-harm, substance abuse, or reckless decision-making, often as a way to cope with emotional distress.
• Hypervigilance and paranoia: PTSD and BPD can cause heightened sensitivity to perceived threats, leading to distrust, paranoia, and exaggerated reactions to stress.
• Issues with self-image and dissociation: Both conditions can involve identity disturbances, feelings of emptiness, and episodes of dissociation, where individuals feel disconnected from themselves or reality.
• Difficulty managing relationships: People with PTSD and BPD often struggle with unstable relationships due to fear of abandonment, trust issues, and intense emotional responses to interpersonal conflict.

How are PTSD and BPD different?

PTSD and BPD are different in the following ways:

• Cause: PTSD is directly linked to a traumatic event such as combat, assault, or accident. BPD is often associated with early childhood trauma but is also influenced by genetics and temperament.
• Core Issue: PTSD revolves around re-experiencing trauma and fear-based symptoms, while BPD is characterized by chronic emotional instability and difficulty maintaining relationships.
• Flashbacks & Nightmares: PTSD commonly involves flashbacks and nightmares directly related to past trauma. In BPD, dissociation and intrusive thoughts may occur, but vivid flashbacks are less common.
• Fear vs. Anger: PTSD symptoms are primarily fear-based, triggered by reminders of past trauma. Borderline personality disorder involves intense emotional swings, including fear of abandonment and episodes of anger.
• Identity Issues: PTSD does not typically cause identity disturbances, though trauma can affect self-perception. BPD, on the other hand, is marked by chronic instability in self-image and a fragmented sense of self.
• Interpersonal Relationships: PTSD may cause individuals to withdraw from relationships due to fear, guilt, or shame. BPD is characterized by extreme fluctuations in relationships, swinging between idealization and devaluation of others.
• Self-Harm & Suicidal Behaviors: While self-harm and suicidal thoughts can occur in PTSD, they are not a defining feature. In BPD, self-harm and suicidal behaviors are core symptoms and a significant concern.

Relationships with BPD Males

Because BPD heavily impacts how individuals experience relationships, it can be difficult to navigate for both the individual struggling with BPD, and their loved ones. BPD is often expressed differently in men than in women, including how they operate in relationships.

Men with BPD in a relationship have a hard time regulating their anger, and can cycle between displays of intense affection and hostility. Constant fear of abandonment is also a strong theme for those with BPD. They may lash out at their partner or another person when they’re worried their partner is going to leave. At a perceived abandonment, they may resort to angry outbursts or threaten an affair and push the other person away [5]. 

Men with BPD struggle with the following issues when it comes to relationships:

• Emotional instability
• Fear of abandonment
• Impulse control and risk taking
• Stability and consistency
• Intense anger

Being in a relationship with someone who has borderline personality disorder can be romantically intense at times, and highly combative at others. However, with the right support and communication, people with BPD can thrive in healthy and fulfilling relationships.

Comorbidities, Complications, and BPD

BPD often co-occurs with other mental health disorders, which can intensify symptoms and make treatment more complex. Studies show that up to 97% of individuals with borderline personality disorder also experience other mental health disorders. This means that only a small minority of patients with BPD only have BPD and no other psychiatric disorders. 

Many times, symptoms of other disorders can overlap with BPD, which can cause clinicians to misdiagnose a patient. If you suspect you or a loved one has BPD but haven’t been diagnosed, it may be beneficial to receive a second opinion to rule out the possibility.

Common co-morbid disorders of BPD include:

• Anxiety Disorders
• Mood Disorders
• Substance Abuse
• Eating Disorders [6]

Other complications that can co-occur with Borderline including:

Substance Use

It is well known in the psychiatric community that BPD often co-occurs with substance use disorders (SUDs). Studies show that about 25% of people struggling with substance use also suffer from Borderline Personality Disorder. Most often, the substance(s) of choice for BPD patients are opioids, alcohol, and cocaine [Springer Nature]. 

Self-Harm

For those with BPD, self-harm is often used as a way to cope with their overwhelming thoughts and feelings. Cutting, burning, or otherwise injuring themselves is a common experience. Suicidal thoughts are also common. These self-harming behaviors are typically triggered by feelings of rejection, abandonment, or disappointment in someone close to them. 

Signs of Self-Harm

If your loved one has BPD and you suspect they are harming themselves, it’s important to know what to look for. Here are the signs of self-harm in men with BPD:

• Unexplained injuries: Cuts, burns, or bruises, often on arms, thighs, or torso.
• Covering up wounds: Wearing long sleeves or pants, even in hot weather.
• Frequent “accidents”: Giving vague or inconsistent explanations for injuries.
• Emotional instability: Intense mood swings, impulsivity, and extreme distress.
• Expressions of self-hatred: Verbalizing feelings of worthlessness or hopelessness.
• Social withdrawal: Avoiding friends and family or isolating after conflicts.
• Other self-destructive behaviors: Substance abuse, reckless actions, or suicidal ideation.
• Difficulty managing distress: Using self-harm as a coping mechanism for overwhelming emotions.

Treating BPD in Men

Men with Borderline Personality Disorder often go untreated because of a lack of diagnosis or a misdiagnosis. This is frequently due to societal expectations for men to suppress extreme emotions and discourage reaching out for help. However, once men with BPD get the help they need, they are able to live much happier, more fulfilling lives. 

Treatment for BPD in men is similar to women, with a potential behavioral focus more on angry outbursts and impulsivity. Talk therapy is the main treatment protocol, in addition to medication and other supplemental interventions such as breathwork and journaling. 

Treatments for Borderline in men include:

• Dialectical Behavior Therapy (DBT): A gold-standard therapy that helps with emotional regulation, distress tolerance, and improving interpersonal relationships. This is considered the most effective treatment for BPD. 
• Cognitive Behavioral Therapy (CBT): Focuses on identifying and changing harmful thought patterns and behaviors. This therapy helps break harmful thought cycles and improves the patient’s feelings of self-worth, and reduces black-and-white thinking. 
• Medication: While there is no specific medication for BPD, clinicians often prescribe medications to help patients deal with co-occurring disorders like depression and anxiety. These medications include antidepressants, mood stabilizers, and antipsychotics.
• Group Therapy & Support Groups: Men with BPD often feel alone in dealing with their feelings and have a hard time opening up. Group therapy provides a safe space for camaraderie, emotional expression, and skill-building.
• Lifestyle Changes: Exercise, mindfulness, and structured routines help manage symptoms. Setting boundaries and learning effective communication also allow those with BPD to experience the joy of healthy relationships. 

Get Treatment for BPD at Connections

If you or a loved one are struggling with BPD, effective treatment is available. At Connections, we offer world-class mental health treatment for BPD and other co-occurring mental health disorders like anxiety, depression, and addiction. 

Our home-like inpatient facilities offer a modern, safe place for stabilization and healing. Our six-client max creates an intimate, personalized space for effective recovery from Borderline in men. Our highly qualified and experienced clinical team cares deeply for our patients, and will ensure that you or your loved one gets the best care possible. 

We also work with a wide range of insurance plans to help cover up to 100% of the costs of treatment. We also assist clients in getting their affairs in order, like work leave, etc., so they can have peace of mind before attending our program.

Call our mental health counselors today for help overcoming BPD at 844-759-0999.

Sources

[1] https://www.sciencedirect.com/science/article/abs/pii/S0165178117303578 

[2] https://www.mayoclinic.org/diseases-conditions/borderline-personality-disorder/symptoms-causes/syc-20370237

[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC11515767/

[4] https://psychiatryonline.org/gun-violence/doi/full/10.1176/appi.ajp.160.11.2018

[5] https://psychcentral.com/pro/exhausted-woman/2017/02/an-interesting-mix-male-borderline-personality-disorder#3 

[6] https://pubmed.ncbi.nlm.nih.gov/30447726/

[7] https://pmc.ncbi.nlm.nih.gov/articles/PMC9135625/#:~:text=A%20Swedish%20national%20study%20reported,diagnosis%20%5B9%E2%80%9311%5D.

[8] https://my.clevelandclinic.org/health/diseases/9762-borderline-personality-disorder-bpd