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Do you or someone you know exhibit the following characteristics: frequent self-injurious behaviors (SIB), suicidal ideations or suicide attempts, frantic efforts to avoid real or imagined abandonment, unstable and intense interpersonal relationships that include alternating between extremes of idealization and devaluation, identity disturbance, impulsivity (acting before thinking), chronic feelings of emptiness, and inappropriate and intense emotions that are sometimes disproportional to the trigger? Many of these characteristics make up the term Borderline Personality Disorder (BPD). BPD tends to be a frequent diagnosis for females, primarily those females who have many of the above symptoms including frequent SIB and suicidal thoughts. Sadly, many males (adolescents and adults) also exhibit symptoms of BPD but are often misdiagnosed as Attention Deficit Disorder or oppositional defiant disorder. The key to identifying BPD in males is to look at the constellation of symptoms and the intensity of the emotions of the individual. This article will focus on highlighting male BPD symptoms and some of the red flags to look out for.

It can be very difficult to identify BPD in women much less men. In fact, BPD can become very confused with bipolar disorder I (mania and depression). Some research suggests that BPD is a disorder often identified and diagnosed mainly in women. Rarely is it ever diagnosed or even considered a diagnosis for a man. Why? Because the pre-established gender norms (that are limited) have made identifying symptoms of BPD difficult in men. This is why most males are misdiagnosed with oppositional defiant disorder, attention deficit disorder, conduct disorder, and even psychosis. As a result, it is important that we understand what BPD symptoms can look like in males. It is even more important to determine what BPD traits (symptoms of BPD) look like in adolescent males who cannot be diagnosed until age 18.

Psychologist Debra Mandel wrote a foreword for the book Hard to Love: Understanding and Overcoming Male Borderline Personality Disorder by Joseph Nowinski and highlighted a very important point which is:

“For years, psychology has been heavily saturated with attention on women and their relationships, as if the male gender didn’t matter. Tons of attention has gone toward understanding and diagnosing insecure and emotionally unstable women, both in the worlds of counseling and self-help. However, the male gender has been seriously short changed. Well, men too, can suffer from low self-esteem, insecurity, and enormous self doubt that can compromise the stability of their intimate relationships. Because we’ve tended to stereotype men as the ‘tough ones,’ we’ve missed the boat on understanding the complexity of their inner world.”

Red flags to look for include:

  1. Frequent romantic relationships (often too close together): Do you know a male who has been with tons of women? Did this guy feel guilty or did they feel admired? Believe it or not, some males with BPD symptoms will date multiple women (feel guilty later) and refuse to commit due to a fear of abandonment. Other males will “scare” their spouses away with their quick tempers, argumentativeness, and sometimes even physical aggression. An interaction with a male with BPD may include the individual saying any and everything to trigger their spouses anger. Their relationships may be frequent and too fast. Individuals with BPD tend to be emotional which is why some individuals pursue multiple relationships that begin too fast and end before you can blink.
  2. Drama laden behaviors and attitudes: Most of society, primarily men, would say that “women are dramatic.” Some women would agree. In fact, it is a natural thing for women to be emotional with all of the emotions and hormonal fluctuations. But for males, the drama would look at bit different. For example, I previous worked with a 13 year old male who would come to therapy idealizing me and his work with me almost all month until the final week of the month when he would become very detached emotionally and standoffish. He fluctuated between liking me and confiding in me, to rejecting my ideas and therapeutic support. During these “episodes,” he would also break up with a girl and pursue another. He would also reach out to old girlfriends via texting with the excuse that: “I didn’t end things right, I need to make it right.” This continued for years.
  3. Roller Coaster emotions, thoughts, and behaviors: Again, as stated above, most men are not dramatic but sometimes the way in which emotions are expressed can feel like multiple personalities. Men with BPD will often become “hot” and “cold,” change perspective quickly, or exhibit very angry and hostile emotions toward others. This is the type of person who will exhibit a consistent and stable pattern of behavior, perhaps even for a long time, and then quickly change into what seems like a completely different person. An example of this would be a teenager being a “daddy’s girl” one moment, and then later telling the father how awful of a person he is and how unfair his parenting is.
  4. Hot and Cold interactions with others:Some individuals with BPD really struggle with relationships and often have trouble with interpretation of comments, body language, and emotions. For example, a male with BPD might find it quite disturbing that his wife speaks to other men while in public. He might begin to behave oddly such as being emotionally distant, becoming easily angered, not openly communicating, or begin taking everything personally. This same man may later act as if nothing happened and instantly appear to be one of the most fair spouses you could ever have. The emotions of BPD are like a roller coaster at times and it can be difficult to determine what emotion the individual might exhibit from one moment to another.
  5. Frequent suicide attempts or SIB: It is a known fact within the world of psychology and psychiatry that individuals with suicidal ideations (i.e., thoughts), gestures, or threats will often use suicide as a way to manipulate their loved ones or somehow prove that they are “lovable.” For example, the man above on #4 might become so jealous of his wife talking to other men than he decides to tell his wife that he will kill himself if she does not refuse to talk to other men.In this case, suicidal thoughts, threats, or in gestures is used to manipulate someone else. However, there are individuals who are seriously considering suicide because the symptoms of BPD “causes” difficulties in various domains.The pain is so intensified including the fear of abandonment that suicidal thoughts may temporarily comfort the sufferer.
  6. Attention seeking behaviors: Some individuals with BPD (primarily adolescents with BPD traits) crave attention, even if it is negative. The loud attitude, the blatant and aggressive words, the criticism, the accusations of being unloved and abandoned all draw attention to the individual. Males who exhibit BPD traits will often cut themselves or harm themselves in some way and then draw attention to how they harmed themselves. Other males with BPD traits may engage in risky behaviors such as unprotected sex, having multiple mother of multiple children, domestically abusing his family, making threats to keep everyone afraid and confused, or entertaining a negative group of peers (e.g., gang involvement),
  7. Dependency/co-dependency: Co-dependency or dependency is often a very common symptom of BPD. As stated above, the fear of abandonment makes it difficult for individuals with BPD to maintain safe, healthy, an satisfying relationships. On the other hand, there may be times when someone connected to the individual with BPD begins to rely, emotionally and psychologically, on the individual with BPD. The relationship is dependent upon the other individual who may be just as (or more) emotionally and psychologically unstable.
  8. Anger outbursts but social charm: Many of us are used to hearing that sociopaths or narcissists are superficial, shallow, and manipulative. But we must also consider that an individual with BPD (who may also have other diagnoses) can become very angry to the point of manipulating situations or responding to confrontations/arguments inappropriately. Anger outbursts can occur more than we think in individuals with BPD.

 

What has been your experience with a male who exhibits BPD symptoms? Did you recognize them right way? Did you separate from them?

 

As always, I look forward to reading about your experiences.

I wish you well

 

References: 

K, Randi. (2014). The faces of male borderline personality disorder. Psychology Today. Retrieved online 5/12/2016 from, https://www.psychologytoday.com/blog/stop-walking-eggshells/201409/the-faces-male-borderline-personality-disorder.