Borderline personality disorder (BPD) in men often includes drastic shifts in mood and experiencing one’s emotions with great intensity. While BPD is characterized by instability in mood and impulse control, men with BPD may display symptoms of narcissism, antisocial behaviors, or extreme anger. Furthermore, they may be more likely to engage in substance use, self-harm, and suicidality.
Find a supportive therapist that can help with BPD.
BetterHelp has over 20,000 licensed therapists who provide convenient and affordable online therapy. BetterHelp starts at $65 per week. Take a Free Online Assessment and get matched with the right therapist for you.
What Is Borderline Personality Disorder?
Borderline personality disorder (BPD) is characterized by challenges with interpersonal relationships, seeking new experiences, intense emotional sensations, quick shifts in mood (“acting hot and cold”), feelings of emptiness, and uncertainty about one’s identity. There are four different subtypes of BPD, and symptoms can vary depending on the individual.
BPD Symptoms in Men
Borderline personality disorder in men includes a variety and combination of BPD symptoms such as intense anger, antisocial behavior, substance use, suicidal ideation or attempts, and novelty seeking. Despite typically exhibiting more aggressive behaviors than women with BPD, men more commonly go either misdiagnosed or undiagnosed altogether.
Symptoms of borderline personality disorder in men may include:2
- Difficulty in relationships
- Displays of intense anger
- Aggression
- Impulsive behaviors
- Uncertainty and difficulty with sense of self
- Novelty seeking,(i.e. substance use and other risky behaviors)
- Self-harm behavior
- Suicidal ideation
- Extreme sadness
- Quick shifts in mood
8 Signs of Male Borderline Personality Disorder
Although a person of any gender may experience similar symptoms, there are signs of BPD that are more prevalent in men, including intense displays of anger, antisocial behavior, and substance use, among others. This is possibly due to a man’s propensity to engage in externalizing behaviors, compared to a woman’s tendency to internalize BPD symptoms.2
Below are eight potential signs of BPD in men:
1. Displays of Intense Anger
More so than their female counterparts, men with BPD struggle with extreme anger, explosive episodes, aggression, and violence. Research suggests this may be due to deficiencies in an area of the brain known as the lateral prefrontal cortex, which is responsible for sending signals that calm the parts of the brain that respond to perceived threats.3
2. Antisocial Behavior
One study found that antisocial personality traits–such as lying, lacking empathy, and disregarding right and wrong– occurred in 57% of men versus 26% of women.1,4 Antisocial behaviors may be signs of BPD when they are done in an effort to avoid abandonment (e.g., conning someone to get them to stay in a relationship with them) or as a means of demonstrating intense anger towards someone else (e.g., bullying or engaging in physical altercations).
3. Substance Use
Men with BPD are significantly more likely to abuse substances than women.1,5 Those who engage in such behaviors tend to experience negative affect, alexithymia, and dissociation.2 They may use substances as a way of coping with these and other symptoms, as impulsive behavior, or as a means of self-harm, all of which are common in those with BPD.
4. Impulsivity
Impulsivity is a core symptom of BPD and involves engaging in risky or careless behaviors without consideration of long-term consequences. Whereas women with BPD may engage in this behavior through eating or dieting habits, men with BPD are more likely to act out against others or use substances.5,6 Additionally, while these behaviors are common for BPD patients, some experts believe that impulsive BPD is its own subtype
5. Self-Harm Behavior
Self-harm is a common symptom of BPD, affecting 65-80% of people with a diagnosis.7 In men, self-harm can take many forms, including cutting, burning, punching (oneself or objects), and head-banging. These actions may serve a variety of functions such as garnering a sense of agency or distracting from emotional pain. They could also be due to one believing they are deserving of punishment.
6. Suicidality
Like self-harm, suicidality (both thinking about and acting on the desire to complete suicide) is characteristic of BPD and may serve a variety of functions (e.g., escape from reality, chronic emptiness, hopelessness, and feelings of worthlessness). Men with comorbid unipolar depression or bipolar disorder are twice as likely to commit suicide compared to women with BPD.2
7. Unstable Relationships
Men with BPD may form insecure attachments, making their dependency, insecurity, and fear of abandonment known to loved ones. This may manifest as revenge-seeking behaviors or aggression toward friends when feeling left out. Men with BPD may also engage in BPD splitting, which involves viewing others as all “good” or all “bad.” Additionally, males may have an unstable relationship with themselves, sometimes resulting in frequent career changes and/or rapidly changing interests
8. Narcissism
Men with BPD are more likely to experience symptoms of vulnerable narcissism and grandiose narcissism.8 While these symptoms may be indicative of a comorbid narcissistic personality disorder (NPD) diagnosis, they may also be an attempt to cope with an unstable sense of self or sensitivity to others’ criticism or rejection.
Help For BPD
Talk Therapy – Get help living with Borderline Personality Disorder from a licensed therapist. Betterhelp offers online therapy starting at $65 per week. Free Assessment
BPD Treatment For Teens & Young Adults – Charlie Health’s virtual mental health program for young people (ages 11-33) includes curated peer groups, individual therapy, and family therapy for teens and young adults with serious mental health issues. Insurance accepted. Learn More
DBT Skills Course – DBT is a popular treatment for BPD. Learn DBT skills with live weekly classes and online video courses. Free Trial
Why BPD in Men Often Goes Undetected
Oftentimes, BPD goes underdiagnosed or undetected in men for a number of reasons, and research shows that women with BPD are three times more likely to receive an accurate diagnosis than men.9 This may be due to a number of factors including gender differences in clinical presentation, clinician bias, and variations in the treatment settings.
BPD in men may be overlooked for reasons such as:
- Clinical presentation: Gender differences in the presentation of symptoms may lead to men’s symptoms being disregarded or attributed to an entirely different issue (i.e., substance use disorder).
- Clinician bias: While findings on clinician bias are mixed, one possible explanation for men’s underdiagnosis of BPD is that clinicians perceive intense anger in women as diagnostic, whereas for men they view it as characteristic of masculinity.9
- Treatment utilization: Men with BPD are less likely to utilize psychotherapy and pharmacotherapy services than their female counterparts.1 Thus, willingness or opportunity to use treatment services may contribute to different rates of BPD diagnoses given among men and women.
Treatment Options for Male BPD
There are multiple borderline personality disorder treatments that can be utilized for men with BPD. Generally, dialectical behavior therapy (DBT) for BPD–a structured treatment involving individual therapy, skills group, and phone coaching– is the front-line method chosen by practitioners. DBT emphasizes learning and implementing skills such as mindfulness for BPD, distress tolerance, emotion regulation, and interpersonal effectiveness. Due to the social and genetic components of BPD, involving loved ones in a person’s treatment plan through family therapy can optimize its outcomes.1o Some patients may also benefit from medications for BPD to help with symptom management.
Unfortunately, men are less likely to pursue treatment than women due to the negative stigmas associated with mental health. Oftentimes, men feel that they must live up to certain social masculine expectations, resulting in a subconscious resistance to seeking help. If you are struggling with the negative symptoms of BPD, you should consider choosing a therapist who specializes in BPD by exploring an online therapist directory.
Final Thoughts
While BPD may feel hard to manage, with education and support there are certainly ways to move forward and build a successful life. Following an effective treatment plan and involving your loved ones in your journey are two steps to help you find relief from BPD symptoms.
Additional Resources
Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.
Talk Therapy
Online-Therapy.com Get support and guidance from a licensed therapist. Online-Therapy.com provides weekly video sessions and unlimited text messaging with your therapist for only $64/week. Get Started
BPD Treatment For Teens & Young Adults
Charlie Health’s virtual mental health program for young people (ages 11-33) includes curated peer groups, individual therapy, and family therapy for teens and young adults with serious mental health issues. Insurance accepted. Learn More
Free BPD Newsletter
A free newsletter from Choosing Therapy for those impacted by BPD. Get helpful tips and the latest information. Sign Up
DBT Skills Course
Jones Mindful Living Dialectical Behavior Therapy (DBT) is a popular treatment for BPD. Learn DBT skills with live weekly classes and online video courses for only $19 per month. Free One Week Trial
Choosing Therapy Directory
You can search for therapists by specialty, experience, insurance, or price, and location. Find a therapist today.
Best Online Therapy Services
There are a number of factors to consider when trying to determine which online therapy platform is going to be the best fit for you. It’s important to be mindful of what each platform costs, the services they provide you with, their providers’ training and level of expertise, and several other important criteria.
Best Online Psychiatry Services
Online psychiatry, sometimes called telepsychiatry, platforms offer medication management by phone, video, or secure messaging for a variety of mental health conditions. In some cases, online psychiatry may be more affordable than seeing an in-person provider. Mental health treatment has expanded to include many online psychiatry and therapy services. With so many choices, it can feel overwhelming to find the one that is right for you.