Borderline Personality Disorder (BPD) in Men: Signs & Effects

Borderline personality disorder (BPD) is a mental health condition characterized by emotional instability. People with BPD tend to see things in black and white and struggle to understand their own and others’ feelings. The difficulty surrounding emotions often leads to intense and unstable relationships.

Historically, BPD has been recognized as more common in women. However, more recent research suggests that prevalence rates are not that different between men and women. Estimates suggest that 2.4% of men and 3% of women have BPD.

Despite prevalence rates potentially being similar across the board, much of the research and clinical evaluation of BPD is still based on female symptoms. However, it’s important to recognize how men might experience BPD. After all, borderline personality disorder in men can present differently.

Regardless of sex, borderline personality disorder affects your ability to manage your emotions. The specific ways BPD affects emotions may be different for men.

For example, men tend to be more outward with their symptoms, and women tend to be more inward. This can look like aggressiveness and impulsivity in men and sadness and suicidal thoughts in women. Men with BPD are also more likely to have substance use disorder. 

Here are some common BPD symptoms that anyone—including women—with the condition can experience and how they may manifest differently in men:

• Emotional instability: Intense mood swings may be displayed externally, like through anger and irritability, in men as opposed to more internally for women, like through sadness and a cycle of negative thoughts (rumination). 
• Impulsivity: Men might be likelier to practice harmful behaviors like substance abuse, reckless driving, gambling, or unsafe sex. They may tend to like new things, always be in search of the next best thing, and chase adrenaline.
• Intense and unstable relationships: People with BPD may fear abandonment. In a frantic effort to avoid abandonment, their relationships can be intense. This can look like starting and ending relationships abruptly or experiencing separation anxiety. 
• Identity disturbance: People with BPD may struggle with forming a stable sense of self, resulting in frequent changes in their careers, values, and relationships. 
• Difficulty regulating emotions: Men with BPD may express their emotional distress through anger and aggression more often than women. 
• Chronic feelings of emptiness: People with BPD may experience depression. 
• Minimization of symptoms: Men are less likely than women to seek help and therapy to address their BPD. 

Borderline personality disorder may manifest differently in men due to societal expectations and gender norms. Men might be taught or expected to act a certain way compared to women in everyday life, and these differences can be magnified in BPD symptoms.

BPD can greatly affect many aspects of someone’s life. Your relationship with family and friends may be affected. You may also experience challenges at work or with finances. These effects on life can happen regardless of your sex or gender.

People with BPD may experience more negative interactions with their friends and family. They might have difficulty forming and maintaining relationships with their peers or family members. This might be due to heightened sensitivity (which can make it harder to interpret social cues), severe emotional reactivity (an emotional response disproportionate to the actual situation), and fear of abandonment.

People with BPD may also experience hardships in the workplace. For many with the condition, work performance can decrease. This may partly be because BPD symptoms can negatively affect someone’s ability to make decisions about how they perform their tasks throughout the workday. People with BPD also tend to have less job security, change jobs more frequently, and have less support from co-workers. 

Finances may also be harder for people with BPD to keep organized and in check. This is largely because people with BPD spend more money than they should because of their tendency to be impulsive.

Being in a Relationship

Healthy relationships are possible for men with BPD; it takes self-awareness, communication, and support from their loved ones. Men with BPD can try to manage their emotional ups and downs by learning emotion regulation skills in therapy. With professional help, you can also address any underlying childhood trauma that may be the root of your fear of abandonment so you can learn healthier ways of communicating your needs to your partner. 

The belief that all men with BPD are abusive is not true. While BPD symptoms are connected to violent behavior, not everyone with these symptoms is necessarily violent or abusive. As the Domestic Violence Hotline points out, mental health conditions do not cause abuse. However, conditions like BPD may increase the risk of abusive patterns since mental illnesses affect different areas of a person’s life, including their relationships. 

Even if your partner has BPD, there is never an excuse for abuse. If your partner does not realize how much their actions are hurting you and is not seeking professional help, they might not be willing to change. If that’s the case, the abuse in the relationship can continue or worsen. At that point, it may be helpful to seek help for yourself, create a safety plan, and consider your options, including leaving the relationship.  

Furthermore, it is important to prioritize your own mental health and boundaries. That’s true in any relationship, and maybe especially so when you know your partner has a mental illness. It’s common to become a caregiver to someone you love, but you can’t pour from an empty cup. That’s why it’s important to practice self-care and set boundaries when necessary. 

Men with BPD tend to externalize their distress, which contributes to their likelihood of experiencing substance use disorder (SUD) and exhibiting signs of antisocial personality disorder (ASPD).

Substance abuse is a common result of BPD. When left unaddressed, substance abuse can turn into substance use disorder, a treatable mental disorder that affects a person’s brain and behavior so that they can’t control their use of substances like legal or illegal drugs, alcohol, or medications. Symptoms can be moderate to severe, with addiction being the most severe form of substance use disorder.

ASPD is a mental health condition that typically starts in childhood or adolescence. With ASPD, there is a pattern of disregarding or violating the rights of others. People with ASPD are often involved in criminal behavior and struggle to learn from their actions.

One study found that people with BPD and ASPD were likelier to have exhibited disruptive behavior in childhood, participated in violent crimes in adolescence and adulthood, and have traits of psychopathy. 

People with BPD may also experience depression and anxiety.

BPD can make you feel like your life is unmanageable. However, it is possible to manage BPD with psychotherapy, skills groups, and/or medication. 

Weekly individual psychotherapy with a therapist trained in mentalization-based treatment (MBT), dialectical behavioral therapy (DBT), transference-focused psychotherapy (TFP), or schema therapy (ST) can help identify and address BPD symptoms. Trauma-focused therapies can help address the underlying trauma or causes of BPD. 

Group therapy, such as DBT skills groups, can be helpful in learning positive coping skills to help manage emotional instability. There, you can learn techniques like mindfulness, interpersonal communication, and emotion regulation. DBT groups teach skills in a group setting, and you then continue meeting with an individual therapist to process what you’ve learned each session. 

While medications like mood stabilizers and antidepressants can help manage some BPD symptoms, there is no medication treatment shown to be helpful in treating BPD itself.

Support is out there for people with BPD. Support groups are available if you don’t feel ready to start seeing an individual therapist. These groups can help you find community and understanding as you continue to learn about BPD. The National Alliance on Mental Illness (NAMI) provides free peer-led support groups all over the country not only for the person with the mental health condition but also for their partners or family members. 

If you are experiencing a crisis or know someone who is, call or text the National Suicide Prevention Lifeline at 988 for free and confidential support 24/7.

If you are in a relationship and are in immediate physical danger, call 911. If you are feeling scared and unsure about your safety, contact the National Domestic Violence Hotline at 1-800-799-SAFE (7233) or by texting “START” to 88788 for confidential assistance from trained advocates.

Borderline personality disorder (BPD) is a mental health condition that has historically been thought to mainly affect women, yet newer research suggests it affects men virtually just as often. BPD makes it hard for someone to control their emotions.

Men with BPD are more likely to show their emotional instability through aggression and impulsivity and are less likely to seek therapy compared to women. However, men with BPD can learn techniques to manage their anger, adopt healthier ways of coping, and have healthy relationships with self-awareness, consistency, and support.