The hit movie Fatal Attraction brought the clinical diagnosis of Borderline Personality Disorder (BPD) into public consciousness. Of course the character “Alex,” as played by Glenn Close, represented an extreme example of BPD, but it’s probably safe to say that since then every woman who’s been told she has BPD lives in fear that others will look at her and see a homicidal and suicidal nut case.
The truth is that, although BPD is very real as a diagnosis, there are very few “Alexes” in the world. Also, the past decade or so has seen the emergence of treatment techniques aimed at helping women with BPD manage their emotional instability, enhance their self-esteem, and become more successful in relationships.
Men with BPD: Misdiagnosed, Mistreated
What about men? Is BPD a diagnosis that applies to women, but not men? Are we men somehow “immune” to BPD. Not at all. In fact, BPD is probably as prevalent in men as it is in women. The problem is that the symptoms associated with BPD, when they manifest themselves in a man, are often attributed to such things as “antisocial personality disorder,” “substance abuse disorder,” or “impulse control disorder.” These men are most often shuffled into treatment programs for “anger management” or substance abuse. And depending on just how much trouble they get into they may very well spend some time in jail. By failing to accurately diagnose these men, we fail to help them understand the roots of their difficulties, and we send them down blind alleys seeking help.
Signs of BPD in Men
So, if BPD in men (BPD) exists, what are some of the signs and symptoms associated with it? Here they are:
- ..He is subject to unpredictable mood changes. His mood can change from anger to excitement to depression in a flash, often for no apparent reason.
- ..He is critical and judgmental of others, but can also be very self-critical.
- …He has a hard time letting go of grievances.
- …He is deeply distrustful and easily slighted. He is "thin-skinned" and reacts to the slightest criticism with anger.
- …He has difficulty sustaining close friendships.
- ...He can be self-destructive, for example by abusing alcohol or drugs, being reckless, or neglecting his health.
- …He seeks constant attention and approval, sometimes by exaggerating problems or fishing for compliments.
Are you now, or have you been, in a relationship with a man who fits the above description? If so, the first thing you need to know is that BPD is not a one-size-fits-all diagnosis--in men or women. Rather, BPD exists on a spectrum. In other words, BPD can vary, from mild to severe, with the differences accounted for largely by past experience (but that's the subject for another post).
You can estimate for yourself just how well the above symptoms describe the man you love by ranking each one from 0 (not at all) to 10 (completely). It’s rare for a man to score above 60, and if he does he may need professional help in order to get hold of his BPD. In this most severe form, BPD causes men to burn out those who care for them. No matter how much these people may have loved them, they often finally give up. But this is a minority of men with BPD—the tip of the iceberg.
The vast majority of men with BPD will fall in the 35-50, or moderate range, and some will manifest only mild signs of BPD. Hardly any men, however, have scores of 0, since that would mean that they are totally immune from all insecurity—that is, too good to be true. As is true for women, the vast majority if men with BPD are not unlovable—rather, they can be hard to love.
A Way Out
Men with mild to moderate BPD can often help themselves overcome it. A necessary first step, however, is for a man to be able to be honest with himself—to look through the above description of BPD and decide if he fits somewhere on that spectrum, be it mild or severe.
It also helps if one or more people who are closest to him understand that BPD exists and what its symptoms are. They can then be in a position to do some things (and avoid doing others) that can help a man break free of the unhappiness that BPD brings to his life.
Future posts will explore BPD further, along with some of the solutions that BPD men have found most useful.
Joseph Nowinski, Ph.D. is a clinical psychologist and author of Hard to Love: Understanding and Overcoming Male Borderline Personality Disorder.