Robert Fischer M.D.

Failure to Launch

Personality Disorders

Young Men with Borderline Personality Disorder (BPD) Traits

Who they are, and how we can help them.

Posted Aug 18, 2015

Dollar Photo Club, used with permission
Source: Dollar Photo Club, used with permission

Young men ages 17 to 28 who exhibit symptoms of Borderline Personality Disorder face uniquely difficult obstacles in getting treatment. For one, these individuals are often overlooked in treatment settings as having BPD, or they never get help for their illness at all.

On the other hand, BPD is traditionally viewed as a hard-to-treat disorder in women. It seems the complexity of treating women with Borderline Personality Disorder has left little consideration for treating their male counterparts, or even any surety that the treatments found to be successful for women will have the same result for men.

Thirdly, societal perspectives regarding what's acceptable behavior for women versus men potentially prevent the borderline male from seeking out treatment. For example, while it has virtually always been understandable for a young woman to require assistance with emotional insecurity or relationship instability, young men are not as equally welcomed to step up and ask for help in such areas.

Perhaps you're still getting over your surprise that men with borderline personality disorder actually exist. They do. Yes, historically, BPD was thought to be more common in women; however, current research reveals a different gender pattern. There appears to be very little variance in the prevalence rates between the two genders. In short, BPD affects women and men about the same.

Now, we've discussed some of the factors that interfere with treatment for the borderline male. Let's discuss what the general composition of a young man with BPD might resemble.

The research leans towards a combination of genetic and environmental factors that ultimately influence the manifestation of BPD. Some aspects of the disorder appear to be inherited. Furthermore, those with diagnoses of BPD largely report traumatic childhood experiences, such as rape, abuse, or surviving other violent crimes. But, trauma isn’t always as severe.

Consider the following scenario for a young man entering treatment for BPD: His parents had a highly volatile relationship because of his dad’s unskillful ways of managing his stress. The kids witnessed countless fights, and there was an anxious and invalidating environment within the home. The parents end their relationship in an acrimonious divorce, and all parties feel estranged, depleted, and alienated from themselves and others. 

The conditions that result in young adults feeling invalidated and alienated present in many forms. Perhaps the common thread is a sense of intense anxiety managed in unskillful ways and a sense that compromise cannot be achieved. A sense of rigidity and black-and-white thinking many times manifests as indirect communication, expressed at times in an impulsive and hurtful manner. 

After many years in such an environment or having had experienced traumatic events outside of their home, young adults may experience a sense of hopelessness about changing unskillful behaviors. Many attempt to deal with their anxiety by utilizing external substances or by carrying indirect communication to the extreme by simply lying and beginning to create their own reality. They themselves become easily agitated, distracted, and find themselves in a web of their own creation, which seems to support further invalidation of their love and their wish simply to find joy and peace, as we all do.

In our experience, life is far more complex. Individuals don’t typically represent all of the criteria expressed in any diagnosis, and even when that is present, each individual has his or her own unique composite of gifts and liabilities. In the end, it is through these gifts and through the acceptance and understanding of our liabilities that we move forward. 

In our experience, we see many families of young adult men with BPD who are dysfunctional, but the level of dysfunction is minimal. Sometimes the trauma, the immersion into a world of insensitivity, of impulsivity, and the unskillful expression of both passion and anger may be present and have occurred outside of the home. Many times, this comes to the attention of parents after many months or years of these behaviors occurring, but it is certainly not helpful to look back. It’s far more important to move forward.

Many of the men we have seen are sensitive and gifted. We’ve worked with musicians, actors, and artists—certainly not stereotypical aggressive, sociopathic, and dangerous males. That is not to say that in the overall spectrum, there are not males who, in fact, behave in this manner, and there are many, many more who do not. 

The same goes for the pejorative, negative, and frightening connotation of aggression and of the virulent projection of chaos stereotypically assigned to women with BPD, and certainly, there are some women who manifest these behaviors, but in reality, there are “shades of grey,” and many more young adult women who do not.

There are also cultural differences in attitudes toward mental health regarding males and females. They cross diagnostic classifications in terms of their abilities to express internal emotions, attitudes toward sexuality, and so on. Within each diagnostic category, there is a vast spectrum of presentations, and in reality, each person is quite honestly, truly, unique.

So, if you know a young adult male who appears to be unhappy, easily agitated, irritable, not succeeding in moving forward, and meeting some of the criteria and/or traits of BPD, there is help available that will enable these young men to find a life worth living.

References

At the Roanne Program for young adults with Borderline Personality Disorder and BPD traits, we intensively integrate DBT and offer compassionate, clinically sophisticated intensive residential help, including genetic testing to determine the best course for medications, if needed.