Female Problems: Controversy in BPD – Part 5

Myth: Only women have BPD, it’s female disorder. 
That’s not to say that BPD isn’t diagnosed more often in women. It certainly is with a 3:1 ration or approximately 75% of people diagnosed with BPD are women. But men have it too. There are a lot of theories about why women are diagnosed with BPD more often:
          Sexual abuse, which is common in histories of BPD patients happens more often to women than men.
This in itself is debatable. Women tend to report these things more often, but does that mean men don’t have a similar frequency?
          Women experience more inconsistent and invalidating messages in this society.
Fortunately I think this is beginning to change, but there’s still a ways to go. And it doesn’t make up for the fact that women have been treated differently than men for most of documentable history. Especially in recent decades of greater communication women have had strong messages of how we’re supposed to act, behave, look, dress, take care of others, etc. imposed upon us… and any deviation from these cultural norms has not been met with open acceptance.  We’re often told it is acceptable to be one way, but when we are it is met with negativity and sentiments of being difficult and different.
          Women are more vulnerable to BPD because they are socialized to be more dependent on others and more sensitive to rejection.
This goes along with the cultural norms imposed upon women. Personally I was taught independence to a fault, and railed against the conflicting messages of the control my parents tried to assert.  I hate the idea of being dependent on anyone. Functionally, in terms of my job, my finances, the day to day aspects of my life this holds true and anyone that questions my ability to do these things is met with a rather volatile response. I hate the idea of emotionally dependent as well. I hate it. I hate it more that this is something that I can’t control when it comes to the people I get close to and involved with. The magnitude of emotional attachment that comes with BPD is part of what makes it a disorder in the first place. Becoming dependent on someone for emotional validation does make the idea of rejection so scary. Especially when there is a tendency for black and white thinking, splitting. If you do one thing wrong, you’ll lose the love and caring of that person. If they reject one thing, they’ll reject all things, and all that will be left is loneliness and abandonment. It’s not rational, but what about this disorder really is? It’s what it feels like that makes it so devastating.
          Clinicians are biased. There have been studies that show professionals tend to diagnose BPD more often in women than men, even when patient profiles are the same.
It’s not that men aren’t diagnosed with anything, their diagnosis is just different. Men tend to display symptoms differently and meet some criteria for paranoid, passive-aggressive, narcissistic, sadistic,
and antisocial personality disorders, which leads to a diagnosis of these even when BPD is a more accurate diagnosis. Since BPD has a feminine association, it’s ruled out for men almost automatically.
          Men seek psychiatric help less often.
It’s hard to diagnose someone with something when they don’t seek help for a problem. I can’t tell you how many guys I know that refuse to even go to the regular doctor when they’re ill, let alone seek therapy. I think it has to do with a culturally cultivated concept of the male ego and how men are supposed to behave. But I could be wrong.
          Men are more likely to be treated only for their major physical presenting symptoms, not necessarily the emotional associations that correspond to them. Their BPD symptoms go unnoticed because it’s assumed to be a woman’s disorder.
          Female borderlines are in the mental health system; male borderlines are in jail.
While Acting In and Acting Out are major issues for anyone with BPD, women acting out still tends to be directed towards themselves or of a magnitude that is not so outwardly destructive. Men tend towards aggression and act out towards other people leading to different consequences.
* I was incredibly destructive and explosive. I absolutely took out my problems on myself. However I constantly picked fights with my family, explosive screaming arguments, I broke down doors, put my fist through windows and walls…though these things weren’t the kind of thing that could get me thrown in jail. However, the vandalizing, drinking, shop lifting all could have.
          There has simply been very little research specifically investigating the occurrence of BPD in men.
This couples with men seeking psychiatric help less often. It’s very difficult to form a study when you don’t have a target group to focus on. It also couples with the fact that men are diagnosed and treated with potential inaccuracy so those men where BPD does present are overlooked.
So, it’s not that Borderline Personality Disorder is only a women’s disorder it’s, again, given a biased perspective. It make me sad really, that there are so many misconceptions and biases in the mental health field. It’s getting better. In the past it was taboo, not something to ever be talked about or admitted. Today it’s pretty common to seek therapy, for men and women. There’s still a ways to go though. Part of my goals for doing this blog are to increase awareness and education for Borderline Personality Disorder. I’m in no way a clinician, but I know how I’m affected, how some people in my life are affected, and I am happy to do A LOT of research to futher my own process of change. Knowing what I’m/we’re up against, options, information, treatments… simply that we’re not alone in this struggle, is encouraging. Hopefully, and it seems to be so, others find this useful as well.
Tomorrow I’ll talk more about the difference in presentation of BPD symptoms in men vs. women.
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5 comments on “Female Problems: Controversy in BPD – Part 5

  1. I for one have learned so much from your blog. I started my own for similar reasons. I could not agree more with all you have said here. How can they say one is more than the other when there are no true studies to prove it. I think another factor is that men are taught to suppress their emotions which causes them to just explode in one big explosion. Then they end up in jail instead of diagnosed. Women tend to have smaller explosions because women are seen as emotional and aren't necessarily forced to bottle as much up. Where do you get your research from? Is it an online source or books or ??

  2. I get my research from both actually. I read a lot of psych journals and periodicals on-line (from psych communities I've registered with), check out BPD sites, done a lot of book research and reading (I have a small library + my roommate has her Masters in Psychology so I have access to her reading material as well), my therapist recommends books for me too, and we talk about stuff pertaining to BPD so she shares her knowledge with me. No to mention a lot of it is just how I relate and my personal experience of it all. I write, journal and record everything.

  3. i'm sure it is under reported in men, but i wouldn't doubt that it is still prevalent in women. on average, the brains of men and women are wired slightly differently and i guess one of the secondary effects of the wiring is more of a predisposition to certain disorders and personality types.on a related note, i found it fascinating that fMRI scans showed that BPDs store memories differently – positive ones in one hemisphere and negative ones in the other, neurotypicals have memories spread evenly around.

  4. ::nods:: I plan to talk about why there's a difference and what guys tend to be diagnosed with tomorrow. But yeah, there's definitely some different behavioral wiring. I was just reading about how areas of the brain in BPDs are developed differently in certain areas of the brain the correlate to emotional regulation and impulse control. I'd be very interested to read/see whatever it is that showed how BPDs store memories differently. Having them stored in different hemispheres would certainly account for why Splitting is such an issue.

  5. 'i found it fascinating that fMRI scans showed that BPDs store memories differently – positive ones in one hemisphere and negative ones in the other, neurotypicals have memories spread evenly around.'dang, that would be an interesting read. thanks Res.

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