“Just before I turned 38, I finally received a diagnosis for borderline personality disorder (BPD). I began dialectical behavior therapy (DBT) with a bunch of beautifully brave and deeply empathetic women. For the whole year of the therapy, I was the only guy in a group of up to eight, and at the end of each module, I would ask my facilitators with a hopeful, childlike upward inflection if there were any men in the next intake. And every time, there wasn’t. Something in me felt like a limb was missing, and I realized that men were not getting the treatment they so desperately needed.
For men living with BPD, there is often a sense of being alone in the shadows. This was amplified by an initial misunderstanding that the disorder was predominantly female (by 3-to-1, according to the DSM-IV), despite recent studies showing a more equal distribution. How could there be just as many of us and yet I’m the only guy in my DBT group for a year?
These questions are really life-and-death-level important given that, according to an Australian meta-review of suicide and mental disorders, the risk of suicide in BPD is 45 times higher than the general population. I imagine that those men who, unlike me, are not being treated or can’t accept their diagnosis are in urgent mortal danger. As a man with this often-brutal illness, which nevertheless has high recovery and remission rates, my heart breaks for my BPD brothers. I long for a way to get them help in a safe space which allows them to move towards acceptance and change. I may be very different from the stigmatizing stereotype of the antisocial, substance-abusing, angry BPD man, but I imagine that our acute core feeling of abandonment accompanied by overwhelming, rapidly changing emotions are similar among other shared symptoms. “
