Are Adolescent Boys and Young Men With Borderline Personality Disorder Being Under Diagnosed?

Are adolescent boys being sent down the wrong path toward a lifetime of marginalization and potential criminalization all because they are not being diagnosed with a personality disorder, such as borderline personality disorder?

According to the National Institute of Mental Health, borderline personality disorder (BPD) is more likely to be diagnosed in women than in men. BPD is marked by pervasive patterns of instability of interpersonal relationships, poor self-image, and mood dysregulation beginning in early young adulthood. Most individuals behaviorally manifest:

1. Frantic efforts to avoid real or imagined abandonment

2. Patterns of unstable and intense relationships, and

3. Impulsive actions that are self-sabotaging or self-damaging.

Women diagnosed and treated for BPD often go into therapy, and learn new coping behaviors that help to regulate their moods, establish better communication, and enhance their relationships.

The prevalence of BPD in adolescent boys and young men may be greater than recognized by most people entrusted with their care and guidance. Adolescent boys and young adult men are less likely to be diagnosed with BPD and more likely to be labeled as: anti-social, aggressive, defiant, violent, criminal, oppositional, hyperactive, or narcissistic.

Under-diagnosed adolescent boys are subsequently not treated for BPD, and may develop into men with severe emotional and behavioral problems. Adolescent boys with BPD-related behaviors are frequently marginalized by the educational system because of their inherent difficulties with authority figures, difficulty abiding by rules, recklessness, unstable relationships, and aggressive behaviors. Once these young men are ignored or put out by the educational system, they quickly fall through the cracks in society. They most likely end up getting into trouble, join gangs, experiencing serious addictions, commit violence and criminal acts. They are often unemployable and may eventually find themselves behind bars.

Parents, unaware of borderline personality disorder, often fail to spot the early warning signs. Parents frequently make the mistake of believing that their sons are just going through a "phase" with the hopes that they will soon mature out of it, only to discover years later that they do not grow out of it. They may have serious problems with impulse control or obsessiveness. And they may develop serious drug and alcohol addictions. Many suffer from the inability to finish school, hold down a job, or sustain healthy and meaningful relationships. Most are bright and creative, yet they often lack the ability to regulate their emotions, thus sabotaging their abilities to achieve success. They can easily become overwhelmed by negative, self-defeating thoughts, feelings, and behaviors, which undermines their confidence and ability to follow through with tasks or goals.

Commonly, men with BPD seem stuck in long-term patterns of self-sabotaging behaviors with underlying impulse control problems that contribute to serious addictions and addictive behaviors.With such dire long-term consequences for men living with BPD, more needs to be done to appropriately diagnose adolescent boys and young adult men early. When parents suspect that their son may be suffering from BPD, it is important to seek professional help so that they can be diagnosed and clinically treated. Early detection and treatment can drastically alter a young man's life, preventing him from needless suffering.

Evidence-based interventions early in life can help a majority of these young men avoid a path of rejection and hardship by giving them coping skills to manage their emotions, communicate their needs, and to help them sustain meaningful relationships. Two major evidenced-based therapeutic treatments have consistently shown good results with helping individuals diagnosed with BPD: Dialectical Behavioral Therapy (DBT) and Mentalization-Based Therapy (MBT). The research indicates that working with a DBT or MBT-trained therapist can be effective with bringing about positive changes in young men suffering from borderline personality disorder. Men, of all ages, struggling with borderline personality disorder can improve over time and live healthier productive lives.

Daniel P. David, MSW, invites you to learn more about male borderline personality disorder and other men's mental health issues and psychological treatments at: http://www.InnerManPsychology.com

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