According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), about 75 percent of people who are diagnosed with Borderline Personality Disorder (BPD) are women. There are a lot of theories about why this might be.

Some psychiatrists attribute this trend to genetic or hormonal reasons, associating BPD in women with severe cases of premenstrual tension. Others blame BPD on early-onset incest, other sexual abuse, or Post Traumatic Stress Disorder (PTSD). Other trauma, such as a devastating separation as the result of a death, rejection, or abandonment from a parent, could be the cause. And yet another theory is that women are simply diagnosed with BPD more often, while the symptoms in men simply go unnoticed, undiagnosed, or are mistaken for something else.

The sexual abuse theory tends to get the most attention. A study in the American Journal of Psychiatry found much higher rates of Borderline Personality Disorder – as well as PTSD – among women who experienced childhood sexual abuse. Incestuous abuse occurs approximately 10 times more often in women than men, and about 75 percent of women with BPD have been physically or sexually abused, according to the study.

Such early abuse tends to create a sense of victimization that can make it difficult for these women to trust men. It can also create the excessive preoccupation with sexuality and a damaged self-image that are characteristic symptoms of women with BPD.

Other theories about why BPD happens more often in women than men include the following:

• Borderline Personality Disorder happens more often in women because they are socialized to be more dependent on others (a symptom of BPD) and can be more sensitive to rejection.
• Mental health professionals and therapists who diagnose women with BPD may be biased. Studies reveal that clinicians are more likely to diagnose BPD in women than men, even in situations where patient profiles differ only in gender.
• Men are less likely to seek psychological help than women, making them less likely to be diagnosed.
• Men might be treated for alcoholism or substance abuse, whereas women are more likely to receive treatment for BPD.
• Men with BPD are more likely to end up in jail, while women with BPD end up in treatment centers and the mental health system.