Histrionic Personality Disorder: Signs, Symptoms and Treatment

Histrionic Personality Disorder

Histrionic personality disorder is one of the ten personality disorders. It is characterised by emotional overreaction, seductive or flirtatious behaviour, and constant attention-seeking.

Histrionic personality disorder

People with histrionic personality disorder tend to overreact or over dramatise certain situations, often leading to depression and severe dysfunction in their relationships.

Undiagnosed and untreated

Studies show that many people with histrionic personality disorder (HPD) often go undiagnosed and untreated since the symptoms of this disorder overlap with other personality disorders, including narcissistic and borderline personality disorder.

Individuals with HPD tend to be highly influenced by others (highly suggestible) and susceptible to many external factors.

Histrionic personality disorder definition

Histrionic personality disorder gets recognised in the DSM 5 (diagnostic and statistical manual) as a ‘’cluster B’’ disorder.

The following marks specific characteristics that get associated with the cluster B personality disorders:

  • Dramatic
  • Erratic
  • Overly emotional

Characteristics

Suppose you suspect that a loved one or someone close to you might have a histrionic personality disorder. 

In that case, you may notice that the person often displays attention-seeking behaviours, fluctuating moods and shallow emotions. 

However, such traits may also signify another disorder or be a part of the person’s natural temperament.

Statistics

People with histrionic personality disorder can often be profoundly manipulative and experience discomfort when they are not the centre of attention.
Generally, histrionic personality disorder affects around 2-3% of the overall population and approximately 9% of Americans.

Personality disorders and pop culture

In recent years, many personality disorders, such as narcissistic and histrionic, have been somewhat sensationalised by the media.

For example, suppose you have been following the recent Johnny Depp and Amber Heard defamation trial. 

In that case, you may have heard about histrionic personality disorder since Ms Heard was diagnosed with the condition.

Other personality disorders

Additionally, a narcissistic personality disorder is another condition that has received much media attention in recent decades, especially within specific online communities and social media platforms.

Although the terms get thrown around often, personality disorders are profoundly complex, and many factors lead to a diagnosis.

Signs and symptoms

It can be challenging to discern an HPD diagnosis from other personality disorders.

Additionally, those with a histrionic personality disorder may believe that their thoughts, emotions and behaviours are natural and rarely seek professional help.
However, there are distinguishable features of HPD that can determine an accurate diagnosis allowing those with the disorder to receive proper support and treatment.

Symptoms

The symptoms of histrionic personality disorder include:

  • Rapid shifts in mood, beliefs and opinions, people with HPD are also highly influenced by other peoples’ opinions.
  • Needing an audience for angry or dramatic outbursts – people with HPD tend to enjoy other people witnessing their dramatic or emotional displays to get validation or attention.
  • Exhibiting excessive albeit shallow emotions and attention-seeking behaviours – those with HPD tend to put on a ‘’performance’’ to get the attention they crave.
  • Exaggerating physical symptoms of disease or body weakness and using suicide threats to cause worry or manipulate other people.

The definition of personality

A helpful definition of personality you may find valuable is how the human personality reflects deeply innate patterns of behaviour – such as how you relate to others, yourself, and the world.

Although not necessarily pathological, characteristics and traits are discernible features of personality. 

However, some personality types may cause impairment or personal issues.

For example, personality disorders can involve inflexibility or rigidness and maladaptive behaviours, thoughts and emotions.

The above may cause disruption, dysfunctional impairment and profound distress to the individual.

Personality disorders

People with histrionic personality disorder frequently feel neglected and unappreciated when they are not the centre of attention.

Thus, people with HPD tend to engage in certain behaviours to get the attention they desire – this may include:

  • Exhibiting excessive emotionality
  • Self – dramatisation and theatricality
  • Constantly seeking attention or approval from others.

Social situations

Those with HPD can be outgoing, energetic and lively individuals who enjoy being the ‘’bell of the ball’’ in social situations.

Like narcissists, people with a histrionic personality disorder may appear charming, open and enthusiastic when meeting new people.

However, due to the emotional fluctuation symptomatic of the condition, people with HPD can oscillate between openness and outright flirtation to sobbing uncontrollably or having temper tantrums.

Risk factors

A study from the Epidemiological on Alcohol and Related Conditions reported that those with histrionic personality disorder are at risk of substance use disorders by around 1.84 per cent. 
Other studies show that people with histrionic disorders may be at higher risk for suicidal thoughts.

Histrionic - Borderline Personality Disorder

Histrionic personality disorder and borderline personality disorder

There has been a lot of discussion within the mental health community about whether histrionic and borderline personality disorder (BPD) are different conditions due to an overlap in symptoms.

Overlap in symptoms

Some experts believe that BPD and HPD may not be different conditions.

Research shows that although BPD and HPD share similar features like rapid shifts in emotions, attention-seeking and manipulative behaviours, other traits separate the conditions.

Shared symptoms

However, borderline and histrionic personality disorders share similar symptoms such as:

  • Strong expressions of emotion
  • Impulsive behaviour
  • Reactive and rapidly shifting emotions

Experts say that although such disorders share common symptoms, the quality and depth of symptoms set the conditions apart.

For example, how someone with HPD experiences rapidly shifting emotions may not be as profound or intense as those observed in BPD patients.

Causes

Experts do not yet know the exact cause of histrionic personality disorder. 

However, similar to other mental health disorders, it is thought that the condition may be caused by a mixture of environmental and genetic factors.

It is possible that genetic influences may put you at risk of developing a personality disorder and that a traumatic experience or adverse life event may trigger the condition.

Additional factors 

Other factors that may increase your risk of developing histrionic personality disorder include:

  • Childhood trauma
  • Parents or caregivers who exhibit volatile or dramatic behaviours
  • Inconsistent or over-indulgent boundaries set by parents or caregivers
  • A family history of mental illness or substance abuse

Treatment options

Treatment options for histrionic personality disorder usually include individual therapy, psychotherapy and medication.

Histrionic personality disorder can be challenging to treat due to many people seeking treatment at the later stages, usually when their condition begins to cause them profound distress.

Psychotherapy

Psychotherapy is a type of talk therapy that helps increase a person’s self-esteem and can reduce the distress of histrionic personality disorder symptoms.

Psychotherapy is also an effective treatment for histrionic personality disorder.

Experts say that supportive psychotherapy is the best treatment option for histrionic personality disorder as this approach focuses on building coping skills, enhancing self-esteem, and reducing emotional distress.

Concurrent disorders

HPD can also co-occur alongside other personality disorders, including narcissistic personality disorder, borderline personality disorder, dependent personality disorder and somatic symptom disorder.

Journey to recovery sign

Getting in touch

If you suspect that you or someone you know may have any of the symptoms mentioned in this article, contact one of our specialists who can help.

The Centres for Health and Healing specialist team are always on hand to offer support and guidance for those who need it – contact a team member today.

Lisa Davies - Program Director of Vaughan Recovery and Kirby Estate

About Lisa Davies

Lisa is the Program Director at Centres for Health and Healing. She lived for most of her life in the Durham region, before moving to Peel five years ago.

Lisa is a Master Hypnotist and is certified in Hypnotherapy (2008), Self-Hypnosis and in 5-phase Advanced Therapeutic Healing. As a Member of National Guild of Hypnotists, she is also specialized in hypnosis training in pediatrics, pain management, neuro-linguistic and stage programming.

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