Histrionic Personality Disorder

Written by Carmella Wint | Published on August 20, 2012
Medically Reviewed by George Krucik, MD

What Is Histrionic Personality Disorder?

Histrionic personality disorder (HPD) is a condition that is a part of a larger group of psychological disorders, called dramatic personality disorders.

People with HPD have a distorted mental image of themselves. They often base their self-esteem on the approval of others. This creates a need to be noticed. Because of this, people with histrionic personality disorder may resort to dramatic antics.

Women are diagnosed with HPD more often than men, but that may be because men report their symptoms less often than women.

What Causes Histrionic Personality Disorder?

The exact cause for histrionic personality disorder is unknown. Psychiatrists believe it is an outcome of both environmental and genetic factors.

Some families have a history of HPD, which lends credit to the theory that the condition is caused by genetics. On the other hand, children of parents with HPD may also simply be exhibiting behavior they learned from their parents. It is also possible that a lack of discipline or positive reinforcement as a child can cause HPD. A child may learn HPD behaviors as a way to get attention from their parents.

No matter the cause, HPD usually presents itself by early adulthood.

Recognizing the Signs of Histrionic Personality Disorder

Histrionic personality disorder is not a devastating psychological disorder. Most people with HPD function successfully in society and at work. In fact, people with HPD usually have great people skills. Unfortunately, they often use these skills to manipulate others.

According to the American Psychiatric Association’s guidelines, a person should display five of the following symptoms to be diagnosed with HPD (APA):

  • be uncomfortable or unhappy if not the center of attention
  • be overly seductive or sexual
  • have emotions that change very quickly
  • use physical appearance to draw the attention of others
  • talk in a way that lacks detail and relies on personal impressions
  • use very theatrical expressions
  • be very suggestible or influenced by the opinions of others
  • believe personal relationships are more intimate than they really are

The Cleveland Clinic states that those with HPD may also be easily frustrated or bored with routines, make rash decisions before thinking, or threaten to commit suicide in order to get attention (Cleveland Clinic).

Diagnosis of HPD

There is no specific test that is used to diagnose HPD. If you are troubled by your symptoms and seek medical care, your doctor will likely begin by taking a complete medical history. He or she may perform a physical exam to rule out any physical problems that might be causing your symptoms.

If your doctor doesn’t find a physical cause for your symptoms, he or she may refer you to a psychiatrist. Psychiatrists are specifically trained to recognize and treat psychological disorders. A psychiatrist will be able to use expert questions to get a clear view of the history of your behavior. An accurate assessment of your behaviors will help your doctor diagnose you, using the APA guidelines.

However, most people with this condition do not believe they need therapy or help, making diagnosis difficult. According to the National Library of Health, many people who have HPD receive a diagnosis after they go into therapy for depression and anxiety, usually following a failed relationship or other personal conflicts (NLM).

Treatment of HPD

Treatment can be difficult if you have histrionic personality disorder. People with HPD often don’t feel they need treatment, or they find the routine of a treatment program to be unappealing to them. However, therapy (and sometimes medications) can help a person with HPD.

Therapy

Psychotherapy is the most common and effective treatment choice for HPD. This kind of therapy involves talking to a therapist about your feelings and experiences. Such talks can help you and your therapist determine the reasoning behind your actions and behaviors. Your therapist may be able to help you learn how to relate with people in a positive manner, instead of continually trying to get attention from them.

Medication

If you experience depression or anxiety as a part of your HPD, your doctor might put you on anti-depressants or anti-anxiety medication. These drugs are potentially addictive, so it is not advised that you stay on them for a long period of time.

Long-Term Outlook for a Person with HPD

Lots of people with HPD lead normal lives, and are able to work and be a part of society. In fact, many people with HPD do very well in casual settings and encounter problems only in more intimate relationships. Depending on your case, your HPD may affect your ability to hold a job, maintain a relationship, or stay focused on life goals. It also may cause you to constantly seek adventure, putting you into risky situations.

You are also at a higher risk for depression if you have HPD. The disorder can affect how you handle failure and loss, and make you more frustrated when you do not get what you want. You should talk to your doctor if you feel that you have symptoms of HPD, especially if they are interfering with your everyday life and work, or your ability to lead a happy, fulfilling life.

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