Histrionic personality disorder (HPD) is part of a larger group of psychological disorders called “Cluster B” personality disorders. Disorders in this category cause a person to be overly dramatic, emotional, or erratic.
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 HPD may resort to dramatic antics.
Women are diagnosed with HPD more often than men. That may be because men report their symptoms less often than women.
HPD 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 Diagnostic and Statistical Manual of Mental Disorders (5th edition), people with histrionic personality disorder have at least five (or more) of the following symptoms:
- Is uncomfortable in situations in which they are not the center of attention
- Has interactions with others characterized by inappropriate sexually seductive or provocative behavior
- Displays rapidly shifting and shallow expression of emotions
- Consistently uses their physical attention to draw attention to self
- Has a style of speech that is excessively impressionistic and lacking in detail
- Shows self-dramatization, theatricality, and exaggerated expression of emotion
- Is suggestible (that is, they are easily influenced by others or circumstances)
- Considers relationships to be more intimate than they actually are
If you have HPD, you might also be easily frustrated or bored with routines, make rash decisions before thinking, or threaten to commit suicide in order to get attention.
The exact cause of histrionic personality disorder is unknown. Scientists 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 may be explained in part by genetics. On the other hand, children of parents with HPD may simply exhibit behavior they learned from their parents. It is also possible that a lack of discipline or positive reinforcement of dramatic behaviors in childhood 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.
There is no specific test that is used to diagnose HPD. If you are troubled by your symptoms and seek medical care, your primary care provider will likely begin by taking a complete medical history. They may perform a physical exam to rule out any physical problems that might be causing your symptoms.
If your primary care provider doesn’t find a physical cause for your symptoms, they 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 primary care provider diagnose you.
However, most people with this condition do not believe they need therapy or help, making diagnosis difficult. Many people who have HPD receive a diagnosis after they go into therapy for depression or anxiety, usually following a failed relationship or other personal conflicts.
Treatment can be difficult if you have HPD. Like many people with HPD, you might think you don’t need treatment, or you might find the routine of a treatment program to be unappealing. However, therapy — and sometimes medications — can help you cope with HPD.
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.
If you experience depression or anxiety as a part of your HPD, your primary care provider might put you on antidepressants or antianxiety medication.
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. Many of them only encounter problems 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 may also 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. It can also leave you feeling more frustrated when you don’t get what you want. You should talk to your primary care provider if 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.