Histrionic personality disorder is a relatively rare, oft-misunderstood condition that can undermine a person’s ability to live a productive and satisfying life.
What is Histrionic Personality Disorder?
Histrionic personality disorder (HPD) is one of 10 personality disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
These 10 personality disorders are grouped into three categories or clusters:
- Histrionic personality disorder is a Cluster B disorder
- The other Cluster B disorders are antisocial, borderline, and narcissistic personality disorders.
- The common feature among people with Cluster B disorders is that they tend to act dramatically, emotionally, and erratically.
Focusing specifically on histrionic personality disorder, this condition involves a persistent pattern of attention-seeking behaviors, as well as exaggerated displays of emotions.
At first, a person with HPD may come across as charming and exciting. However, their unceasing efforts to call attention to themselves and their inability to cede the spotlight to others can quickly become tiresome.
Signs & Symptoms of Histrionic Personality Disorder
To be diagnosed with histrionic personality disorder, a person must meet at least five of the following criteria:
- Experiencing discomfort in situations where they are not the center of attention
- Engaging in sexually seductive or provocative behaviors when interacting with others
- Undergoing rapid shifts in emotion
- Using their physical appearance to draw attention to themselves
- Speaking in a vague, general manner that emphasizes their feelings but lacks details or evidence for their opinions
- Expressing their emotions in a dramatic, theatrical, or exaggerated manner
- Being easily influenced by other people, trends, and fads
- Believing that their relationships are more intimate than they actually are
Moving from clinical criteria to everyday actions, someone with HPD may frequently:
- Spend a considerable amount of time and effort on maintaining their appearance, which can include excessive spending on clothes and exhaustive grooming regimens
- Become upset at even minor criticisms of how they look, or at photos that they don’t believe portray them in the best possible light
- Attempt to garner affection and approval through flattery and gift-giving
- Need constant external stimulation to stave off boredom
- Speak loudly and use ornate and/or provocative language to attract attention
- Act impulsively on hunches, intuition, or “gut feeling,” instead of thinking through the possible ramifications of what they’re about to do
- Take on additional work or launch new projects with great enthusiasm, yet quickly lose interest and fail to follow through
- Express frustration when not able to immediately get what they want
- React to relatively small setbacks with temper tantrums
Many people will occasionally exhibit one or more of criteria or behaviors listed in this section. But the DSM-5 emphasizes that infrequent or sporadic demonstrations of these symptoms would not qualify a person to be diagnosed with HPD.
When a person has histrionic personality disorder, the characteristics listed above will be the norm, not the exception. Without effective professional intervention, someone with HPD will be unlikely to change their behaviors, even after their actions have led to problems at home, at work, or in other important areas of life.
What Causes Histrionic Personality Disorder?
Experts have not identified a definitive cause of histrionic personality disorder, but they have determined that a person’s risk of developing this condition can be influenced by factors such as:
- History of abuse or neglect during childhood
- Overindulgent or inconsistent parenting
- Certain genetic variations
- Various medical and neurological concerns, including head trauma, brain tumors, and Huntington’s disease
Gender may also be a risk factor, as women are diagnosed with HPD more frequently than men are. However, some experts have suggested that this imbalance may be due to gender bias within the general culture as well as among diagnosticians.
Treatment Options for Those Who Have HPD
Treating people with HPD can be challenging for several reasons, including:
- People who have this condition are unlikely to believe that they have a problem or concede that they need treatment.
- Many people with HPD also have additional mental health concerns, such as depression, somatic symptom disorder, conversion disorder, and other personality disorders.
- Research into histrionic personality disorder has been somewhat sparse.
- No medications have been developed to address the symptoms of HPD.
This doesn’t mean that people with histrionic personality disorder can’t learn to manage their symptoms and improve their behaviors. It simply acknowledges the obstacles that families may encounter when attempting to find appropriate care for a loved one.
As with other mental illnesses, personalization can be the key to a successful treatment experience for someone with HPD. It’s important to find a provider that can evaluate the full scope of the individual’s needs – including underlying issues and co-occurring conditions – then develop a customized plan just for them.
Elements of care that can be helpful for people with HPD include:
- Individual, group, and family therapy
- Cognitive behavioral therapy (CBT)
- Psychodynamic therapy
- Dialectical behavior therapy (DBT)
- Interpersonal therapy
- Social skills education
- Somatic therapy
- Trauma-informed therapy
Also, while there are no medications for HPD, people who have co-occurring conditions such as anxiety and depression may benefit from prescription meds to address these concerns.
Contact Montare Behavioral Health About Treating Histrionic Personality Disorder
If someone in your life has been exhibiting the symptoms of histrionic personality disorder, Montare Behavioral Health is here to help.
Our network of mental health treatment centers in Southern California offers customized inpatient and outpatient programming for adults who have HPD and other complex mental health disorders. When you choose a Montare facility, you can rest assured that your loved one will be cared for by a team of experienced professionals who are committed to providing personalized services in safe and respectful environment.
To learn more about us or to schedule a free assessment, please visit our Contact page or call us today.
