How to help loved ones with histrionic personality disorder

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How to help loved ones with histrionic personality disorder

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How to help loved ones with histrionic personality disorder

Histrionic Personality Disorder (HPD) is a mental condition characterized by a number of traits, including extreme extroversion, obsession with personal appearance, and an often inappropriate use of seduction to manipulate others. A person with HPD is quite often the life of a party, with an engaging personality and a natural lack of social inhibition. Ironically, the positive traits displayed by a sufferer match much of what society usually considers to be ideal behavior. Those with HPD often rise high in social and business circles because of their outgoing personalities and lofty ambitions.

However, HPD is considered to be a personality disorder for a reason. While sufferers may display all of the qualities admired by others, many of them are also plagued by internal thoughts of inferiority. While someone with this condition may express empathy or affection, the actual level of emotional connection quite often ends at the surface. Someone with HPD can mimic, or even exaggerate, an appropriate emotional response, but his or her selfish nature often prevents a true bond with others. A true sufferer could feel lost in a crowd if he or she is not constantly the center of attention.

The “histrionic” element of HPD is often displayed as dramatic outbursts which are rarely commensurate with the triggering incident. An adult with HPD can literally burst into a childish temper tantrum following an argument with a romantic partner. Sufferers tend to revert to the emotional manipulations of childhood whenever they feel powerless. Many people may have first-hand experiences with so-called “drama queens” who tend to fly off the handle whenever the slightest hint of conflict arises. Others with HPD may create an atmosphere in which others feel compelled to acquiesce to their needs rather than provoke an emotionally charged responses.

Both men and women are susceptible to the development of HPD, which many experts believe has both genetic and social origins. Women with this condition tend to pursue unrealistic relationships, often projecting idealized qualities onto less-than-ideal partners. Sexual promiscuity is also a hallmark symptom of HPD, as is recreational drug use. Women with HPD may also spend hours working on their physical appearance, from excessive workouts to the overuse of cosmetics. Negative emotions are often bottled up in favor of exaggerated smiles and a penchant for hedonistic behavior in public.

Treating HPD can be a difficult process, because many sufferers fail to see their behavior as problematic. They may only seek treatment voluntarily after a volatile romantic break-up or complete social ostracism by those who can no longer tolerate the person’s self-absorbed behavior. Others may be ordered into professional counseling as a result of illegal or immoral acts. Psychologists can prescribe anti-depressants to address some of the behavioral issues, and long-term psychotherapy may help HPD sufferers understand how destructive their self-absorbed lifestyle choices can be to themselves and others.

A regular contributor, Michael enjoys doing research in order to satisfy his wide-ranging curiosity about a variety of arcane topics. Before becoming a professional writer, Michael worked as an English tutor, poet, voice-over artist, and DJ.

A regular contributor, Michael enjoys doing research in order to satisfy his wide-ranging curiosity about a variety of arcane topics. Before becoming a professional writer, Michael worked as an English tutor, poet, voice-over artist, and DJ.

How to help loved ones with histrionic personality disorder

Histrionic personality (HPD) is most often recognized by dramatic behavior, rapid shifts in emotion, high suggestibility, and attention-seeking acts. People with this condition feel uncomfortable or otherwise distressed when they are not the center of attention. They may try to draw the attention of others with flirtatious behavior, tantrums, enthusiastic outbursts, or gushing praise.

The actions of a person with HPD can confuse their family and friends. Rapid changes in emotion can seem shallow. Flirtatious behavior can negatively affect professional bonds and friendships. Attempts to manipulate others to get attention can also cause harm to romantic relationships. People with HPD are often aware their actions have negative effects on themselves and others, but they might struggle to effectively manage emotions and make different choices. Depression can develop as a result of problems with work or relationships.

There is help for histrionic personality. Professional support from a counselor or therapist can lead to improvement of symptoms. In therapy, you can also learn new skills to manage emotions and deal with situations in different ways. Therapy can also help treat depression and other co-occurring conditions. It’s especially important to reach out if you have severe depression or thoughts of suicide. Begin your search for a counselor here.

Treatment for Histrionic Personality

The support of a therapist or counselor can be beneficial for people with HPD. Therapy can help people understand the reasons for their thoughts and behavior. Individuals in therapy can begin working toward positive changes, such as finding new ways to relate to other people.

For therapy to be successful, an individual usually has to desire help. This generally means recognizing that what they experience is a mental health issue. With personality disorders, this often happens when the condition has strongly impacted a person’s life. For example, a person’s emotional outbursts may end a long-term friendship, forcing them to realize the negative consequences of their behavior.

Certain traits of histrionic personality can offer challenges in therapy. A person with HPD may try to flatter or flirt with the therapist to get approval. Because people who have HPD often become bored easily, it may be difficult to stick to something that follows a routine, like counseling.

Depression occurs commonly with HPD, especially if people have a pattern of relationship difficulties or failed friendships. People who have histrionic personality and another condition, such as depression, may be more likely to seek help.

Types of therapy that can help with HPD include:

    : This approach helps people explore conflicts in their relationships. People can then work to change these conflicts to improve their relationships.
    : This type of therapy teaches people how to challenge negative thought patterns and change them.
    : Working with other people who have similar mental health challenges can help people learn new ways of relating to others. They can also practice social and interpersonal skills.
    : When a person’s mental health affects family members and partners, family and relationship counseling may be recommended. In counseling, partners and family members can also learn more about the mental health issue and how to offer support.
    : While mindfulness practices shouldn’t replace professional support, learning to be more mindful can help people manage emotions. Practicing mindfulness can be helpful when trying to keep from reacting in a certain way.

How to Help a Loved One with Histrionic Personality

Personality disorders are mental health issues involving fixed patterns of thinking and behavior. These patterns can create difficulties at school, work, or in relationships. Even though a person’s actions may cause problems for them and other people in their lives, they might have a hard time making changes that lead to healthier interpersonal dynamics.

When a loved one has HPD, it may sometimes be difficult to relate to them. It can be hard to understand their need to be the center of attention. If they lie or use manipulation to get sympathy, you may feel hurt or worried.

It can help to remember that HPD is a mental health condition. A person’s HPD symptoms may be upsetting to you, but they also cause your loved one distress. While a diagnosis is not an excuse for any hurtful actions, it can explain why your loved one behaves a certain way.

You can offer support to a loved one who has HPD by:

  • Setting boundaries. Have a discussion with the person about how you will respond to certain behaviors from now on. You might say something like, “I care about you, but I feel uncomfortable when you make scenes in public. If you throw a tantrum in public, I’ll go home.”
  • Knowing when to distance yourself. It can be difficult to deal with histrionic personality issues on an ongoing basis. It is okay to take a break on occasion and spend some time caring for yourself.
  • Telling them you care for them. It may help the person to know that even when you can’t give them your full attention, you still care for them.
  • Encouraging them to evaluate their actions. Impulsivity and suggestibility are common traits in HPD. If your loved one tries to act on impulse (or another person’s suggestion), you can encourage them to consider what they’re doing and why. This can help them learn to think through their decisions.
  • Keeping calm when they become excited or act in dramatic ways. It can help to offer a distraction if your loved one is considering an impulsive action. . Be honest about your feelings. If your loved one upsets you, let them know calmly. If you have expressed a boundary about that action, stick to it. This can help your loved one know their actions affect others.
  • Offering to go to couples counseling or family therapy. If your loved one wants to get help, show them you support their decision by offering to go with them.

While support from friends and family can be invaluable, it cannot replace professional therapy. If your loved one’s histrionic personality is affecting their daily life, chances are they need treatment. A compassionate counselor can provide your loved one guidance.

Our team can tell you more about our treatment programs, amenities, and more.

Personality disorders are a category of mental health conditions characterized by unhealthy or rigid patterns of thinking and behaving. Individuals with personality disorders struggle to perceive and relate to people and situations correctly. Personality disorders can lead to severe limitations in daily functioning and frequently cause problems in school, work, social situations, and relationships. Harmony Hills is a Florida personality disorder treatment center.

If you or a loved one has a personality disorder such as histrionic personality disorder (HPD), we can help you learn the tools you need to take back control of your life. To learn more about the options for personality disorder treatment in Florida, contact Harmony Hills today at 855.494.0357.

Histrionic Personality Disorder Treatment How to help loved ones with histrionic personality disorder

For diagnostic purposes, personality disorders are broken into three clusters based upon common characteristics. Histrionic personality disorder (HPD) falls under Cluster B, characterized by erratic or dramatic behaviors. “Histrionic” means overly theatrical or melodramatic. Individuals with histrionic personality disorder have:

  • Intense, unstable emotions
  • Distorted self-image
  • Overwhelming desire to be noticed
  • Dramatic or inappropriate behavior
  • Self-esteem tied to approval from others

HPD usually presents in adolescence or early adulthood, and it is more prevalent in women than men. HPD is often difficult to treat in large part because those with the disorder usually do not believe they need treatment. These individuals like to exaggerate their feelings and often dislike routines which also contributes to treatment difficulties. Usually, individuals with HPD seek treatment only when their behavior leads to depression or anxiety. Psychotherapy, medications, or a combination of the two are the most effective treatments. Effective treatment for HPD should include:

  • Education about histrionic personality disorder
  • Changing maladaptive ways of thinking and behaving
  • Social and emotional skills training
  • Education and support for family members
  • Improving interpersonal, communication, and coping skills
  • Dual diagnosis treatment
  • Providing insight into the internal nature of problems

Because individuals with HPD demonstrate attention-seeking behaviors and the desire to exaggerate feelings can be triggered or worsened when they feel they have an audience, group and family therapy is not recommended. Additionally, residential treatment is recommended for personality disorders such as HPD because the structure, routine, and supervision allow maladaptive behaviors to be mitigated and corrected in real-time. Residential treatment also will enable clients to become totally immersed in the therapeutic process without the distractions of everyday life.

Recognizing the Symptoms of Histrionic Personality Disorder

The exact cause of histrionic personality disorder is unknown. However, mental health professionals agree that it is likely a combination of inherited traits and learned behaviors. HPD tends to run in families, suggesting a genetic component. That said, it is also possible that children of parents who have HPD may just be repeating learned behaviors. Additionally, children who are not disciplined, receive inappropriate reinforcement for behavior, or have unpredictable attention from parents are at higher risk of developing personality disorders.

In most cases, individuals with histrionic personality disorder possess good social skills but manipulate people and situations to be the center of attention. A person with HPD might also:

  • Dress provocatively and display inappropriate sexual or flirtatious behavior
  • Be overly concerned with physical appearance
  • Make impulsive and rash decisions
  • Be extremely sensitive to criticism or disapproval
  • Constantly seek attention, approval, and reassurance
  • Be self-centered and show little concern for others
  • Be gullible and easily influenced by others

As a result of these and other personality characteristics, those with HPD struggle to maintain healthy relationships. They are perceived as being shallow and insincere. Because they have a low tolerance for frustration and quickly become bored with routines, they also struggle in school or at work.

Call Harmony Hills for Histrionic Personality Disorder Treatment

If you have histrionic personality disorder, live with someone who does, or have a relationship with someone who does, life can feel chaotic and overwhelming. In a Florida personality disorder treatment center, you can receive education about HPD that provides insight into your thoughts and behaviors. The treatment team at Harmony Hills can provide the tools needed to overcome HPD and live a happy, healthy, fulfilling life. Call us at 855.494.0357 to learn more.

This article was co-authored by Padam Bhatia, MD. Dr. Padam Bhatia is a board certified Psychiatrist who runs Elevate Psychiatry, based in Miami, Florida. He specializes in treating patients with a combination of traditional medicine and evidence-based holistic therapies. He also specializes in electroconvulsive therapy (ECT), Transcranial Magnetic Stimulation (TMS), compassionate use, and complementary and alternative medicine (CAM). Dr. Bhatia is a diplomat of the American Board of Psychiatry and Neurology and a Fellow of the American Psychiatric Association (FAPA). He received an MD from Sidney Kimmel Medical College and has served as the chief resident in adult psychiatry at Zucker Hillside Hospital in New York.

There are 8 references cited in this article, which can be found at the bottom of the page.

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Histrionic personality disorder (HPD) is a personality disorder characterized by a need to be the center of attention, overly provocative behavior, and overly theatrical or dramatic actions. [1] X Trustworthy Source MedlinePlus Collection of medical information sourced from the US National Library of Medicine Go to source Many people diagnosed with HPD don’t believe they need treatment and don’t receive the treatment they need. To a certain extent, all people have some aspects of a personality disorder. If it becomes pathological, then you need to seek help. If you have been diagnosed with histrionic personality disorder, get treatment from a mental health professional so that you can manage your disorder, adjust your behavior, and live a healthier, more fulfilling life.

How to help loved ones with histrionic personality disorder

Histrionic personality disorder (HPD) first appeared in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980. It is classified as a Cluster B personality disorder, meaning it involves impulsivity and emotionality. Since HPD’s inclusion in the DSM, mental health professionals have argued whether or not it should be considered its own diagnosis.

With a prevalence rate of only 1.8%, HPD is the least common of the Cluster B personality disorders. It often co-occurs with narcissistic personality (NPD) and borderline personality (BPD). Given this context, some experts believe HPD should be classified as a subtype of narcissism or borderline personality.

Other individuals argue that the symptoms of histrionic personality are distinct enough to warrant their own diagnosis. The most recent edition of the DSM (DSM-5) still lists HPD as a separate condition.

Why Is Getting the Right Diagnosis Important?

In many cases, people with histrionic personality can function at a high level. They might have trouble recognizing their symptoms as a mental health concern, even when said symptoms cause distress. This can make diagnosis and treatment difficult.

Opinions about the importance of diagnosis differ. Some professionals believe diagnosing a specific condition is less necessary than addressing an individual’s distress. Other professionals believe a diagnosis helps them establish clear goals for therapy. In some cases, receiving a diagnosis of histrionic personality may help a person understand their symptoms more clearly.

Having a holistic understanding of one’s symptoms can be vital to effective therapy. The distress caused by HPD can lead to co-occurring mental health issues. For example, an individual may seek help for depressive symptoms caused by HPD. If the root of the depression (the HPD) isn’t addressed, then treatment may be less effective.

Misdiagnosis can also have a negative impact on treatment. Therapy designed to improve the symptoms of one condition may not be as effective for another. For example, a person with HPD may benefit from cognitive behavioral therapy (CBT), which can help people address negative thoughts. Yet CBT would be much less effective for someone with BPD. Experts consider dialectical behavior therapy, which strongly emphasizes emotions and social functioning, the best treatment for BPD.

Histrionic Personality Versus Borderline Personality

Borderline personality (BPD) is another cluster B personality disorder. HPD and BPD share some characteristics, and it’s possible to have both conditions. But they are, in fact, different diagnoses.

Like histrionic personality, BPD may involve impulsive and attention-seeking behavior. However, existing research does not suggest people with BPD actively desire to be the center of attention. Rather, their actions are often motivated by fear of abandonment. They are also more likely to engage in self-destructive behavior than those with HPD.

A pattern of unstable relationships can be seen with both diagnoses. A person with histrionic personality may have trouble maintaining a relationship due to their flirtatious behavior. They may leave a long-term relationship out of boredom. Someone with BPD, meanwhile, may feel rage at the mere idea of a relationship falling apart. This anger can become a self-fulfilling prophecy and drive their partner away.

Lastly, both diagnoses involve rapidly changing emotions. Yet those with histrionic personalities are more likely to express themselves in a “theatrical” way. They are less likely to report the feelings of deep emptiness which are common in borderline personality.

How Does Histrionic Personality Differ from Narcissism?

Narcissism, or narcissistic personality disorder (NPD), is another cluster B personality disorder. It’s similar to HPD in many ways, but there are a few key differences.

One diagnostic requirement for narcissism is a lack of empathy. People with this condition may ignore how others feel and have little compassion. People with histrionic personality may engage in self-centered behavior, but they don’t necessarily lack empathy.

Another important distinction lies in the reasons for attention-seeking behavior. People with narcissism want to be recognized as special or superior to others. They often lie or exaggerate their own accomplishments in order to receive praise, recognition, or status. People with HPD need the attention of others but may care less about how they get it. They may take on the role of victimhood and allow others to think of them as fragile or helpless.

Histrionic Personality or Typical Teenage Behavior?

Teenagers tend to experience intense feelings and react in ways that may seem extreme to friends and family. They might also seem self-centered, suggestible, and impulsive, other significant characteristics of HPD. Since histrionic personality symptoms often appear during the teen years, they may be mistaken for typical adolescent experiences. This can make diagnosing HPD difficult.

Often the key to determining if a teen has histrionic personality is to examine the context of their behaviors. Have the symptoms lasted for at least a year? Does the individual show unusual behavior all the time, or just when they are in a bad mood? Could the teen be taking any drugs (recreational or prescribed) that may affect their emotions?

Personality is unique and made up of many factors. It’s possible for someone to seek attention, behave dramatically, or experience intense emotions without having HPD. What makes HPD a mental health diagnosis is the distress and difficulty it causes in daily life. A person with histrionic personality may regret alienating others or acting impulsively but feel unable to change.

A licensed therapist can help the teenager comprehend their situation and manage symptoms. If the teen’s behavior has affected their home life, family therapy may also be appropriate. A family therapist can help loved ones understand HPD and address conflict in a healthy manner. There is no shame in seeking support.

Histrionic personality disorder is one of a group of conditions called dramatic personality disorders. People with these disorders have intense, unstable emotions and distorted self-images. For people with histrionic personality disorder, their self-esteem depends on the approval of others and does not arise from a true feeling of self-worth. They have an overwhelming desire to be noticed, and often behave dramatically or inappropriately to get attention. The word histrionic means “dramatic or theatrical.”

This disorder is more common in women than in men and usually is evident by early adulthood.

Symptoms and Causes

What causes histrionic personality disorder?

The exact cause of histrionic personality disorder is not known, but many mental health professionals believe that both learned and inherited factors play a role in its development. For example, the tendency for histrionic personality disorder to run in families suggests that a genetic susceptibility for the disorder might be inherited. However, the child of a parent with this disorder might simply be repeating learned behavior. Other environmental factors that might be involved include a lack of criticism or punishment as a child, positive reinforcement that is given only when a child completes certain approved behaviors, and unpredictable attention given to a child by his or her parent(s), all leading to confusion about what types of behavior earn parental approval.

What are the symptoms of histrionic personality disorder?

In many cases, people with histrionic personality disorder have good social skills; however, they tend to use these skills to manipulate others so that they can be the center of attention.

A person with this disorder might also:

  • Be uncomfortable unless he or she is the center of attention
  • Dress provocatively and/or exhibit inappropriately seductive or flirtatious behavior
  • Shift emotions rapidly
  • Act very dramatically—as though performing before an audience—with exaggerated emotions and expressions, yet appears to lack sincerity
  • Be overly concerned with physical appearance
  • Constantly seek reassurance or approval
  • Be gullible and easily influenced by others
  • Be excessively sensitive to criticism or disapproval
  • Have a low tolerance for frustration and be easily bored by routine, often beginning projects without finishing them or skipping from one event to another
  • Not think before acting
  • Make rash decisions
  • Be self-centered and rarely show concern for others
  • Have difficulty maintaining relationships, often seeming fake or shallow in their dealings with others
  • Threaten or attempt suicide to get attention

Diagnosis and Tests

How is histrionic personality disorder diagnosed?

If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose personality disorders, the doctor might use various diagnostic tests to rule out physical illness as the cause of the symptoms.

If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, healthcare professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder.

Management and Treatment

How is histrionic personality disorder treated?

In general, people with histrionic personality disorder do not believe they need therapy. They also tend to exaggerate their feelings and to dislike routine, which makes following a treatment plan difficult. However, they might seek help if depression—possibly associated with a loss or a failed relationship—or another problem caused by their thinking and behavior causes them distress.

Psychotherapy (a type of counseling) is generally the treatment of choice for histrionic personality disorder. The goal of treatment is to help the individual uncover the motivations and fears associated with his or her thoughts and behavior, and to help the person learn to relate to others in a more positive way.

Medication might be used to treat the distressing symptoms—such as depression and anxiety—that might co-occur with this disorder.

What are the complications of histrionic personality disorder?

Histrionic personality disorder can affect a person’s social or romantic relationships, and how a person react to losses or failures. People with this disorder are also at higher risk than the general population to have depression.

Prevention

Can histrionic personality disorder be prevented?

Although prevention of the disorder might not be possible, treatment can allow a person who is prone to this disorder to learn more productive ways of dealing with situations.

Outlook / Prognosis

What is the outlook for people with histrionic personality disorder?

Many people with this disorder are able to function well socially and at work. Those with severe cases, however, might experience significant problems in their daily lives.

Last reviewed by a Cleveland Clinic medical professional on 01/23/2018.

References

  • Janowsky D. Chapter 30. Personality Disorders. In: Ebert MH, Loosen PT, Nurcombe B, Leckman JF. eds. CURRENT Diagnosis & Treatment: Psychiatry, 2e. New York, NY: McGraw-Hill; 2008.
  • Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision. Copyright © 2000, American Psychiatric Association.
  • Hales RE, Yudofsky SC, Gabbard GO. The American Psychiatric Publishing Textbook of Psychiatry. American Psychiatric Pub; 2008.
  • Young JQ. Chapter 26. Personality Disorders. In: Feldman MD, Christensen JF. eds. Behavioral Medicine: A Guide for Clinical Practice, 3e. New York: McGraw-Hill; 2008.

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How to help loved ones with histrionic personality disorder

Histrionic personality (HPD) is an emotional/impulsive personality disorder. People with this diagnosis tend to have an unstable self-image and may go to unusual lengths to keep others’ focus on them. They often develop self-centered behavior and a sensitivity to criticism. These traits appear in almost all areas of a person’s life and can cause significant distress.

If you (or a loved one) show signs of histrionic personality, consider reaching out for help. While personality disorders can be difficult to treat, therapy does help many people. In therapy it’s possible to learn how to cope with and manage symptoms. You can begin searching for a counselor here.

DSM-5 Criteria for Histrionic Personality

Histrionic personality belongs to the Cluster B personality disorder category. These conditions share features such as emotional thinking and unpredictable behavior.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists eight diagnostic criteria for HPD. To be diagnosed, a person must display at least five characteristics over an extended period, in more than one setting. A person who only displays these behaviors among friends and never at work or school would likely not be diagnosed with HPD.

  1. Being uncomfortable when not the center of attention.
  2. Acting in flirtatious or sexually suggestive ways toward coworkers, acquaintances, teachers, and others. The flirting may be inappropriate for the situation, the relationship, or both.
  3. Emotions that change quickly and often. An individual may seem shallow or superficial.
  4. Trying to get attention from others with one’s physical appearance (clothes, makeup, hair, etc.). Individuals may seem overly concerned with their looks.
  5. A dramatic yet vague manner of speaking. An individual may express strong opinions without being able to elaborate on them in any detail.
  6. A pattern of exaggerated emotions and reactions that may seem excessively theatric. Even when these emotions appear to be intense, they may change so rapidly that they seem fake.
  7. Being suggestible, overly trusting, and easily influenced by others.
  8. A pattern of believing friendships and relationships are much closer than they actually are.

According to the DSM¬5, only about 1.8% of people have HPD. This pattern of behavior appears by early adulthood, often during the teen years. Some research suggests HPD occurs more often in women, but other studies indicate the rates of HPD may be similar for all genders.

What Causes Histrionic Personality?

Research about histrionic personality is still limited. It’s less common than other personality disorders, and the causes aren’t fully understood. Research suggests children of people with HPD may be more likely to develop it, which could indicate genetic factors. It could also mean children learn the behaviors from their parents.

That said, adults don’t need to be diagnosed with HPD to offer inconsistent parenting. Parents may provide attention or positive reinforcement at unpredictable times. They may offer little to no criticism or behavioral guidance. When children aren’t sure what “good” behavior and “bad” behavior is, they may continue to act unpredictably or emotionally later in life in order to get approval from others.

Such factors may prevent people with HPD from developing a strong sense of self-worth. They might instead link feelings of self-esteem to attention received from others. To get this attention, they might act in ways that seem inappropriate. They may flirt, start “drama,” or express extreme affection for people they don’t know well. They may also be overly influenced by the opinions of others.

How Does Histrionic Personality Affect Relationships?

HPD can make it hard for a person to control their emotions. An individual might lose patience easily or be very sensitive to criticism and rejection. They may have childlike tantrums or emotional breakdowns when things go wrong. This behavior can make them seem unpredictable or dramatic.

Recognizing emotions may be a struggle as well. According to a 2018 study, people with HPD have difficulty recognizing emotions in others. They may also have alexithymia, which is a deficit in recognizing one’s own emotions. These issues can make someone with histrionic personality seem as though they lack empathy.

This lack of emotional intelligence can create difficulties for people with histrionic personality. Although most people with HPD can function on a day-to-day basis, their symptoms often interfere with their social lives. For example:

  • People with HPD can become easily frustrated with challenges at work. While they often show enthusiasm at the start of a task, boredom may cause them to lose motivation. They may be oversensitive to any criticism or feedback.
  • Friends may struggle to understand an individual’s need to always have attention on them. Emotional breakdowns may embarrass or alienate others.
  • Excessive flirtation could cause conflict in one’s social circle. It could also cause legal issues in a professional setting.
  • An individual may have trouble achieving emotional intimacy in romantic relationships. They might feel insecure and try to manipulate their partner in order to hold their attention. In other cases, an individual’s desire for novelty may lead them to give up on a long-term relationship in order to pursue a new one.

These behaviors can lead to a pattern of troubled relationships in general. Feelings of depression or hopelessness may result. Like other personality disorders, HPD can cause significant distress and disruption in one’s life. Working with a therapist to address histrionic personality issues can lead to improvement of symptoms.

Histrionic Personality and Comorbid Mental Health Issues

People who meet the criteria for histrionic personality often meet criteria for another personality disorder. It often co-occurs with other Cluster B diagnoses: narcissistic, antisocial, and borderline personalities. Dependent personality is another common comorbidity.

Research suggests HPD is linked to a high risk for depression. Difficulty coping with rejection or failed relationships may contribute to feelings of depression in people who have HPD.

Somatization (in which real physical symptoms appear with no medical cause) and conversion disorder (a form of somatization with neurological symptoms) also commonly occur with HPD.

Research has linked cluster B personality disorders to increased suicide risk. A study from 2015 linked HPD with a higher lifetime risk of suicide attempts. Suicide risk may be higher when histrionic personality co-occurs with depression. Clinical data suggest people with HPD may attempt suicide if they feel others do not care for them enough.

If you suspect you may have HPD, you can get support from a mental health professional. A therapist can help you manage your emotions and address harmful behaviors. They can also treat any co-occurring diagnoses. Therapy is a confidential way to get help without judgment.