Histrionic Personality Disorder

Personality is the essence of a person. It is how they perceive the world, how they relate to it, and think about themselves and their surroundings. Personality traits can really define how we live our lives. Because of that, personality disorders can be detrimental to our functioning everyday. We all know someone who is narcissistic and needs to be the center of attention. And we might chalk it up to a big personality. However, there is another real chance that this is a disorder called histrionic personality disorder (HPD).

What is Histrionic Personality Disorder or HPD?

Histrionic Personality Disorder refers to people who are overly emotional individuals. This usually presents itself in being extremely open, flirtatious, enthusiastic, and loving. From the sounds of it, it is a positive thing. However, it can become problematic. Too much of these emotions becomes excessive. It can cause embarrassment or feelings of being uncomfortable for other people, while the person with histrionic personality disorder wouldn’t even realize it. 

And if there are positive emotions with this, there are also negative ones. Often, it presents as extreme sadness or anger. A person with HPD has a tendency to view things through an emotional filter. Displaying attention-seeking behavior, they want to be the focus. And if they aren’t the center of attention, it can make them feel both uncomfortable and unappreciated. These types of behaviors can often cause depression and anxiety in the person suffering from HPD.

Other behaviors that are associated with histrionic personality disorder are being dramatic, a constant seeking of approval, self-dramatization, being self-centered, and being sexually inappropriate in situations where it truly wouldn’t be acceptable (i.e. workplace, social settings). Even if they are lively and exciting, the initial charm of openness and flirtatiousness only lasts so long. And the interests and conversation will be centered around them, similar to narcissistic personality disorder. Similarly, this is closely associated with borderline personality disorder.

Causes of HPD

In truth, we aren’t sure what exactly causes histrionic personality disorder. But there are a few things we know. HPD occurs more often in women than in men, though it may be just diagnosed more often. The estimations are that about 3% of people suffer from this disorder. It also seems that this disorder happens more often in Hispanic or Latin-American cultures and less likely in Asian cultures. Through case studies, it seems to occur more in people who have dealt with a trauma sometime in their childhood.  

Many in the mental health field think that it may be a combination of both inherited and learned factors. For example, it may run in the family and it is inherited that way. However, a parent who raises a child with that mindset could just be repeating what he was taught. Social and Environmental factors are huge contributors for raising kids. People learn such a large part of their identity and behavior. Similarly, a lack of criticism or punishment as a child and varied attention given to a child by the parents may also contribute. 

Histrionic Definition

Breaking down the words, histrionic means “Excessively dramatic or emotional, especially with the intention to draw attention”. It also has a meaning of relating to acting. This makes sense as people with histrionic personality disorder take over the role of the “life of the party.” This can either be someone who uses physical appearance or behaviors to draw attention to themselves. 

Sycophantic Definition

This term refers to someone who attempts to flatter someone in the effort to gain a service or a favor from the person. A form of manipulation, it can more broadly be used to describe a fake person or being two-faced. This contributes to HPD in that someone can bait someone into supporting whatever it is that makes them tick. Sycophants insincerely flatter people in order to manipulate and control them to fulfill their own needs. 

This is the key aspect of histrionic personality disorder. And getting what you want by flattery is just one of the symptoms associated with this disorder. 

Histrionic Personality Disorder Symptoms

The symptoms that you should look at when it comes to HPD are generally ones that have been around for a long time. We are all human. And we all occasionally have emotional outbursts and show attention seeking behavior. This is normal. But if this continues to happen over a long period of time consistently, then there is a  chance something else is going on.  Some indicators that you can look for are the following:

  • Self-centeredness in many/all aspects of your life
  • Need to always be the center of attention
  • Feel awkward or uncomfortable when you aren’t the center of attention
  • Constantly needing approval or reassurance no matter what you are doing
  • May be overly sexual and seductive, often at inappropriate times
  • Changes emotional states very quickly, often times with no warning
  • Excessively dramatic with all emotions
  • Easily affected and influenced by other people’s opinions and thoughts
  • Excessive showing of different emotions throughout the day
  • These symptoms cause stress and create difficulty in the personal and professional life of the person suffering

While talking to someone with HPD, you might also notice they are excessively impressionistic, speaking in large grand statements and lacking detail. A person with this disorder would be likely to work well in fields that require imagination and creativity. They are more likely to have a difficult time with things that require analytical and logical thinking. 

Remember that a combination of these over a long period of time is key. Given this, talk to a medical professional if you feel you exhibit some or most of these symptoms consistently. He will be able to help you test if histrionic personality disorder is something you suffer from.

Histrionic Personality Disorder Test

Since we know some of the symptoms of HPD occur in people without the disorder as well, how can we tell exactly? In some ways, there is no exact science or test that will give you the answer. 

However, when you visit a therapist, you will be assessed to help you figure out if HPD is an accurate diagnosis. The purpose of a standard psychiatric interview is to gather information about you so as to make a diagnosis. Other tests you might be given are the MMPI or PAI. Both of these are administered by mental health professionals and are used to learn about your personality and mental state. They form a solid base from which therapists can make a diagnosis and beging to help you.

Overall, it is very important to take the words and diagnosis of these tests and the people giving them to you seriously. It can only help you. Being fair and honest with their assesment will allow you know if this is something you need to look at more and get treatment. Getting a skillful look at your mental health goes a long way, so make sure you get the help if you need it. Knowing where you are will help you find the way to treatment and overall being able to manage HPD. Ask your healthcare professional if you have questions about HPD and bring up your concerns with them. 

Histrionic Personality Disorder Treatment

If you’ve been diagnosed with histrionic personality disorder, don’t fret. There are some common ways of treating this disorder. Generally speaking, therapy is used to overcome HPD. Therapy is the first step to moving past histrionic personality disorder. You should start with one on one counseling first, and move on to larger groups later. One on one keeps it intimate, and group settings have the potential to encourage provocative behavior and narcissistic behavior. Over time, reintroducing a person into a group setting in therapy can help the process of recovery.

Medications might be prescribed will help with conditions that can also occur with histrionic personality disorder. These can include depression or anxiety. Selective serotonin reuptake inhibitors (SSRIs) are usually given in to help treat these symptoms. Symptoms can be treated as they present themselves, but it isn’t going to put a stop forever necessarily. These can pop up throughout the life of the person. That being said, HPD is very manageable. With proper treatment, people diagnosed with histrionic personality disorder are more than capable of living a full and wonderful life. 

Histrionic Personality Disorder: Final Thoughts

This can be a confusing disorder to really understand and identify. While we probably all know someone who needs to be the center of attention, this is much more than that. It is a set of behaviors that a person can’t help doing. It can result in inventing situations and complete exaggerations just to make an impact. While it seems harmless, it can have a real effect on the people and relationships in your life. 









author avatar
Angel Rivera
I am a Bilingual (Spanish) Psychiatrist with a mixture of strong clinical skills including Emergency Psychiatry, Consultation Liaison, Forensic Psychiatry, Telepsychiatry and Geriatric Psychiatry training in treatment of the elderly. I have training in EMR records thus very comfortable in working with computers. I served the difficult to treat patients in challenging environments in outpatient and inpatient settings
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