Histrionic Personality Disorder: What Is It and How Is It Treated?

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November 26, 2020

Your friends and family describe you as dramatic. Maybe you even agree with that description. You do tend to experience extreme emotions. Plus, your expressions, gestures, and tone are exaggerated by other people’s standards.

So is this tendency toward drama just a normal, albeit quirky, part of your personality? Or are you suffering from a personality disorder?

Histrionic personality disorder can explain extreme cases of the description above. People with histrionic personality disorder struggle with their emotions and relationships. They may also face obstacles in their professional lives. Fortunately, treatment is available. However, it relies on a proper diagnosis and understanding of your condition.

What Is Histrionic Personality Disorder?

Histrionic personality disorder is one of several personality disorders. It’s part of a group called Cluster B personality disorders.

People with Cluster B disorders struggle to regulate and express their emotions. They are often described as dramatic and overly emotional. Moreover, their behavior and thinking can be unpredictable.

Other Cluster B disorders include:

  • Antisocial personality disorder
  • Borderline personality disorder
  • Narcissistic personality disorder

Symptoms of Histrionic Personality Disorder

The symptoms of histrionic personality disorder affect a person’s emotions and thoughts. These internal experiences, in turn, influence a person’s behaviors. 

Intense and Shifting Emotions

Histrionic personality disorder is characterized by intense emotions. These emotions can shift rapidly. Even small frustrations can cause a significant change in a person’s mood.

Low Self-Worth

People with histrionic personality disorder lack an innate sense of self-worth. Instead, they base their self-esteem on others’ approval. Because they rely so heavily on external approval, they seek constant reassurance. They also struggle to deal with criticism or disapproval.

Their reliance on others extends to other aspects of their lives as well. Those with histrionic personality disorder may be easily influenced by other people’s opinions. While gullible, they are also selective in the opinions they believe and act on. If a belief serves their needs—for attention or esteem, they may use it to manipulate others.

Need for Attention

Individuals with histrionic personality disorder crave attention. As a result, they engage in dramatic and even inappropriate attention-seeking behaviors. At the extreme, a person may even threaten or attempt suicide to gain attention.

Even in ordinary conversations, people with histrionic personality disorder seem to be “performing.” They use exaggerated facial expressions, gestures, and tone of voice.

Focus on Appearances

Since they crave attention, these individuals focus excessively on physical appearances. They may seem obsessed with their looks. They may also dress provocatively. Plus, in another bid for attention, they may behave seductively or flirtatiously.

Rash Decision Making

People with histrionic personality disorder often act without thinking. They also tend to become bored or feel “confined” by ordinary routines. Struggling to maintain interest, they may leave a trail of unfinished projects.

Relationship Difficulties

Common adjectives others use to describe people with histrionic personality disorder include:

  • Manipulative
  • Shallow
  • Fake
  • Self-centered

Consequently, those with histrionic personality disorder struggle to form and maintain relationships. The relationships they do have tend to be superficial.

Histrionic Personality Disorder, call Socal Empowered for help

What Causes Histrionic Personality Disorder?

With many psychological disorders, it is difficult to separate “nature” from “nurture.” In other words, both inherited and learned factors likely contribute.

Histrionic personality disorder tends to run in families. This may suggest a genetic component. Yet, a child raised by a parent with the disorder may also learn disordered behaviors.

Children who develop histrionic personality disorder may have experienced:

  • A lack of punishment or criticism
  • The excessive use of positive reinforcement, including praise, for approved behaviors
  • Unpredictable attention from parents, caregivers, or other family members

Finally, an individual’s temperament and preferred coping mechanisms can also play a role.

Who Is Affected by Histrionic Personality Disorder?

At least 9% of the population suffers from at least one personality disorder. The prevalence of histrionic personality disorder is approximately 2-3%. 

Symptoms usually appear by adolescence or young adulthood. Yet, many people delay seeking treatment. Some never seek treatment. As a result, the prevalence of histrionic personality disorder is likely even higher.

As a whole, women are more likely to be diagnosed than men.  

How Is Histrionic Personality Disorder Diagnosed?

The symptoms of histrionic personality disorder can overlap with other psychological disorders. Furthermore, psychological symptoms can have physical causes. 

If you suspect you have histrionic personality disorder, talk to your doctor. Your primary care doctor can conduct a full physical exam. Your doctor might also order bloodwork or neuroimaging to rule out physical conditions.

Still, your physical test results may come back normal. In this case, your doctor may refer you for a psychiatric evaluation.

Psychologist, psychiatrists, and behavioral health counselors can diagnose your condition. Based on interviews and other targeted assessments, they will craft a treatment plan.

How Is Histrionic Personality Disorder Treated?

Histrionic personality disorder can be treated. Unfortunately, many people with the disorder refuse to believe they need help. They also struggle with routines and perceived criticism. This makes accepting advice and following a treatment plan challenging.

Individuals who do seek help can expect psychotherapy as the first line of treatment. Cognitive-behavioral therapy (CBT) is among the most common types of psychotherapy. CBT can be an effective treatment for histrionic personality disorder.

Through counseling, patients uncover the reasons for their disordered thoughts and behaviors. Therapy also teaches the patient more productive coping mechanisms for stressful situations. Ultimately, therapy aims to improve the patient’s relationship with himself and others.

People with histrionic personality disorder are also at risk for other psychological disorders. These include major depressive disorder (MDD) and anxiety. Patients with these conditions may also incorporate medication into their treatment.

Histrionic Personality Disorder: When All the World’s a Stage

Histrionic personality disorder is a serious psychological disorder. It affects an individual’s self-esteem, relationships, and professional life. Fortunately, treatment is available and effective. 

Maybe you think you or someone you love has histrionic personality disorder. If so, contact Socal Empowered to begin your healing journey today.

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