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Histrionic Personality Disorder

10 Minutes

Edited & medically reviewed by THE BALANCE Team

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CONTENTS

Are you someone who always has to be the centre of attention? Someone who commonly engages in highly emotional, excitable, volatile, or erratic behaviour? If so, you may be suffering from a histrionic personality disorder (HPD). People with HPD are often labelled as dramatic due to their tendency to exhibit exaggerated displays of emotions. They may also seem like the life of every party; however, beneath these perceived theatrics of this personality disorder lies a deep need for validation and attention from others.

Here is what you should know about histrionic personality disorder, its symptoms, and its management.

As social creatures, it is in human beings’ DNA to crave attention. They may wish to spend time with others, get their support, and share stories. Because of this need, their mental health can be negatively affected if they are isolated for a long time.

In people with histrionic personality disorder, this need for attention from others can be particularly obsessive. HPD may force them to require validation and support from others constantly, and if they do not get it, such people may behave in extreme ways, such as:

Exhibitionism

People with HPD love show off without any reason. Their manner of speaking, acting and dressing are planned to make themselves the centre of attention. Such people will do whatever it takes to steal the spotlight from others.

Obsession with Physical Appearance

There is absolutely nothing wrong with being a little cautious about your appearance. However, for people with HPD, this obsession goes way beyond a healthy limit. These individuals are obsessed with their physical looks and ensure that their hair, makeup, and clothes are perfect.

Blaming Others

Life does not always go as planned, and mistakes do happen. A person who has a histrionic personality disorder may find it difficult to accept these mistakes or learn from them. Instead, they may blame others even when it is their failure.

Easily Influenced

People with HPD easily get influenced to the extent that it becomes difficult for them to say no to others. Hence, others may easily lead them on and force them into situations that they would usually not get into.

Overly Dramatic

Everyone gets emotional now and then, and for most people, their emotions are appropriate to the circumstances. However, these emotional episodes might be exaggerated for a person with a histrionic personality disorder.

Shallow

Most people with histrionic personality disorder are materialistic, and most decisions are solely based on the other person’s outward appearance.

Too Sexually Forward

People with histrionic personality disorder have a strong desire to be wanted and to fulfil it; they may routinely act in extreme ways. For example, they may become too sexually forward to everyone, even if they are not attracted to them, just to prove their desirability.

Exaggeration of relationships

People with histrionic personality disorder tend to frequently exaggerate the element of intimacy in their relationships with others.

The Need for Constant Reassurance

Another common symptom of histrionic personality disorder is the constant need for reassurance and validation from others. They need others to tell them that they did okay or require positive feedback about their actions and appearance regardless of how many times they have already been told so.

Sometimes, a person with a histrionic personality disorder may exhibit symptoms suggestive of more than one type of personality disorder. For example, they may have a dependent personality disorder, borderline personality disorder, or narcissistic personality disorder in addition to HPD. Among these, borderline personality disorder is the most common to occur.

Some other types of behavioural and mental health disorders that routinely co-exist with HPD include the following:

Depression

Histrionic personality disorder often gives rise to a strong emotional response when a person suffering from it experiences disappointment or rejection. As a result, such people are more likely to slip into clinical depression.

Anxiety disorders

Up to 52% of people with an anxiety disorder also meet the criteria for a personality disorder, such as HPD.

Eating disorders

About one-third of eating disorder sufferers also have one or more co-occurring personality disorders, often including HPD.

Substance use disorders

Some studies have proven a strong connection between histrionic personality disorder and addiction. However, this association may not be as strong as other personality disorder types.

When an additional behavioural or mental health condition is diagnosed in individuals with HPD, their treatment plan must focus on both issues equally.

A histrionic personality disorder is amenable to treatment for those truly willing and motivated to change their psychological and emotional reactions. Undertaking intensive outpatient or inpatient treatment programs in an appropriate rehabilitation facility is the ideal way out for people with this disorder. Psychotherapy forms the main component of intervention for HPD, and some of its common types of especially proven effective for this mental illness include:

Cognitive behavioural therapy (CBT)

People with histrionic personalities particularly benefit from CBT as the therapy helps them think and act more calmly and in contemplation. CBT is also effective against other psychiatric illnesses, like anxiety and depression, which may co-occur with HPD.

Psychodynamic therapy

Psychodynamic therapy aims to minimise emotional reactivity by recognising and demystifying the underlying cause of HPD.

Group therapy

People with histrionic personality disorders are commonly encouraged to participate in group discussions and engage in role-playing sessions with their peers and other people with HPD. Doing so allows them to improve their interpersonal relationships and social behaviours.

Family and couples therapy

Unfortunately, the effects of HPD are not limited to a single person, but its impacts may also extend to the family members and friends of the afflicted ones. Many rehabs offer family intervention and couples therapy to minimise these impacts on the extended family and resolve any conflicts that arise due to them. These therapies aim to address the issues secondary to HPD in a solution-oriented environment with the support of loved ones.

Holistic practices

Mindfulness techniques learned through yoga, meditation, biofeedback, Tai Chi, and other holistic interventions can significantly benefit people with HPD. These techniques help such people reprogram their minds to achieve better control over their emotional reflexes.

With in-depth, compassionate and careful intervention extending from initial treatment to aftercare programs, people with HPD can minimise their symptoms and their effects on life. While the disorder cannot be cured entirely, most individuals do learn how to limit their emotional reactions to a manageable level

In addition to seeking professional treatment, practising self-care can also help clients heal from histrionic behaviours and improve their overall well-being. Here are some essential tips to keep in mind in this regard:

Get enough sleep

Sleep is undoubtedly an undermined aspect of physical and mental health. If you cannot sleep properly, it can severely worsen your existing mental health issues, including histrionic behaviours. Hence, invest in making a proper sleep schedule and stick to it so that your body can get enough time to relax, unwind, and heal every night. Additionally, follow good sleep hygiene by limiting your intake of coffee and alcohol close to bedtime, ensuring that your room is dark, cool, and comfortable, and avoiding using any electronic gadgets in the bedroom.

Exercise regularly

Regular exercise can work wonders for your everyday life by reducing stress levels, improving sleep, and positively contributing to your well-being. If possible, try engaging more in activities that increase your heart rate for 150 minutes a week.

Eat healthily

No self-care is complete without nutrition. Try incorporating healthy eating habits into your everyday life. If doing so seems overwhelming, start smaller by adding one or two healthy foods to your daily meals per week while reducing the portion of processed and unhealthy foods.

Practice mindfulness

Yoga, mindfulness, and relaxation exercises can all help you reduce the element of stress in life. This allows you to control better your behavioural and emotional issues related to histrionic personality disorder.

What causes histrionic personality disorder?

Unfortunately, experts are not entirely sure what triggers histrionic personality disorder in people. Some believe it has a genetic component as the disorder typically runs in families. Others believe certain childhood experiences and events may trigger it in individuals with a genetic weakness. It is also possible to pick up the symptoms of this personality disorder as learned behaviour from a caregiver or a parent. Some other environmental factors that seem to play a role in causing histrionic personality disorder include:
An overly optimistic parenting style with a lack of punishment or criticism
Confusion in children about the type of behaviour that will earn them approval from a parent
Unpredictable attention given by a parent to a child
Provision of positive reinforcement when a child performs certain approved behaviours only

So far, there don’t seem to be any individual experiences or traits that possibly lead to histrionic personality disorder in children and adults.

I think I have a histrionic personality disorder. What should I do now?

If you suspect to be suffering from a histrionic personality disorder, it is imperative to seek professional help as soon as possible. Get in touch with your therapist or doctor and ask them for detailed assessments and evaluations to ensure that you have been accurately diagnosed. Doing so will confirm that your treatment meets your needs to achieve early recovery. The process of getting a diagnosis for histrionic personality disorder involves the following steps:
A referral for a medical examination to rule out any physical cause for your symptoms
A detailed clinical evaluation and personal interview to narrow down the prospective diagnoses
Confirmation of diagnosis, followed by the creation of a treatment plan including therapy and medication

Remember that certain histrionic personality disorder symptoms may keep coming and going during and sometimes even after treatment. Depending on your preference, you may seek treatment in the form of a one-long session or take breaks in between from time to time.

Is it possible to cure histrionic personality disorder?

It is possible to control histrionic personality disorder’s symptoms with appropriate treatment and follow-ups. Psychotherapy usually serves as the treatment of choice for most individuals; however, experts may combine it with psychodynamic psychotherapy and other supportive therapies for long-term management and success.

What are some histrionic personality disorder examples?

Some common examples of behaviours exhibited by people with histrionic personality disorder include:
Wearing brightly-coloured clothes to an all-white themed party
Exaggerating their struggles to gain success
Trying to be the centre of attraction at every party or event

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