Histrionic Personality Disorder: Signs, Symptoms, and Treatment Options

Table of ContentsView AllTable of ContentsUnderstanding Histrionic Personality DisorderSymptoms and DiagnosisCauses and Risk FactorsImpactTreatment and ManagementLiving with Histrionic Personality Disorder

Table of ContentsView All

View All

Table of Contents

Understanding Histrionic Personality Disorder

Symptoms and Diagnosis

Causes and Risk Factors

Impact

Treatment and Management

Living with Histrionic Personality Disorder

Do you know someone who is basically always overly dramatic, excessively emotional, and seems toneed to be the center of attentionin all situations? Maybe you’ve been told that you are like this multiple times or noticed this behavior in a friend or family member. Whatever the case, you’re probably wondering how and where this behavior stems from. The answer? Histrionic personality disorder (HPD).

Not everyone who tends toward drama and attention-seeking has apersonality disorderbut when taken to the extreme, sometimes these behaviors are signs of histrionic personality disorder.Want to learn more? Scroll down to find everything you need to know about HPD, including what it is, what it looks like, how it impacts people who have it, and how it can be treated and managed.

Like other personality disorders, histrionic personality disorder tends to be chronic, meaning that people live with the disorder throughout their lives. You may start to show signs in your teen years or when you are a young adult. People who have HPD are often described as dramatic, flirty, self-centered, and extremelyextroverted. They may even be callednarcissistic.

Origins and Background

Why is it called histrionic personality disorder? Its origin goes back to Greek and Roman times when people with intense, overly dramatic personalities were often called “hysterical.” Typically, this description was stereotypically given to women. The word “histrionic,” though it derives from a Latin root, has similar connotations.Sigmund Freudoften discussed the idea of “hysteria” and women’s behaviors, but histrionic personality disorder, as we know it now, wasn’t formally recognized in the psychology world until 1980. Only then was it added to theDiagnostic and Statistical Manual of Mental Disordersas a condition and could be diagnosed.

NoteTo be clear, HPD isnota women’s only condition and is thought to affect women and men equally.It’s not totally clear how many people have HPD, but research estimates that it’s about 1.8% of the population.

Note

To be clear, HPD isnota women’s only condition and is thought to affect women and men equally.It’s not totally clear how many people have HPD, but research estimates that it’s about 1.8% of the population.

HPD is a type of personality disorder—namely, acluster B personality disorder. “Histrionic personality disorder is the third disorder in the Cluster B of personality disorders and has similar characteristics tonarcissistic personality disorder (NPD)andborderline personality disorder (BPD),” explainsElisabeth Crain, PsyD, a licensed psychotherapist based in Southern California. Besides narcissistic personality disorder and borderline personality disorder, other cluster B personality disorders includeantisocial personality disorder.

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According to Dr. Crain, some other common symptoms of HPD include:

Diagnosing Histrionic Personality Disorder

Diagnosis of HPD is based on the DSM-5 from the American Psychiatric Association. You must exhibit five of the following signs to be diagnosed with HPD:

Even if you display five or more of the symptoms above, it doesn’t mean you’re guaranteed to receive a diagnosis. Since personality continues to evolve, professionals don’t typically diagnose until after age 18. Furthermore, mental health professionals require a lot of information, from history to relationships and behaviors, to assess before making a proper diagnosis. This is not to say youcan’tget diagnosed, but the process is much more complex.

Similar to other personality disorders, it’s not fully known what causes histrionic personality disorders. Experts believe that it’s likely a combination of influences. These include genetic factors, early childhood experiences, and environmental impacts.

There are certain factors that may put you at higher risk of having HPD. These include:

Impact on Life and Relationships

Having HPD not only impacts the person who has the condition but also affects those around them.

HPD can shake up your personal relationships, says Lewis. “Someone with HPD might seek constant attention, which can make it challenging to maintain long-term, stable relationships,” she explains. This behavior doesn’t just impact your friendly and familial connections but also your relationships in the workplace, as attention-seeking and acting out are usually frowned upon in work environments.

Folks with HPD often have issues withconfidenceand identity, too. “Their self-image and self-esteem are often fragile since they depend so much on outside approval,” Lewis shares.

“When that attention is absent, it can lead to insecurity and frustration, causing ripple effects in many areas of life.”

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The sad truth is that the majority of people with HPD don’t get treatment for their disorder, often because they don’t recognize they need the help, or aren’t able to see that their behaviors are problematic. Furthermore, people with HPDdon’t like to be criticized, and admitting that something may be wrong can feel like too much of a critique.

There aren’t any formal treatment plans for HPD, though it’s typically treated withpsychotherapy. “Therapy is often the most effective way to help someone with HPD manage their behaviors and work towards healthier relationships,” Lewis describes. Unfortunately, it’s often thought that HPD treatment is only minimally effective because it’s a life-long personality trait, rather than a problem that can be isolated and treated.

That said, many people with HPD and their loved ones find relief with therapy. “The go-to treatment for HPD is therapy, especiallycognitive behavioral therapy(CBT), which helps individuals identify and change unhealthy thought patterns and behaviors,” Lewis explains. “Dialectical Behavior Therapy(DBT) can also be helpful, focusing on managing emotions and improving relationships.”

And what about medication? There are no approved HPD medications. But it’s possible to treat some of the symptoms you may experience if you have HDP. “While medication does not directly treat HPD, it can help if there are co-occurring issues like anxiety or depression,” Lewis offers.

How to Cope With a Personality Disorder

Living well with histrionic personality disorder can be challenging, but it’s possible. According to Lewis, some coping strategies include:

Lewis emphasizes the importance of therapy for people with HPD, and shares a successful story of an HPD client she worked with. “One client felt a constant need for attention, which led to dramatic behavior that pushed people away,” she describes. “Through therapy, she learned to develop deeper connections and reduce her reliance on external validation.”

As time went on, Lewis’s client was able to find fulfillment in more authentic relationships and was able to learn healthier coping mechanisms where she was not the center of attention. “It was not an easy journey, but it was gratifying for her,” says Lewis.

Use Friends and Family for Support

Having support from friends and family members is also vital when someone has HPD. Lewis shared thoughts on how you can support a loved one who has HPD:

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The Bottom Line

People with histrionic personality disorder are often misunderstood. Their behaviors of being overdramatic, attention-seeking,impulsive, and volatile can be off-putting and relationship-ruining. But it’s important to understand that people who display these behaviors aren’t doing this to intentionally harm others—in some cases, they are dealing with a personality disorder.

Remember: never try to diagnose histrionic personality disorder yourself, even if you are convinced you or a loved one has it. Always seek advice and care from a licensed mental health professional if you are showing signs of histrionic personality disorder.

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6 SourcesVerywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Babl A, Gómez Penedo JM, Berger T, et al.Change processes in psychotherapy for patients presenting with histrionic personality disorder.Clin Psychol Psychother. 2023;30(1):64-72. doi:10.1002/cpp.2769Torrico TJ, French JH, Aslam SP, et al.Histrionic Personality Disorder. In:StatPearls. StatPearls Publishing; 2024.Novais F, Araújo A, Godinho P.Historical roots of histrionic personality disorder.Front. Psychol. 2015;6. doi:10.3389/fpsyg.2015.01463Zimmerman M.Histrionic Personality Disorder. Merck Manual.MedlinePlus.Personality Disorders.American Psychiatric Association.What are Personality Disorders?

6 Sources

Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Babl A, Gómez Penedo JM, Berger T, et al.Change processes in psychotherapy for patients presenting with histrionic personality disorder.Clin Psychol Psychother. 2023;30(1):64-72. doi:10.1002/cpp.2769Torrico TJ, French JH, Aslam SP, et al.Histrionic Personality Disorder. In:StatPearls. StatPearls Publishing; 2024.Novais F, Araújo A, Godinho P.Historical roots of histrionic personality disorder.Front. Psychol. 2015;6. doi:10.3389/fpsyg.2015.01463Zimmerman M.Histrionic Personality Disorder. Merck Manual.MedlinePlus.Personality Disorders.American Psychiatric Association.What are Personality Disorders?

Babl A, Gómez Penedo JM, Berger T, et al.Change processes in psychotherapy for patients presenting with histrionic personality disorder.Clin Psychol Psychother. 2023;30(1):64-72. doi:10.1002/cpp.2769Torrico TJ, French JH, Aslam SP, et al.Histrionic Personality Disorder. In:StatPearls. StatPearls Publishing; 2024.Novais F, Araújo A, Godinho P.Historical roots of histrionic personality disorder.Front. Psychol. 2015;6. doi:10.3389/fpsyg.2015.01463Zimmerman M.Histrionic Personality Disorder. Merck Manual.MedlinePlus.Personality Disorders.American Psychiatric Association.What are Personality Disorders?

Torrico TJ, French JH, Aslam SP, et al.Histrionic Personality Disorder. In:StatPearls. StatPearls Publishing; 2024.

Novais F, Araújo A, Godinho P.Historical roots of histrionic personality disorder.Front. Psychol. 2015;6. doi:10.3389/fpsyg.2015.01463

Zimmerman M.Histrionic Personality Disorder. Merck Manual.

MedlinePlus.Personality Disorders.

American Psychiatric Association.What are Personality Disorders?

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Origins and Background#

Note#

Diagnosing Histrionic Personality Disorder#

Impact on Life and Relationships#

Use Friends and Family for Support#

The Bottom Line#