Understanding Histrionic Personality Disorder

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Nearly everyone likes to be the center of attention once in a while. At one time or another, most people are guilty of showing off or doing what they can to get others to notice them. People with histrionic personality disorder take these behaviors much further and act in a highly emotional manner in hopes of drawing attention to themselves. These individuals have a pervasive and consistent pattern of seeking the spotlight and behaving in excessively dramatic ways.

What is Histrionic Personality Disorder?

The term “personality” describes the combination of qualities that form an individual’s distinctive character. These involve patterns of behavior and the way individuals perceive, relate to and think about themselves and their world. Personality traits may include noticeable features, but they are not necessarily pathological, even if they may cause interpersonal problems from time to time.

By contrast, personality disorders are rigid and maladaptive, causing impairment in functioning or internal distress. A personality disorder is an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time and leads to distress or impairment.

Histrionic personality disorder (HPD) is a specific mental health condition that affects the way a person thinks, perceives and relates to others. Specifically, HPD causes people to act in very emotional and dramatic ways to garner attention.

Those suffering from HPD have a strong inclination for creating drama across a wide variety of situations. Histrionic personality disorder typically includes character traits such as being highly emotional, charming, manipulative, seductive, demanding, energetic or impulsive.

As the term “histrionic” implies, there is a tendency toward melodrama, as the one affected craves attention and the perceived reward derived from it. When they’re not at the center of attention, those with HPD feel deprived of this reward and are uncomfortable as a result. The discomfort leads to increasing distress, resulting in extreme behaviors to capture everyone’s attention.

What are the Signs and Symptoms of Histrionic Personality Disorder?

Specific symptoms and their intensity will vary from one individual to another but involve behaviors such as:

  • Constantly seeking reassurance or approval
  • Excessive dramatics with exaggerated displays of emotion
  • Excessive sensitivity to criticism or disapproval
  • Inappropriately seductive appearance or behavior
  • Overly concerned with physical appearance
  • Tendency to believe that relationships are more intimate than they actually are
  • Self-centeredness, uncomfortable when not the center of attention
  • Low tolerance for frustration or delayed gratification
  • Rapidly shifting emotional states that appear shallow to others
  • Opinions are easily influenced by other people, but difficult to back up with details
  • Blaming failure or disappointment on others

With these types of symptoms, it’s easy to see how histrionic personality disorder could adversely affect a person’s social or romantic relationships and their ability to cope with loss or failure. Craving excitement may cause boredom and lead to dangerous or risky behavior. These and other factors may lead to an increased chance of depression and co-occurring substance abuse.

Histrionic personality disorder does not usually affect the person’s ability to function adequately in a superficial work or social environment. However, problems often arise in more intimate relationships, where deeper involvements are required.

What are the Treatment Options for Histrionic Personality Disorder?

There are no specific tests for detecting histrionic personality disorder, and the diagnosis is based primarily on a psychological evaluation. A health care professional will also consider the duration and severity of a person’s symptoms by examining behavior and overall appearance.

According to the American Psychiatric Association, there are no medications specifically to treat personality disorders. However, antidepressants, anti-anxiety medication or mood stabilizing medication may be helpful in treating some symptoms. More severe or long-lasting symptoms may require a team approach involving a primary care doctor, a psychiatrist, a psychologist, social worker and family members.

The most effective methods of treatment currently involve certain types of psychotherapy. Commonly used types of psychotherapy include psychoanalytic/psychodynamic therapy, dialectical behavior therapy, cognitive behavioral therapy, group therapy and psycho-education.

During therapy, individuals gain insight and knowledge about the disorder and what is contributing to their symptoms. Therapy provides important opportunities to talk about their thoughts, feelings and behaviors and how their illness affects others and themselves. They also learn to manage or cope with symptoms and to reduce behaviors that cause problems with day-to-day functioning and personal relationships.

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