Histrionic Personality Disorder (HPD): Causes, Symptoms and More

What is histrionic personality disorder?

Histrionic personality disorder (HPD) belongs to a group of psychological disorders known as “Cluster B.” personality disorders. Generally, this category involves mental disorders that are dramatic, emotional or erratic.

A person with HPD has a distorted self-image. A person’s sense of self-worth often depends on how others perceive them. Consequently, people tend to want to be noticed. Individuals with HPD may become dramatic because of this condition.

Most cases of HPD are diagnosed in women. Symptoms are reported less frequently by men than by women, perhaps because of this.

In the DSM-5, there are 10 categories of personality disorders. A Cluster B disorder is highlighted by extreme personality changes, emotional outbursts and unpredictable behavior. Histrionics refers to dramatic or theatrical performance.

There is approximately 9 percent of Americans have at least one personality disorder, and roughly 2 percent to 3 percent of those have a histrionic personality disorder, defined by shallow emotions, attention-seeking and manipulative behavior.

Identifying the signs of histrionic personality disorder

The disorder is not devastating. It is common for those with HPD to function successfully both at work and in society. HPD patients tend to be excellent communicators. These skills are often used for manipulative purposes.

Heterotronic personality disorder is defined as exhibiting five (or more) of these symptoms according to the Diagnostic and Statistical Manual of Mental Disorders (5th edition):

  • Not being the center of attention makes them uncomfortable
  • Has inappropriately seductive or provocative interactions with others
  • Expresses emotions rapidly and shallowly
  • Physically draws attention to themselves
  • Often speaks too impressionistically and lacks detail
  • Self-dramatizes acts theatrically, and exhibits exaggerated emotions
  • Is suggestible (meaning that others or circumstances have the ability to influence them)
  • Does not see the intimacy of relationships as it actually is

In addition, HPD might also cause you to make rash decisions before thinking, or to threaten suicide with an intention to gain attention.

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What causes histrionic personality disorder?

Psychologists believe that both learned and inherited factors play a role in developing a histrionic personality disorder, but there is no clear explanation. Histrionic personality disorder has a tendency to run in families, suggesting that the disorder may be inherited.

However, it might be that the child of a person with this disorder just repeats learned behaviors. A child who is not punished or criticized, who is only rewarded for completing certain approved behaviors, and whose parent(s) offer inconsistent attention to the child are examples of environmental factors that might contribute to confusion about what types of behavior are approved by parents.

The development of personality disorders is also influenced by the individual’s temperament, personality type and ways of coping with stress.

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Related conditions

Other personality disorders co-occur with histrionic personality disorder, including:

Diagnosis of HPD

HPD is not diagnosed by a specific test. Your doctor will likely begin taking your medical history if you are troubled by your symptoms and seek medical care. If your symptoms are caused by a physical problem, they may perform a physical exam.

You may be referred to a psychiatrist if your primary care provider cannot find a physical reason for your symptoms. The purpose of psychiatric training is to identify and treat disorders that affect the mind.

You can expect the psychiatrist to ask you expert questions in order to gain a better understanding of your behavior. Your primary care provider can accurately diagnose you by assessing your behaviors.

Despite this, many people with this condition don’t believe they require therapy or assistance, which makes diagnosis difficult. Often, when someone is diagnosed with HPD, they have been treated for depression or anxiety, usually after a failed relationship or other conflicts in their lives.

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Treatment of HPD

Treatment of HPD
Treatment of HPD

HPD can make treatment challenging. You may feel that you don’t need treatment, or you may discourage yourself from embarking on a treatment program due to the routine. You may be able to cope with HPD with the use of therapy and sometimes medication.

Therapy

HPD is mostly treated with psychotherapy, which is the most effective and common treatment option. It involves speaking about your experiences and feelings with a therapist.

It’s important to have such conversations with your therapist in order to figure out how your actions and behaviors are linked. By engaging in positive social interactions instead of constantly seeking attention, a therapist may help you develop a positive relationship with people.

Medication

A primary care provider may prescribe antidepressants or antianxiety medications to you if you experience depression or anxiety as part of your HPD.

Hetronic personality disorder is not treated with an FDA-approved medication; as a result, medicine might be used for the symptoms of affective dysregulation, such as mood swings, anger, tears, anxiety, and depression. Antidepressants are recommended for treating depression and anxiety.

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HPD vs. BPD

Hetronic personality disorder (HPD) and borderline personality disorder (BPD) exhibit overlapping symptoms and some believe HPD may not be recognizable as an individual disorder at all.

Borderline is defined by self-destructiveness, angry disruptions in intimate relationships, chronic feelings of deep absence, and identity disturbances, although attention-seeking and manipulative behavior can also be present.

There are numerous similarities between the two conditions, including:

  • Emotions that change rapidly and react quickly
  • Affect impulsive behavior
  • Emotionally strong expressions

There is some debate among clinical professionals as to whether HPD and BPD have different features of these symptoms — specifically, whether the rapidly shifting emotions in HPD can be as well-recognized as those in BPD. However, other experts have specifically disputed the distinction between HPD and BPD.

The HPD diagnosis was not removed from DSM-5, despite predictions to the contrary, so it remains its distinct diagnosis.

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HPD and long-term outcomes

People with HPD are able to live normal lives, work, and participate in society. Many HPD individuals have no problem fitting in with casual environments.

Intimate relationships are the only ones that cause problems for them. You may have trouble holding down a job, maintaining a relationship, or concentrating on life goals if you suffer from HPD. The constant search for adventure may also lead you into dangerous situations.

In addition, HPD also increases your risk of depression. You may experience failure and loss differently if you have this disorder.

Also, not getting what you want may leave you feeling more frustrated. HPD is not as common as it once was, but symptoms are a cause for concern when they are interfering with your daily life, work, or the quality of your life.

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