Our personality is our way of feeling, thinking, and behaving that separates us from others, making us unique. Our personality is influenced by our environment, including life situations, surroundings, experiences, and characteristics we inherit from our family and peers. Our personality doesn’t change much and typically stays the same over time. However, a person who experiences a personality disorder will alter how the person feels, thinks, causing them to behave differently from societal norms. It can also cause problems functioning, distress, and persist over time in an individual’s life.
Histrionic personality disorder is one of 10 different types of personality disorders that a doctor can diagnose a person with. Personality disorders are long-term patterns of behavior and inner experiences that are significantly different from what is usually expected. These patterns of altered behavior and experience start by late adolescence or early adulthood, causing problems or distress in how the person functions. Without adequate care, personality disorders will persist for life. If you’re diagnosed with a personality disorder, it can affect two of the following areas:
- The way you respond emotionally
- The way you think of yourself and other people
- The way you relate to other people
- The way you control your behavior
The 10 types of personality disorders include the following:
- Antisocial personality disorder
- Avoidant personality disorder
- Borderline personality disorder
- Dependent personality disorder
- Histrionic personality disorder
- Narcissistic personality disorder
- Obsessive-compulsive personality disorder
- Paranoid personality disorder
- Schizoid personality disorder
- Schizotypal personality disorder
For an accurate diagnosis, a mental health professional must view long-term patterns of how a person functions and examine their symptoms. A personality disorder diagnosis mostly takes place in a person over the age of 18. Individuals under 18 are not usually diagnosed with a personality disorder because their personalities are still functioning. Those struggling with personality disorders likely don’t realize they have a problem. In addition to this, most people have more than one personality disorder.
According to the National Institute of Mental Health (NIMH), an estimated 9.1 percent of the population in the United States struggles with a personality disorder. Neither sex nor race was considered to be factors with the prevalence of these conditions. However, women are four times more likely to be diagnosed with histrionic personality disorder than men. While these disorders can be crippling, there are significant differences between them.
Below, we’ll examine the differences between the conditions and delve into histrionic personality disorder to learn about the symptoms, causes, and how mental health professionals treat it.
What Is Histrionic Personality Disorder?
The American Psychiatric Association (APA) defines histrionic personality disorder as a condition that displays extreme attention-seeking, typically in the form of a need for approval or flirtatious actions. It’s a unique condition that can have serious repercussions on a person’s social life.
Histrionic personality disorder, sometimes referred to as a dramatic personality disorder, is characterized by patterns of exaggerated emotionality and attention-seeking. The condition is categorized within the “Cluster B” personality disorders. Cluster B personality disorders include narcissistic personality disorder, antisocial personality disorder, and borderline personality disorder.
These personality disorders are commonly referred to as seductive, flirtatious, charming, impulsive, manipulative, and lively. For histrionic personality disorder, four times as many women are diagnosed than men. It’s noticeable in early adulthood. Those with histrionic personality disorder use their physical appearance to act inappropriately seductive or provocative for attention from others. They lack self-direction and are highly suggestible, and will act submissive to keep the attention of others.
According to Merck Manual, the estimated prevalence of histrionic personality disorder is less than 2 percent of the general population. While it’s diagnosed more often in women than men, Merck’s findings may only reflect the prevalence among women in clinical settings where they acquired the data.
Signs and Symptoms of Histrionic Personality Disorder
Those who fall under the Cluster B personality disorders have unstable and intense emotions with a severely distorted image of themselves. The self-esteem of a person with histrionic personality disorder is solely dependent on others’ approval.
Someone with histrionic personality disorder cannot boost their self-esteem by themselves or have a true feeling of self-worth without someone else telling them. Their desire to be noticed is overwhelming, and they behave in a dramatic or inappropriate way for attention. Positive attention from others is what they live for. The word “histrionic” means theatrical or dramatic.
In many cases, a person with histrionic personality disorder will have exceptional social skills. However, they don’t use these skills for good. Instead, they’re used to manipulate others and be the center of attention. A person with histrionic personality disorder might also exhibit the following:
- Feel a sense of discomfort unless they’re the center of attention at school, work, or a social gathering.
- Rapidly shift their emotions.
- Dress provocatively or exhibit inappropriate flirtatious or seductive behavior.
- Act extremely dramatic, seeming like they’re performing in front of an audience with exaggerated expressions and emotions. They typically lack sincerity while acting this way.
- Constantly ask for approval and reassurance.
- Will be overly concerned about their physical appearance.
- Will be gullible and easily influenced by others around them.
- Have a low tolerance for frustration and get bored easily by routine, causing them to start new projects without finishing them or skipping from one event to the next.
- They’re unable to accept criticism or disapproval.
- They don’t think before they act.
- They’ll make rash decisions and act impulsively.
- They’re self-centered and won’t show concern for others.
- They’re unable to maintain relationships and often seem fake or shallow when dealing with others.
- They’ll go as far as threatening or attempting suicide just to get attention.
As human beings, it’s in our nature to be social and want the attention of others. It’s in our DNA to spend time with others, share stories, and seek support from our peers. Due to this need, our physical and mental well-being is significantly affected when we’re isolated for prolonged periods, which is why solitary confinement is an adequate punishment for those in prison.
The need for attention can become obsessive. Those with histrionic personality disorder need to feel they’re getting constant attention from others, causing them to act in extreme ways to get the attention they need. Here are more extreme signs that a person with histrionic personality disorder will exhibit:
- Obsession with their physical appearance: It’s human nature to feel the need to look nice when you go out and mingle with others. We do our best to present ourselves to the public, and there’s nothing wrong with that. However, those with histrionic personality disorder are obsessed with their appearance. Their hair, makeup, and clothes must be perfect at all times. You’ll notice someone with the condition heading to the bathroom several times throughout the night to clean up their appearance and make sure it remains perfect. They’ll spend hours getting ready and be uncomfortable if they don’t feel “perfect.” Oftentimes, they’ll be obsessed with plastic surgery to make sure they look how they want.
- Overdramatic: Life is made up of highs and lows. On some days, we’re happy as can be, while others are a bit harder to let that smile shine through. People with histrionic personality disorder will become emotional over minor issues, leading them to act dramatically and exaggerate their problems. Their moods are prone to change in a flash, showing that it’s all an act.
- Exhibitionism: It can be funny and entertaining to show off and help someone else have a good time. For example, comedians, actors, and sports players do this. However, it’s done within reason. For a person with this condition, it’s common for them to go overboard with how they speak, dress, and act, all with the intention of making them the center of attention. A person with the disorder will do whatever it takes to get the spotlight, even if it means stealing it from someone else.
- Blaming others: As you know, life loves throwing us curveballs. Even with the most precise and careful planning, things don’t go according to plan. With that said, we can learn from our mistakes and be better for next time. However, a person with histrionic personality disorder cannot accept when they’ve made a mistake. They try to display a perfect image, so admitting they made a mistake is not something they do. This leads them to blame others for their own failures.
- Easily influenced: We learn from our peers. It’s human nature to be influenced by others and integrate the positive attributes of others into ourselves. With that said, most of us can say no when it comes to our peers pressuring us. People with histrionic personality disorder are easily influenced by others and have challenges saying no, leading to potentially dangerous situations.
- Overly sexual: For men and women alike, looking for sexual relationships is nothing new. However, when anyone goes overboard with their flirting, it can have disastrous consequences. Men or women with the disorder may only flirt for attention and not be looking for sexual encounters. The desire for attention is so strong that they’ll act in extreme ways to capture it and be the center of attention. With their inability to say no, it may lead to unwanted sexual advances from others.
- Shallow: Brand-name clothing and exterior appearance are not important to most people. Many of us are focused on getting through life happy and making sure our families are fed. Those with histrionic personality disorder only care about how themselves and others appear. Materialism and beauty are more important than what’s inside, and many of their decisions are based on how someone looks.
- Exaggerated relationships: As you get older, the number of friends you have becomes less important. You’re more focused on the quality of relationships rather than the quantity. Someone with histrionic personality disorder will exaggerate how many friends they have and the type of relationship they have with someone. They genuinely believe they’re best friends with someone they hardly know.
- Manipulation: No matter the cost, being the center of attention is the objective of someone with this condition. They’ll use manipulation and seduction to achieve this and don’t care about hurting others in the process.
- The constant need for reassurance: In most cases, we’re confident about what we’re doing. However, it’s natural to seek the opinion of others to assure us we’re doing all right. A person with histrionic personality disorder is in dire need of being told they’re OK or receiving positive feedback about their actions and appearance, no matter how many times someone has said it to them in a day.
What Causes Histrionic Personality Disorder?
Unfortunately, the cause of histrionic personality disorder is still unknown. However, some are under the impression that it could be a genetic disorder that runs in families, while others believe events from childhood could have an effect on genetic weakness that already exists in some children. The child could also be repeating learned behaviors. More research is necessary to determine the cause of this condition.
The following are some environmental factors that could influence histrionic personality disorder:
- Not being criticized or punished as a child.
- Feeling confused about which behaviors will earn approval from the parent.
- Positive reinforcement that’s given specifically when a child completes unapproved behaviors.
- The parents give unpredictable attention to the child.
There does not seem to be any specific traits or experiences that cause this disorder in adults or children. Instead of looking to find a single cause, it’s possible for people from all backgrounds to develop the condition at some point in their lives.
Some medical professionals have suggested that childhood trauma is a possible cause of histrionic personality disorder. Children who are abused, whether it be physically, emotionally, or sexually, have been known to act out behaviors similar to the symptoms of the disorder. Children might do this as a way to cope with how they’re feeling inside. Unfortunately, this may turn into a full-blown disorder if not dealt with professionally at an early age.
Substance Use Disorders and Personality Disorders
Many people who have personality disorders, major depressive disorder (MDD), anxiety disorder, or any other ailment that affects their mental health turn to substances to cope. When this occurs, it’s known as a co-occurring disorder or dual diagnosis. If a person has a substance use disorder (SUD) and a personality disorder, they’ll need to undergo a thorough and individualized treatment program to address the conditions and create a balanced state.
One of the most challenging and lonely feelings in the world is going through life with an untreated mental illness. You feel as though you can’t talk to anyone about it because of the shame and stigma attached to mental illness, so you push those feelings down and use drugs to cope. This mental illness can fester and lead to anxiety and depression, which causes you to use more drugs to calm the inner turmoil. This vicious cycle is where addiction starts and complicates an already difficult situation.
Drugs and alcohol change the chemistry of your brain. As these changes progress, the mental illness will worsen, causing your life to deteriorate even further. At this point, the individual has two choices left—professional treatment or death. While it may sound a bit harsh, drug addiction alone is often fatal without treatment, so by adding in mental illness? It’s a path toward destruction.
Depression and Histrionic Personality Disorder
The condition has the ability to affect a person’s romantic, social, and professional relationships and how they react to disappointments or losses. As you might expect, a person diagnosed with histrionic personality disorder has a much higher risk of becoming depressed.
In some cases, a person with the disorder will attend therapy because of the depression they’re battling. Depression on its own is tough to overcome. The illness zaps you of your energy, your confidence, and even worse, you stop caring about being perfect because you don’t have the energy. For someone trying to be perfect and not having the energy to do so, it’s exhausting and takes a significant toll on your psyche. Fortunately, depression can be treated with antidepressant medication, and talking to a therapist can help get to the root of why you need to feel perfect in the first place.
How to Cope with Histrionic Personality Disorder
If you’re diagnosed with histrionic personality disorder, you might be wondering what to do next. The future may seem bleak, but you shouldn’t lose hope. You must seek out professional help immediately. Speak with your doctor or therapist for tests to determine the diagnosis is correct. By doing so, it’ll help you find treatment that’s tailored to your specific needs. Getting diagnosed includes the following:
- Seek a referral for a physical to discover to determine if there’s a root cause for your physical symptoms other than histrionic personality disorder
- The next step will be the clinical evaluation interview.
- The treating physician or therapist will take these tests and narrow down their possible causes.
- Once the diagnosis is confirmed, you’ll be recommended for treatment, which could include medication, therapy, or a combination of both.
- When you look for a therapist, look for someone with experience with treating histrionic personality disorder.
After treatment, symptoms of the disorder may come and go over time. In some cases, treatment may persist over a prolonged period to ensure you’ve learned what you need to learn. In some cases, you may be able to take breaks from treatment.
Is There a Cure for Histrionic Personality Disorder?
Unfortunately, at this time, no, there is no cure for the condition. However, treatment is available. It’s a manageable condition that can get better with time and medication, but there is still a lot left to be learned by doctors. Psychotherapy is the first choice you should consider for treatment. Psychodynamic therapy and supportive therapy have proven to be successful. However, keep in mind that everyone is different. While one may work for them, it may not work for you. You may need medication, another form of therapy, or to change therapists for a better connection.
For some conditions, group therapy may be recommended to get you around peers going through the same symptoms. However, group therapy is not an ideal choice for histrionic personality disorder because of the symptoms. When battling this condition, you can’t stop yourself from being the center of attention, which may cause the person to dominate the group process and not make any progress. For that reason, one-on-one therapy is the best option when trying to combat this condition.