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What is Histrionic Personality Disorder?

Part of a group known as “Cluster B” or “dramatic” personality disorders, a histrionic personality disorder (HPD) is a less known mental health condition. People with HPD have an overwhelming desire to be noticed, to the point, they’ll go through extreme lengths to get what they want. The problem with a histrionic personality disorder is that it becomes evident in adolescence and early adulthood, so many times it goes undiagnosed. 

Understanding Histrionic Personality Disorder

A histrionic personality disorder is a mental condition characterized by a pattern of extreme attention. One of the ten personality disorders recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), people with this condition are dramatic, erratic, and overly emotional. Some people even compare it to borderline personality disorder.

About 9% of the United States’ general population has at least one personality disorder, and histrionic personality disorder affects roughly 3% of the population. HPD is characterized by attention-seeking and manipulative behavior, accompanied by shallow emotions. 

Symptoms and Causes

Since histrionic personality disorder doesn’t involve symptoms that appear out of the ordinary, it’s often challenging to diagnose. Most people don’t even realize they have a condition because their acting and thinking seem natural. People with histrionic personality have remarkable social skills. They use these to manipulate others and become the center of attention. 

The most common symptoms of histrionic personality disorder include:

  • Excessive but shallow emotions paired with attention-seeking behaviors
  • Exaggerated signs of illness or weakness used as threats to manipulate others
  • Fleeting moods, beliefs, and opinions
  • The compulsive need for others to witness and validate their emotional displays
  • Use provocative behaviors to control others or gain attention
  • Feel uncomfortable unless they’re receiving attention
  • Be overly concerned about their physical appearance
  • Rarely show concern for the wellbeing of others
  • Not thinking before acting and making rash decisions
  • Act inappropriate, sexually seductive, or provocative

Unfortunately, there’s no primary cause associated with a histrionic personality disorder. Mental health professionals believe it’s a combination of genetic and environmental factors paired with learned behavioral factors during their development. Other factors that may play a role in the risk of developing a personality disorder include:

  • Having inconsistent or over-indulgent boundaries as a child 
  • Parents who model volatile and dramatic behaviors
  • Family history of psychiatric disorders, personality disorders, or substance abuse
  • Childhood trauma

Relationship with Substance Abuse

Substance abuse is relatively common among people with personality disorders. It is most common in people with attention-seeking personality disorders, like HPD. In a desperate effort to seek attention, people with HPD often exhibit risky behaviors, such as using drugs. Part of their personality disorder entails being overly dramatic and exaggerated, so they’re more likely to use intravenous medications as they can be seen as a more dangerous substance. 

In one study in the International Journal of Experimental and Clinical Pathophysiology and Drug Research, researchers found that anywhere from 40 percent to almost 80 percent of patients suffering from alcoholism also had a personality disorder. Also, the National Institute on Drug Abuse (NIDA) estimates that nearly half of people with a mental illness are also struggling with a substance misuse disorder.

Unfortunately, the nature of those with a histrionic personality disorder also makes them less likely to seek treatment. Even if family members manage to convince them, they are likely to have challenges and setbacks throughout therapy to gain attention, which makes their recovery more difficult. 

Histrionic Personality Disorder Treatment Options

The prognosis for people with HPD is good, as it isn’t a devastating disorder. Since they already have good social skills, people with HPD are likely to maintain their jobs and be active members of society. The best way to treat histrionic personality disorder is through therapy to help them address their behaviors. Also, if there’s a co-occurring substance use disorder or another mental health condition like depression, therapy can simultaneously address these multiple issues. 


Therapy can help treat HPD, as it can help improve self-esteem, lower emotional distress, and enhance a person’s coping skills. Unlike other disorders, group therapy and family therapy are generally not advised for HPD. Since symptoms include seeking attention, group settings can become triggers and dampen the progress made in individual treatment.


Currently, there are no medications approved for the treatment of histrionic personality disorder. However, certain medications can help treat mood swings, anxiety, and depression symptoms that often accompany the condition. Antidepressants can help treat many of these symptoms, so patients can focus on therapy and healing.

Holistic Therapy

Beyond psychotherapy, mindfulness techniques and biofeedback can help those with a histrionic personality disorder. Holistic therapies are an excellent maintenance choice to help those with HPD control their feelings, manage impulsivity, and prevent emotional reactivity. 

Finding Help Near Me

It can be challenging to recognize histrionic personality disorders by oneself. But, if a friend or family member exhibits some of these symptoms, try to encourage them to seek help. Without professional treatment, it’s unlikely that their symptoms will improve.

Although histrionic personality disorder itself isn’t devastating, sometimes the actions those with the condition make are. Many with HPD will attempt suicide and engage in risky behavior that can be life-threatening.

If you or a loved one is struggling with a histrionic personality disorder, contact us today. Our therapists and dual diagnosis specialists can help design a comprehensive treatment program that addresses the condition’s underlying cause. Together, we can help you find the help and support you need to find comfort and start your recovery journey. 

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