What is histrionic personality disorder (HPD)?

Histrionic personality disorder (HPD) is a mental health condition that involves excessive emotionality and attention-seeking behaviors. People with HPD may use seduction, flirtation, or a provocative physical appearance to gain attention. They often lack a sense of self and may be more likely to engage in people-pleasing behaviors.

HPD is relatively uncommon, affecting less than 2% of the general population. And, in some circles, it’s considered a controversial diagnosis. This is due to a history of overdiagnosis in people who were assigned female at birth and an incorrect assertion that women are more likely to fit the diagnostic profile of someone with HPD. Due to this critique, some experts advocate for removing the diagnosis from the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), while others maintain its validity. 

However, HPD is a very real diagnosis that affects people of all genders. With the right understanding and approach, individuals can receive effective treatment and support.

What do symptoms of histrionic personality disorder look like?

Like other personality disorders, HPD can shape how a person sees themselves and affect their relationships. Some of the most common symptoms of HPD include:

• Constant need for attention: A strong desire to be the center of attention, often through dramatic or noticeable behaviors
• Inappropriate flirtation or seduction: Acting overly flirtatious or seductive in situations where it’s not appropriate
• Shallow, shifting emotions: Showing intense feelings that change quickly and may seem over the top
• Vague way of speaking: Using broad or unclear language that sounds dramatic but lacks detail
• Over-the-top emotions: Being overly dramatic or theatrical when expressing emotions to get attention
• Easily influenced by others: Going along with other people’s ideas, opinions, or behaviors too easily
• Focus on appearance: Putting too much emphasis on looking attractive to get attention and approval
• Belief that relationships are closer than they are: Seeing casual relationships as more intimate or significant than they really are

Keep in mind that showing these symptoms occasionally doesn’t automatically mean you have HPD or a similar condition, like borderline personality disorder (BPD) or narcissistic personality disorder (NPD). We all have days when we want to avoid discomfort, do something novel or exciting, or feel accepted for who we are. 

But for people with HPD, these feelings and tendencies are chronic. They’re also severe enough to negatively impact their mental health, relationships, and quality of life. To be diagnosed with HPD, a person must demonstrate an ongoing pattern of intense emotionality and attention-seeking behaviors. 

What causes histrionic personality disorder?

The causes of HPD are not fully known, but it may be linked to:

• Genetics: A family history of personality disorders may increase your risk.
• Childhood experiences: Growing up with inconsistent attention or being praised for dramatic behavior can lead to the onset of personality disorders.
• Childhood abuse or neglect: Experiencing abuse or neglect during childhood may contribute to the development of HPD.
• Social and cultural factors: Societal pressure to seek attention or act in a certain way may contribute.

Is histrionic personality disorder dangerous?

There are few studies on the long-term outlook for people living with HPD. However, it’s considered a chronic condition that’s unlikely to improve without treatment. While there’s no cure for HPD, there are interventions that can improve social stability, reduce symptoms of co-occurring conditions, and improve the quality of life for people with HPD.

Self-care strategies for dealing with HPD

If you have a personality disorder, you’ll likely require professional help throughout your life. But in addition to seeking therapy, there are some individual strategies you can use to strengthen your mental health.

• Manage stress. Whether it’s taking a walk outside, listening to some music, or journaling, make time to manage your stress level each day.
• Try mindfulness. Mindfulness can help you slow down to notice what’s happening in your mind, body, and environment without judging what comes up.
• Care for your body. Eating a balanced diet, making time for movement you enjoy, and prioritizing sleep can help you keep your mind and body healthy.
• Avoid substances. Unhealthy substance use is common among people with personality disorders and may increase the risk of unsafe behaviors. 
• Connect with others. Sometimes, having a mental health condition like a personality disorder can be an isolating experience. Joining a support group (either in person or online) can help you feel less alone.

How is histrionic personality disorder treated?

Most personality disorders are treated in the same way — typically with therapy and, in some cases, medication. While there’s no medication approved to treat HPD, it can help reduce symptoms of co-occurring mental health conditions, like anxiety or depression. It’s important to work with your provider to determine if medication is right for your unique needs. Therapy for HPD often includes:

• Psychodynamic therapy: This approach focuses on uncovering underlying emotional causes of HPD.
• Cognitive behavioral therapy (CBT): CBT aims to change distorted thinking and improve self-awareness and coping skills.
• Group therapy: This approach helps people develop healthier ways to relate to others and manage attention-seeking behaviors.

With consistent therapy, people with HPD can improve their emotional regulation and build healthier relationships.

Find care with Rula

People with HPD may feel distressed when they’re not the center of attention, leading them to act in ways that draw attention to themselves. HPD can affect people of all sexes and genders, and while it can present challenges, there is hope. With the right support and treatment, people with HPD can find stability and develop healthier relationships. There are effective therapies and resources available that can help people with HPD manage their emotions and thrive.

When you need specialized care for your mental health, we invite you to explore Rula. Whether you’re living with HPD or another condition, you can explore our network of over 10,000 providers to find the right therapist for your needs. In just a few clicks, you can sift through your options, find a provider who takes your insurance, and schedule your first live-video session for as soon as tomorrow.

Get started with Rula today