What Is Histrionic Personality Disorder?

Medically reviewed by Julie Dodson, MA, LCSW
Updated October 21, 2024by BetterHelp Editorial Team
Please be advised, the below article might mention trauma-related topics that include suicide, substance use, or abuse which could be triggering to the reader.
Support is available 24/7. Please also see our Get Help Now page for more immediate resources.

Some people are more extroverted than others, which can manifest as enjoying being the center of attention and having a big personality. However, when someone requires attention to the point that they regularly exaggerate or invent situations to get more of it and display excessive emotions often, it could be a sign that a mental health condition like histrionic personality disorder is at play. Read on to learn more about other symptoms of this disorder as well as causes and treatment options.

Symptoms of histrionic personality disorder

What are personality disorders?

Personality disorders are “conditions in which an individual differs significantly from an average person in terms of how they think, perceive, feel, or relate to others”. People with personality disorders often have trouble managing emotions and may exhibit odd behavior, both of which can make forming and/or maintaining relationships difficult. Personality disorders are often comorbid with other mental health issues, such as depression or substance use disorders. They’re often grouped into categories or “clusters” according to similarities in how they manifest. Histrionic personality disorder is classified as a “cluster B” disorder, along with antisocial personality disorder, narcissistic personality disorder, and borderline personality disorder. Each of these is characterized by difficulties relating to others and often-volatile behavior.

What is histrionic personality disorder?

While some other types of personality disorders manifest as difficulties showing emotion, histrionic personality disorder (HPD) usually manifests as persuasive patterns of emotions shown in excess of what a given circumstance seems to require.

People with this disorder tend to be extremely enthusiastic, open, flirtatious, and loving, though they may experience anger or sadness in excess as well. They’re unlikely to feel a sense of embarrassment when they display these in excess or in inappropriate situations, but those around them may. Other signs of this disorder can include:

  • Needing to be the center of attention
  • Discomfort or anxiety around not being the center of attention or being ignored
  • Needing approval or reassurance
  • Easily influenced by the thoughts and opinions of others
  • Overly seductive/sexual behavior
  • Emotional states that may transition quickly and without warning
  • Excessive concern with personal appearance
  • Excessive displays of different emotions
  • Difficulty forming or maintaining intimate relationships, as they may come across as fake or shallow
  • Symptoms causing distress and affecting the personal and/or professional life of the individual

This personality disorder is fairly rare, estimated to affect around two to three percent of the population. Women are four times more likely to be diagnosed with HPD than men. However, researchers suggest that this may simply be due to the fact that sexually forward behavior is less socially acceptable for women, and that the disorder may actually appear in men and women with equal frequency. Onset typically begins in late adolescence or early adulthood, which is generally the case with most personality disorders. The cause of HPD is not fully understood, but genetics likely play a role. The experience of childhood trauma and/or an over-indulgent parenting style that lacked boundaries may also contribute to the development of this disorder in an individual.

Diagnosis and treatment of HPD

Receiving a diagnosis of HPD may involve a few different steps. First, it may be worthwhile to meet with your doctor for an examination to rule out any potential physical cause of your symptoms. Next, you’ll likely be encouraged to meet with a mental health professional for a clinical evaluation to assess your symptoms and narrow down the possible causes. 

For a person who receives a diagnosis of histrionic personality disorder, treatment typically involves some form of psychotherapy—sometimes in tandem with medication to help manage symptoms. Psychodynamic therapy in particular is a common choice, as it focuses on drawing the client’s awareness to unconscious processes that may be influencing their behavior so they can adjust them. Through this or other therapy modalities, providers can help individuals with HPD improve their self-esteem, develop constructive coping skills for strong emotions, and learn to observe healthy boundaries. Through this type of treatment, they may be eventually able to experience less frequent emotional distress and more stable relationships. 

Seeking support for symptoms of HPD

Those who are experiencing symptoms of HPD and are interested in speaking with a mental health professional about them can typically choose the therapeutic format with which they feel most comfortable. For those who would prefer to meet with someone in an office setting, traditional in-person therapy sessions may be best. For those who don’t have access to reliable transportation, have a busy schedule, can’t locate a provider in their area, or simply feel more comfortable meeting with someone online, virtual therapy options may be worth considering. With an online therapy platform like BetterHelp, you can get matched with a licensed therapist with whom you can meet via phone, video call, and/or online chat. Research suggests that internet CBT can be an effective treatment for psychiatric disorders, so most individuals can choose the format that feels right for them.

Takeaway

The key symptoms of histrionic personality disorder typically include a strong need to be the center of attention and excessive displays of emotion. Treatment for HPD often consists of psychotherapy. Those who are seeking treatment for this or another mental health condition can typically choose between in-person or virtual visits with a qualified provider.
Work through personality disorder symptoms
The information on this page is not intended to be a substitution for diagnosis, treatment, or informed professional advice. You should not take any action or avoid taking any action without consulting with a qualified mental health professional. For more information, please read our terms of use.
Get the support you need from one of our therapistsGet started