Introduction

A person with Histrionic Personality Disorder (HPD) continually seeks attention, whether it’s favorable or not.  They are charismatic and can manipulate other people into giving them their full attention.  Someone with HPD is often alienated due to their emotional volatility.  This makes it difficult to gain and maintain any healthy relationship.   They are bored easily and they loath routine.

Social Behaviors

Someone with HPD gains attention through being flamboyant and/or overly flirtatious.  They need to ‘make an entrance’ and will make sure all eyes are on them.  They seek attention in any situation by wearing loud and provocative clothes, being exceedingly obsessed with their appearance, and acting in overly expressive ways. These are the “drama queens” and the ones who need the limelight. For example, a person with this disorder will be the one to take the mic from you, will dance more outrageous than anyone on the dance floor, and the one that will have a tantrum if their date or other company ignores them or pays attention to someone else.

Someone with HPD will believe that all of their relationships are far more intimate than they really are; believing that their boss is in love with them, or that their neighbor is their best friend. They are also easily influenced; not only will they follow the crowd, but they will find a way to take it over whether they believe in the cause or not. They are also theatrical, that is, they exaggerate their emotions and create melodrama in even the simplest situation.

A person with HPD will dress very inappropriately for the situation they are in; tight dress and high heels to a child’s soccer game, or low-cut blouse and short skirt to a PTA meeting.  This can make them even more romantically and sexually adventurous than the norm, which can turn into sexual recklessness. As stated earlier, those with HPD will get attention any way they can, even if it’s through making other people feel guilt, shame, outrage, anger or even shock.

Sometimes they lack sincerity because they are simply waiting for others to stop talking so that they can have the floor. Their movements and expressions are exaggerated which can make them seem shallow or fake (which they may in fact be).  Someone with HPD seeks approval from others and is very sensitive to any criticism or rejection.  They are unable to fully focus on any single project and have difficulty maintaining a job.

Diagnosis, Causes and Treatment

Histrionic personality disorder affects anywhere between 1-3 percent of the general, American population.  Women are diagnosed more than men with HPD.

Like most personality disorders, the cause is unknown. There is some evidence that genetics coupled with childhood incidents may be involved. As stated above, women are diagnosed more than men; however, some believe that women are more often diagnosed because the behaviors for this disorder (sexual recklessness, attention seeking, flamboyant/outrageous appearance, etc.) are more socially acceptable for men than they are for women, so there must be something wrong with her.

A person with HPD can be treated with medication especially as depression is generally associated with those with HPD. Medication can include anti-depressants or mood-stabilizing drugs, although medication has not been consistently successful.  Different types of therapy can also help.  The symptoms tend to decrease in intensity with age.  The most extreme symptoms tend to be minimized in a person’s 40s or 50s.

Psychotherapy is the most recommended treatment, even though it is generally very challenging. This is because the person with HPD will exaggerate their situations or environments as well as their interactions with others. Therapy is also challenging because the client-therapist relationship will be thought of as a more intimate relationship, pushing the boundaries of this professional relationship.