What is Histrionic Personality Disorder

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A personality disorder is a type of mental health condition that is characterized by inflexible and unhealthy types of thinking, feeling, and behaving.  A person with a personality disorder has trouble with their perception of situations and interactions with others.  These difficulties lead to distress in several areas of their lives, including academic, occupational, and social functioning.  There are three types of personality disorders, Cluster A, Cluster B, and Cluster C.  Cluster A personality disorders are defined by odd and unusual thinking and behaving, Cluster B personality disorders are characterized by theatrical, emotional, and erratic thinking and behavior patterns, and Cluster C is exemplified by feelings and behaviors that are linked with anxiety and worry.

Histrionic personality disorder is categorized in Cluster B, or dramatic disorders.  Individuals with histrionic personality disorder have heightened and intense feelings and emotions.  They have a distorted image of themselves and their self-esteem is defined by how others see them.  People with histrionic personality disorder are constantly seeking the approval of other people and have low confidence and self-worth.  They are extremely attention-seeking, overdramatic, and will try to seek attention in inappropriate ways. 

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Individuals with histrionic personality disorder often have good socialization habits, but use their social skills to manipulate others, causing them to have difficulties in maintaining their relationships.  If they are not the center of attention, they will quickly become uncomfortable and upset.  Individuals may dress or behave inappropriately to receive attention, even sometimes resorting to threatening self-harm or suicide.  A person with histrionic personality disorder will act in a theatrical manner with exaggerated facial expressions and emotional responses, portraying a lack of sincerity.  They are self-centered, highly concerned with their physical appearance, and always seeking validation from others.  They are extremely sensitive to criticism or lack of approval, have rapidly changing emotions, and can be very impulsive.  An individual with this personality disorder has a low frustration tolerance, can become bored easily, and makes poor decisions without thinking them through first.     

The cause of histrionic personality disorder is unknown, but believed to arise from genetic factors and learned behaviors.  There may be a hereditary component if other family members have the disorder.  In addition, a person could potentially learn to repeat behaviors that are witnessed or learned from their environments.  Other causes may include growing up in an unpredictable environment without structure or boundaries.

Treatment is available for individuals with histrionic personality disorder.  Psychotherapy is the treatment of choice, but people with this personality disorder often feel as if they do not need therapy.  Treatment goals are designed to assist people in identifying and understanding their thoughts and behaviors.  Individuals are educated on how to interact and relate to others in a healthier way. 

People with this personality disorder are often at risk for developing depression.  Medications may be prescribed if a person has other underlying mental health conditions, such as mood or anxiety disorders.  Medication is not the ideal treatment for individuals with histrionic personality disorder, but can help them to decrease and manage symptoms causing distress.  Antidepressants or anti-anxiety medications may be prescribed and included as part of a comprehensive treatment plan, but are closely monitored to ensure that it is not being used for self-destructive behaviors.

Most individuals with histrionic personality disorder are able to function on an everyday basis, although their personal, social, and romantic relationships are often impacted.  They have difficulty accepting and adapting to losses or failures and may have trouble in their academic or occupational pursuits.  In very severe cases, people may have trouble with their daily functioning.  Despite this fact, people with histrionic personality disorder often have a positive prognosis.