What is HPD? Symptoms, Causes, and Treatments With Example

Histrionic personality disorder, or HPD, affects approximately 2.1% of adults in the US. It belongs to Cluster B of personality disorders. It’s characterized by disturbance in social, emotional, and behavioral patterns.

Four mental conditions are listed under Cluster B, and histrionic personality disorder is one of them. The other illnesses include:

• Borderline personality disorder
• Antisocial personality disorder
• Narcissistic personality disorder

Before we understand what HPD is and how it manifests itself, let us describe personality disorders.

What are Personality Disorders?

Let me start by giving some background context in this section. This way, we can understand histrionic personality disorder better.

The personality of a person defines their fundamental qualities. It includes their unique thought patterns, emotional reactions, values, and coping strategies in life. It is shaped by internal and external factors such as genetics, upbringing, and critical circumstances.

A negative impact or a noticeable disturbance in these characteristics constitutes personality disorders. Personality disorders make the patient diverge from socially and culturally acceptable behavioral norms.

Unexplained abnormalities in interpersonal interactions characterize Personality Disorders. This, in turn, creates a lot of functional difficulties.

Most people who have personality disorders face trouble regulating their emotions and behavior. They also generally harbor complex perspectives (mostly pessimistic) on themselves and the people around them.

There are 10 personality disorders, and I will discuss Histrionic Personality Disorder in this article.

What is Histrionic Personality Disorder?

This section explains what HPD, or histrionic personality disorder means.

Histrionic Personality Disorder or HPD is characterized by overly exaggerated expression of emotions. It also includes inconsistent emotional responses in social situations.

Patients usually experience such passionate outbursts when they feel like they are not being paid enough attention to.

This behavior may regularly arise out of the intense urge to seek admiration. So, people suffering from HPD tend to look for praise through pleasant outward appearances or by showing off wealth/status.

Those suffering from HPD are often stereotyped as being too dramatic, striking, and extroverted. They want to be the talk of the town and the life of the party wherever they go.

Public approval-seeking behavior is the hallmark of this mental condition. So, a slight ignorance of their presence or actions can lead to their unstable behavior.

Symptoms of Histrionic Personality Disorder

This section discusses the major symptoms of histrionic personality disorder. This way, you know what signs to look for to confirm the diagnosis.

People affected by histrionic personality disorder tend to have extremely rigid thoughts.

Therefore, they may have serious trouble adapting to positive life changes. This can, in turn, consistently damage their personal and professional relationships.

Here are a few important signs and symptoms of HPD you should be aware of:

• They constantly expect a lot of attention from others
• Social validation helps them survive most of the time, else they might get uncomfortable
• They tend to be overly manipulative and sociable
• HPD patients can display beyond extroverted behavior
• They are generally excessively impulsive
• Their thought patterns do not fit socially and culturally acceptable standards
• They use their charisma and attractiveness to engage in inappropriate behavior
• They are good at theatrical displays of emotions and love throwing tantrums if ignored
• They get quickly offended when mildly disregarded or disrespected/underappreciated
• They are more inclined towards inappropriate sexual behavior
• They can be clingy and not too honest when expressing emotions
• They tend to humiliate others, especially friends and family members
• They tend to wear revealing/provocative clothes to attract attention
• They do not speak clearly, and their communication can deceive others
• They have unrealistic thoughts and expectations about their close relationships

Causes of Histrionic Personality Disorder

Let us examine the key causes of histrionic personality disorder in this section.

There are many environmental and genetically linked factors involved. However, the exact underlying cause is not known yet.

Following is the list of possible causes or risk factors:

• Childhood trauma or excessive stress in the adolescence phase
• HPD can be a cause of a negative coping mechanism due to a bad childhood or upbringing
• There may be a hereditary predisposition for HPD if it runs in the family through generations
• Children of abusive parents may develop histrionic personality disorder in the future
• Overly lenient parenting may also lead to behavioral issues in kids. It may set the stage for histrionic personality disorder
• The presence of other psychiatric conditions may also increase the chances of developing HPD
• Children of impulsive parents engaging in unacceptable sexual behavior may grow up to develop HPD in adulthood

Diagnosis of Histrionic Personality Disorder

Let us take a look at how to diagnose this mental health condition in this section.

The right diagnosis will pave the way for appropriate treatment. A person’s personality undergoes many changes till the age of 18. Therefore, a confirmed diagnosis and mental health evaluation are crucial. It would make more sense to do so once the patient reaches adulthood.

According to the DSM-5, at least five of the below criteria must be present to identify histrionic personality disorder in an individual medically:

• Extreme sensitivity
• Inappropriate behavior – flirting, being seductive, etc.
• Gives in to extreme persuasion
• Excessive usage of uncertain language/communication style
• Constantly attracting others with outward appeal
• Randomly shifting superficial feelings
• Overinterprets intimacy in relationships
• Over-the-top emotional responses/behavior

A major difference between histrionic and narcissistic personality disorder is that both patients crave attention in different ways.

The person affected by a narcissistic personality disorder chases attention arising out of admiration. In contrast, people with a histrionic personality disorder do not mind negative publicity. They can go to any lengths to get some validation by hook or by crook.

Treatments for Histrionic Personality Disorder

I will go into the details of all the effective treatments for histrionic personality disorder in this part of the article.

Histrionic personality disorder is best treated by psychotherapy or talk therapy. Supportive counseling can help provide constructive feedback on inappropriate behavior.

This way, the patient feels less isolated. They would be gradually coached to eliminate toxic urges of wanting attention all the time.

Psychodynamic talk therapy may be equally effective in treating histrionic personality disorder. This technique focuses on collecting key behavioral insights and resolving past emotional conflicts.

This method can help in building a positive sense of self-worth. How so? By making the patients realize that their emotional theatrics are counterproductive to their daily functioning. They are motivated to act and speak more practically to ease social interactions with others.

The therapist must maintain strict boundaries while counseling a patient with HPD. It will prevent the patient from getting too close or inappropriate with the counselor.

Histrionic personality disorder cannot be cured. Mental health providers generally opt for hugely successful talk therapy. However, medications are used to improve treatment outcomes.

Mood stabilizers, antidepressants, or antipsychotics may be prescribed to address symptoms such as:

• Frequent mood fluctuations
• Hysterical crying
• Extreme irritability
• Intense panic, depression, or anxiety episodes

I am listing a few prescription drugs used for supplementing the treatment of HPD. They have shown positive results with proven therapeutic efficacy.

• Olanzapine
• Lamotrigine
• Haloperidol
• Desipramine
• Aripiprazole
• Risperidone
• Fluoxetine
• Lithium
• Carbamazepine
• Amitriptyline and more

These medications are not FDA-approved. So, they must be taken under the guidance of your mental healthcare expert to avoid potential side effects.

Responsible consumption in correct dosages can successfully control your impulses. And help reduce dysregulated behavior.

Conclusion

No cure does not mean the condition is not treatable. Histrionic personality disorder symptoms can be alleviated so you can lead a healthy, productive, and normal life.

You should educate yourself about the condition. Patients who proactively understand how the disorder manifests have a higher chance of success.

If left untreated, you can fall into a more dangerous rabbit hole of substance abuse and depression. Therefore, understanding the diagnosis and taking timely treatment can help you or your loved ones with HPD live extremely fulfilling lives.

Please let me know your thoughts in the comments below.