Histrionic personality disorder (HPD) is also known as an attention-seeking disorder, which is an apt description. People with this disorder live for attention and will do whatever they can to stay in the spotlight. Their sense of self-worth is dependent on the approval of others. HPD sufferers are viewed as overly dramatic, emotional and unpredictable.
While HPD is rare, with one survey finding only 1.8% of American adults have it, it’s still a debilitating condition. It comes with depression and anxiety, especially if the person’s need for attention isn’t being fulfilled. It’s hard for them to realize they have a problem that needs to be treated, even if they alienate everyone around them.
What Is Histrionic Personality Disorder?
HPD is a Class B personality disorder that’s marked by exaggerated emotions and erratic actions. People suffering from HPD disorder are dramatic and constantly seek attention from others. Some experts believe that actresses Anna Nicole Smith and Marilyn Monroe may have had this disorder, as well as the high-profile convicted sex offender Jerry Sandusky.
Women are more likely than men to have HPD, and symptoms can begin as early as young adulthood.
What Causes HPD?
While medical experts haven’t found an exact cause, they believe that both genetic and environmental factors contribute to HPD. In some cases, the disorder is seen in several generations of a family, indicating that they might be genetically susceptible. However, children often imitate their parent’s behavior, meaning the child of an HPD sufferer may appear to have symptoms but doesn’t actually have the disorder. It’s hard to determine what the genetic component might be.
The environmental factors can begin as early as childhood. If the child isn’t disciplined or criticized for bad behavior but is given positive attention for things they don’t understand, they won’t know how to gain their parent’s approval. They might act erratically and learn it’s the only guaranteed way to get attention. This belief can then carry into adulthood, where they won’t understand how to gain the approval of their peers in an appropriate way.
While it might get them temporary attention, the over-the-top behavior often alienates their loved ones. The drama, need for constant reassurance and jealousy toward anyone getting more attention than them are hard for others to deal with. Both friendships and romantic relationships are usually short-lived, and even family members may cut ties.
What Are the Three Symptoms of HPD?
Most HPD symptoms revolve around gaining attention. Three prominent histrionic personality disorder symptoms include:
- Dramatic, rapidly shifting emotions. Those with HPD get bored, frustrated and angry easily. Their emotions may seem shallow or fake. They often seem to be putting on a performance rather than actually experiencing emotions. Some studies suggest that they have trouble understanding emotions both in themselves and in others.
- Inappropriate social behavior. They use erratic behavior to gain attention. If someone else is receiving more attention, they get angry at that person. Often, people with HPD are overly sexual and hyper-focused on their appearance. They might mistake relationships as more intimate than they really are. Those with HPD seek constant reassurance on everything and are overly sensitive to criticism.
- Defense mechanisms such as repression and dissociation. These reactions are automatic protections from overwhelming anxiety or depression. Repression is the act of avoiding painful thoughts or memories. Dissociation is a feeling of disconnect from a sense of reality and their own thoughts and feelings. These symptoms can be exacerbated by the feeling of constant failure in social relationships.
How Is HPD Diagnosed?
People with HPD often don’t realize there’s anything wrong, and it takes a loved one confronting them to realize it. Even then, they may not accept that they need anything diagnosed. If they decide to see a doctor, they’ll begin with a physical examination and lab tests. While HPD is a personality disorder, there could be a medical cause for the behavior.
If nothing is physically wrong, the next step is a consultation with a psychiatrist or psychologist. They’ll be able to identify the disorder and then work on treating it. This is typically the most helpful route for people with HPD.
What Subtypes Might a Histrionic Personality Disorder Specialist Diagnose?
Often, a histrionic personality disorder specialist will diagnose a person with a specific subtype of HPD mental disorder. Psychologist Theodore Millon introduced the concept of HPD subtypes, creating six classifications, each with its own set of symptoms and traits.
By determining what subtype a person is, a mental health professional can better tailor HPD treatment to their individual needs.
Appeasing Histrionic Personality Disorder
People with appeasing histrionic personality disorder often develop dependence on other people and can engage in compulsive behaviors. They often seek out attention to their own detriment. Traits include:
- Trying to fix other people’s problems
- Tendency to placate other people to avoid conflict
- Frequently compromising or conceding to let others have their way
- Making sacrifices in hopes of gaining recognition from others
- Exerting lots of energy into satisfying people, even those who can’t be satisfied or are difficult to please
Vivacious Histrionic Personality Disorder
Someone with this type of wanting attention disorder shares traits with bipolar people who experience hypomania and with individuals who have narcissistic personality disorder. An individual with this subtype aims to be noticed for their unpredictable, lighthearted behavior. Characteristics of the subtype include:
- Exhibiting a bubbly, free-spirited personality
- Acting impulsively, which can lead to poor decision-making
- Attempting to lighten the mood and be cheerful even at inappropriate times
- Proposing wild, reckless ideas for the sake of fun
- Being overly animated or energetic
Tempestuous Histrionic Personality Disorder
Individuals with tempestuous histrionic personality disorder share some traits with those who have passive-aggressive personality disorder. Tempestuous types seek attention by exhibiting negative behaviors. They may:
- Act impulsively or seem out of control
- Go through periods of moodiness
- Complain or sulk when inconvenienced
- Become upset or angry easily
- Shift moods rapidly
- Escalate conflicts suddenly, possibly even resorting to violence
Disingenuous Histrionic Personality Disorder
The disingenuous subtype has characteristics in common with antisocial personality disorder. Individuals with this type of HPD mental disorder may seek out attention, even at the expense of other people. It can be difficult to get them into HPD treatment because they are often egotistical and may believe they don’t need to change.
Some traits of this subtype include:
- Scheming or behaving in unethical ways
- Manipulating other people to get noticed
- Telling lies or deceiving others
- Acting or speaking without sincerity
- Betraying the trust of others
Theatrical Histrionic Personality Disorder
Theatrical histrionic personality disorder is what some people consider the classic form of the HPD mental disorder. People who fall under this category attract attention through dramatic behaviors, such as:
- Holding an unusual or striking posture
- Modifying their appearance to catch attention
- Putting on an act or persona when interacting with others
- Striking poses when they know others are looking
- Exaggerating their reactions to things
Infantile Histrionic Personality Disorder
A person with infantile histrionic personality disorder exhibits some traits of borderline personality disorder. They seek attention through childlike behaviors and may have the following characteristics:
- Being emotionally volatile and prone to outbursts
- Tending to pout when they don’t get their way
- Making unreasonable demands on others
- Forming unhealthy attachments to other people
- Clinging to others physically or emotionally
What Are the Treatment Options for HPD?
Mental health professionals are the best treatment option for those with HPD. However, as noted above, admitting they need treatment for anything is very difficult. If they start therapy, they can explore the cause of their disorder and how they can adjust their thinking and behavior. Treatment will require a lot of dedication from the sufferer, which may be hard if they get bored or frustrated easily. They’ll be more likely to succeed with a strong support network that encourages them to stick with treatment.
In some cases, medicine is an appropriate option. Often, it will be for the depression and anxiety that come along with HPD. This could help with mood swings, dissociation and the anxious feelings of not getting enough validation.
What Do I Do If I Have HPD?
It’s hard for HPD sufferers to admit they have a problem. If you’re having problems with social and romantic relationships, consider what your role in them is. Examine your relationships with the HPD symptoms in mind. People with HPD will sabotage friendships or romantic relationships with their constant need for attention and reassurance.
The lack of social connection can cause depression and anxiety. Sufferers might bounce around between relationships, then feel a deep depression when they fall apart. They might feel a loss of control. If this sounds familiar, consider reaching out to a mental health professional.
Uncovering a mental health problem is tough. However, if you can come to terms with it, you’re ready to get help. If you feel it’s time to explore your mental health and get help, contact us at Restore. You can reach us 24/7 at (877) 594-3566, and our counselors will be able to help you decide your next steps.