Someone suffering from this condition might be colloquially referred to as a “drama queen” – i.e. someone who may react in an exaggeratedly dramatic way to most, if not all, events. As a genuinely debilitating personality disorder, this is an unhelpful label. Those suffering from this condition are – just as with any personality disorder – suffering from a rigid and inflexible mindset. Most crucially they are subject to a personality structure which is unhelpful in terms of their quality of life and their ability to function in society. The emotions experienced by those with this condition are nearly always seen as extreme, with the individual demonstrating little or no control over their feelings or reactions to events.

In addition to an overwhelming need to be the constant centre of attention, sufferers typically react to situations (whether these are everyday occurrences or more significant life events) in an overly emotional manner. As such sufferers can be hard to be around, demonstrating extreme emotional responses to even the smallest of occurrences. Consequently, those suffering from Histrionic Personality Disorder may often struggle to maintain relationships, falling into a deep depression with the associated feelings of hopelessness or despair.

People with HPD may also act in a sexually seductive fashion in the most inappropriate of circumstances – completely beyond what might be considered normal social interaction during their working life or leisure time. They will struggle noticeably when they are not the centre of attention, perhaps even demonstrating extreme behaviour to bring the focus back to them alone.

In this article, we will be looking at, not only at the symptoms of those suffering from Histrionic Personality Disorder but also the latest ideas on the causes of this condition. Most importantly, we will be covering the potential treatment options and the related benefits for sufferers.

Recognising symptoms of Histrionic Personality Disorder

People can feel a range of emotions and reactions when they are made the centre of attention. For some this kind of pleasurable event (such as having a birthday, enjoying your wedding day or celebrating the birth of a new child) and can be enjoyed over a short period with their life returning to normal shortly afterwards. On the other hand, it’s perfectly normal to feel a little shy or uncomfortable at being made the focus of a gathering or event – not everyone enjoys the limelight and will feel happier when people’s attention shifts elsewhere. Both of these are a perfectly normal reaction and are not considered extreme or in any way maladaptive.

For the person with HPD however, the need to be the centre of attention at all times is overwhelming and constant. While a more generous description may call them ‘the life and soul of the party’ they often feel driven to entertain others, dress provocatively, and even act seductively with the people around them. Although those with this disorder tend to have excellent social skills they often use them in a manipulative manner – most often to ensure that the attention of everyone is firmly fixed on them as the ‘star of the show’. In some cases the HPD sufferer may not even be consciously aware of what they are doing, simply feeling that it is a natural course of action. Despite these traits people with Histrionic Personality Disorder may also crave the approval of those around them and can be unduly influenced by the thoughts or opinions of others – this can reach such an extent that the sufferer may be described as ‘gullible’ or easily led.

The primary distinguishing and overriding symptom in Histrionic Personality Disorder is a marked tendency towards both acting in an unnecessarily dramatic fashion and overemotional reactions to the smallest of things.

Symptoms of Histrionic Personality Disorder include:

  • Being highly uncomfortable and upset if they are not the centre of attention at all times
  • Frequent emotional instability characterised by extreme shifts in mood and reactions Common examples of this include sobbing uncontrollably at minor upsets, throwing temper tantrums when things go against them, greeting new acquaintances with an inappropriate degree of passion or excitement
  • Sufferers may dress in a highly sexualised &/or inappropriate way
  • Consistently display exhibitionist and ‘over the top’ mannerisms, often to such an extent that they are labelled a ‘drama queen’.
  • Individuals may have an unusually a low tolerance of delayed gratification
  • Overly concerned or even obsessed by physical appearance
  • Is easily swayed by others, even to the point of gullibility
  • Prone to making rash decisions and taking ill thought out actions
  • May behave in an egocentric and self-centred manner, or frequently act in a selfish manner

This disorder tends to be seen predominantly in females, with only a small proportion of those diagnosed being male. In terms of the frequency and number of those experiencing HPD current figures suggest that this condition is quite rare, affecting less than 2% of the general population. Most sufferers of Histrionic Personality Disorder will not develop or start to show symptoms much before the age of 15 and well into the onset of puberty.

As with many other forms of personality disorder the symptoms of HPD tend to lessen with age. Those in the 40’s or 50’s with this condition often display fewer extreme symptoms than younger people.

It has been theorised that HPD is actually related to Antisocial Personality Disorder with some research indicating that 2 out of every 3 sufferers displaying traits which could be related to either condition. However, it should be remembered that this currently still only a working theory and has not been empirically proven one way or the other.

Formal diagnosis by a trained mental health professional is always required before undertaking any form of treatment.

The Causes of Histrionic Personality Disorder

As with so many of the varied personality disorder conditions, there are no clear-cut answers on what actually causes HPD. While little formal research has been done on the matter, it is generally accepted that Histrionic Personality Disorder is most likely attributable to a combination of genetic predisposition, social factors with psychological development, and experiences in early life. This belief that actually a wide selection of factors must be combined to create this personality disorder ties in very well with what medical professionals have learnt about the condition since it was first identified. This also explains why Histrionic Personality Disorder is a relatively rare occurrence – being seen in just 1.8% of the population – with a set of specific causes needed to all be present in the individual.

The current hypothesis suggests that there may be a generic component which can be indicative of an increased hereditary risk for parents to pass this condition onto their children. However, this has by no means been definitely established. There is a strong indication that the most common physiological trait amongst sufferers is due to an as yet unknown abnormality with neurotransmitters in the brain.

A more psychological understanding of Histrionic Personality Disorder comes from psychoanalysis, which has suggested that an authoritarian or distant manner in one or both of the parents is often at the route of the problem. However, this is highly contested even within the field, and many are people who favour a purely scientific explanation are sceptical of this explanation.

Treatment of Histrionic Personality Disorder

Talking therapies are usually the preferred method to manage and treat HPD. These can take the form of both cognitive therapy or psychotherapy, or both in conjunction. Medication can also be a helpful factor, especially in cases where Histrionic Personality Disorder is accompanied by extreme feelings of depression and/or anxiety.

Treatment by talking therapy can be challenging for the provider of the service, as those with HPD may have a tendency to exaggerate their symptoms or attendant problems, and frequently try to overstep the professional boundaries set by the therapist. However, solution focused and supportive therapy can provide real benefits to sufferers.

Tell us your experiences with Histrionic Personality Disorder

Do you, or someone you know, suffer from Histrionic Personality Disorder? Do you suspect that you suffer from this condition or have you been formally diagnosed? We would be delighted to hear from you about your own personal experiences as a sufferer, or of those of your family and friends. Everyone’s experience of HPD is different and sharing your story could help others. How have you learned to cope with your symptoms? What kind of impact does it have on your friendships, family and relationships? Has HPD caused you issues at work or made it hard for you to find employment? Whatever your experiences it is important to understand that Histrionic Personality Disorder is a serious and much misunderstood mental condition.

Please take a moment now to leave your thoughts, tips and observations below. We are very grateful for any comments you would like to make on this article or a personal story.

Lastly, if you believe that you or someone you know may have Histrionic Personality Disorder why not get in touch with us now? We can promise a friendly, understanding and no obligation chat about how talking treatments can help in the battle against Histrionic Personality Disorder.