- Histrionic personality disorder (HPD) is a condition that is characterized by acting overly dramatic.
- People with HPD may have shifting, shallow emotions and use their appearance to get attention.
- They may also be easily influenced by other people and have difficulty finding their own identity.
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Histrionic personality disorder (HPD) is a mental health condition in which a person constantly seeks approval from others and acts overly dramatic or seductive to grab attention.
HPD is relatively rare — less than 2% of Americans have the condition. HPD can be difficult to treat, but there are options available to help improve symptoms.
What is histrionic personality disorder?
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), some of the most common symptoms of HPD include:
- Feeling uncomfortable when they aren’t the center of attention
- Acting in a dramatic, theatrical way
- Acting inappropriately sexual or seductive with others
- Having quickly shifting, shallow emotions
- Consistently using their appearance to get attention
- Describing events in a vague, emotional way that lacks any real detail
- Being easily influenced by other people
- Thinking their relationships are closer than they actually are
People with histrionic personality disorder often have a hard time forming a sense of their own identity, so they may rely on other people’s reactions to reassure them, says Teyhou Smyth, PhD, LMFT, a therapist and professor of psychology at Pepperdine University.
“Generally, people with this condition rely heavily on their physical appearance and depend on compliments and praise to feel good,” Smyth says.
“Individuals with histrionic personality disorder often see themselves as unlovable, unworthy, inferior, or unappealing,” says Judith S. Beck, PhD, president of the Beck Institute for Cognitive Behavior Therapy.
This may explain why they show extremely dramatic or theatrical behavior. “They tend to believe, ‘If I keep people entertained, they’ll accept me, but if I don’t, they’ll reject me,'” Beck says.
The causes of histrionic personality disorder
There are many different factors that can make you more likely to develop histrionic personality disorder. This can include:
- Having a parent who has HPD — experts aren’t certain whether this is because HPD is inherited genetically or if children learn the behavior from their parents, or if it’s a mixture of the two.
- Experiencing unpredictable or inconsistent discipline from parents in childhood — this can include being rewarded for dramatic behavior.
- Experiencing trauma during childhood like neglect or abandonment.
In addition, more women have HPD than men, although some experts believe that men may be underdiagnosed.
Diagnosis and treatment
A mental health provider can diagnose histrionic personality disorder by conducting a psychological evaluation and observing the person’s behavior.
People with HPD often don’t realize they’re struggling with a personality disorder and instead seek help for related issues like anxiety, depression, and chronic relationship problems.
Histrionic personality disorder can be difficult to treat, but there are some options that may help people manage their symptoms:
- Cognitive Behavior Therapy (CBT) may help shift the person’s negative beliefs and behaviors. The therapist helps by “providing evidence that they see their clients as appealing and worthwhile, regardless of whether the clients are being entertaining or not,” Beck says.
- Medication may not work to treat HPD itself — the US Food and Drug Administration (FDA) hasn’t approved any drug as a treatment. However, HPD often comes with other issues like depression or mood swings, so antidepressants or mood-stabilizing medications may be helpful.
Histrionic personality disorder is a rare condition in which people depend on their outward appearance and other people for their sense of identity.
HPD isn’t always easy to treat, but “these individuals can learn to modify their unhelpful thinking and behavior and learn how to develop and strengthen better relationships with others,” Beck says.
If someone you’re close to has HPD,”you can be a help by being a steady, honest friend,” Smyth says.