Most of us enjoy getting compliments about what we do or how we look. But if your main driving force is getting noticed or approved by others, and this negatively affects your life, you might be diagnosed with histrionic personality disorder (HPD).
Histrionic personality disorder (HPD) primarily involves a tendency to view situations emotionally and display overdramatic behaviors that aim to draw attention to you constantly.
These aren’t conscious tactics to manipulate or control others. It may feel very natural to you to act this way. You might not be aware of how these behaviors affect your relationships with other people.
What do histrionic traits look like? It depends. Not everyone expresses them the same way or with the same intensity.
A good first step toward becoming more aware of your histrionic behaviors and attitudes is learning more about the condition. This article can be a good starting point for you.
HPD is one of 10 personality disorders. It falls into cluster B classification together with borderline, antisocial, and narcissistic personality disorders.
Typically, these cluster B conditions are characterized by difficulty controlling emotions and a tendency to act dramatically and unpredictably.
The word histrionic means “theatrical” or “dramatic.”
Specifically, a persistent pattern of extreme emotionality and constant attention-seeking behaviors characterizes HPD.
There might also be a tendency to present yourself in an overly dramatic way, even if you’re not usually aware that you do.
You might also find it challenging to control your impulses and emotions, which could lead you to face friction in your relationships.
Because of that, HPD has been associated with
- somatic symptom disorder (formerly known as hypochondriasis)
Most personality disorders are diagnosed during late adolescence and early adulthood. Since it’s a formal mental health diagnosis, only a professional is trained to do it correctly.
The criteria to diagnose any personality disorder is based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). This is a reference handbook that mental health professionals use to make diagnoses.
To diagnose HPD, a mental health professional will want to talk with you and learn about your medical and personal history, concerns, and difficulties.
They’ll also assess your thoughts, emotions, and behaviors. They’ll be looking for a behavioral pattern that gives them enough information to compare it with the diagnosis criteria established by the DSM-5.
This behavioral pattern should be evident across situations, and usually begins during early adulthood. This is why it’s not common for children or younger teens to receive a personality disorder diagnosis.
HPD is more common in adult females than males. It occurs in about
Like most personality disorders, symptoms of HPD typically decrease in intensity with age. Many people experience few of the most extreme symptoms by the time they’re in the 40s or 50s.
HPD isn’t a personal choice of behavior. In fact, most people with HPD are not even aware of how they behave and how this affects their relationships.
The histrionic behaviors that characterize the disorder are
- childhood relationships and experiences
- environmental and cultural influences
In some instances, social learning is also an important factor. For example, when a child observes and then repeatedly imitates an adult’s behavior and attitude.
But the exact cause of HPD, or any personality disorder for that matter, isn’t yet established.
Everyone might have a few histrionic traits that appear in some situations, like during a party with friends, or in some industries, like acting or modeling.
So, when looking at the list of symptoms, it’s natural to identify with one or even a few of them.
But you could have some of the personality traits that characterize HPD, or any other personality disorder, without actually having the condition.
The difference is that when someone lives with a personality disorder, these traits become behaviors that persistently show up across situations and also cause interpersonal problems and distress to the person.
This is why mental health professionals look for a long history of at least five of the following eight symptoms to diagnose HPD accurately.
If you have HPD, you may typically feel the constant need to act in specific ways to receive a lot of attention wherever you are. If you aren’t receiving a lot of attention, you might feel deeply uncomfortable and disappointed.
To get this attention, you might start using different tactics. Some examples include:
- dressing dramatically or provocatively
- making up or exaggerating stories about you or things that have happened to you
- exaggerating or making up the symptoms of an illness
- showering other people with compliments and love declarations even if you just met them
- getting into minor accidents that require other people to “rescue” you
- getting competitive with others in many situations or trying to trump whatever they’re talking about (e.g., “That happened to me, but in this better way”)
Remember, these aren’t deliberate attempts to manipulate others.
Most of the time, these are unconscious behavioral patterns that are adopted over years because they’ve worked in the past.
Every time you got positive attention for any of these behaviors, you felt accepted, and you liked that. That could have led you to repeat or cause these incidents to feel this way again. Now, you thrive on getting this attention.
Your need for attention might trump everything else and is the driving force behind how you act. That’s why some of your behaviors might not follow the social norm, or might seem inappropriate to others.
Because of this, you might also feel drawn to low-key people who don’t mind letting you get more attention.
You might dress and act in a sexually provocative or flirtatious way, even in situations and places where this may be perceived as inappropriate, like in an office setting with your co-workers or boss.
This isn’t an attempt to actually get into an intimate relationship with others. Rather, it’s another unconscious way to get the attention of those around you.
Superficial emotions that fluctuate rapidly
Someone with HPD might experience constant changes in mood but also changes in interests and emotions. These changes might seem quick and intense. Other people might perceive them as being out of proportion for the situation at hand.
This constant shift in emotions might also lead others to perceive you as insincere.
Frequent lifestyle changes might also be a consequence of these rapid shifts in your mood and emotional states.
You may also often feel very enthusiastic about a relationship or a project and then lose interest quickly.
For example, this may drive you to have multiple job changes, new hobbies, or recurring romantic partners. Longer-term relationships may be neglected to make way for the excitement of new activities and relationships.
Focus on physical appearance
If you have HPD, you may consistently change and work on your physical appearance to draw attention to yourself.
This behavior could present itself in many ways. For example:
- repeatedly changing your hair color or hairstyle, sometimes making dramatic and eccentric decisions
- wearing flashy clothes and shoes
- adding colorful or dramatic accessories to your look
- putting yourself down physically in an effort to get compliments
Vague and showy speech
Perhaps you like to talk a lot. But, inadvertently, you might favor style over substance. You may also feel inclined to use big words but few details or explanations.
If confronted by others about your point during a conversation, you might not be able to explain it clearly and get annoyed.
You may also give an opinion about someone or something but not have any reasoning behind it.
For example, you might tell someone you love an actor, and that she’s the absolute best. The other person asks you why you love her exactly, or which of her characters you enjoyed the most and why. You feel confused and reply she is great, and all her characters have been fantastic.
Because of this type of conversation, you might be perceived by others as superficial, or run into friction in your relationships.
People with HPD tend to exaggerate and dramatize how they feel. This is why you might show over-the-top emotional expressions toward others and have impulsive behaviors.
A few examples include:
- acting ecstatic and over the moon every time you see someone, even if you just saw them a few hours ago or see them every day
- kissing people on the mouth or hugging them extensively even when it’s not a close relationship
- dramatizing a physical sensation, like announcing you’re about to faint because it’s too hot
These types of behaviors may seem exciting to others at first, but they may quickly become overwhelming. They can lead other people to take a step back from your relationship.
Highly suggestible and easily influenced
As someone with HPD, you could be overly trusting of others and frequently swayed by their opinions.
This might also lead you to follow the latest trends, even when making big decisions. You might also adopt other people’s philosophies or lifestyles quickly, even if you don’t fully understand them.
This tendency to go with what others say and do might lead you to experience relationship difficulties.
Considering people closer to you than they really are
You might feel very close to those around you, even if you just met them. This might lead you to act very casually around them and constantly use terms of endearment or public displays of emotion, even without their permission or acceptance.
You might not be aware or pretend to be disrespectful when relating to others this way. It feels natural to you to treat others like this and to be emotionally expressive.
But when others feel like they’re just getting to know you, these displays of affection might feel overwhelming or not sincere.
You’re not pretending to like others. You might feel close to people you just met and feel the need for them to see you the same way.
Because of all of this, you might face challenges achieving emotional intimacy in your relationships. Without being aware of it, you might also tend to act out certain relationship roles.
In many cases, you may get attached very quickly and easily to others without interacting much with them first. This might push some people away if they feel it’s too much, too soon.
Even though it may be perceived this way, a person with HPD doesn’t necessarily enjoy all these attention-seeking behaviors.
There’s often intense emotionality that shows as anger, frustration, depression, and anxiety.
Behind your histrionic behaviors, there might be an urge to be accepted and to connect to others quickly, and a feeling of constant disappointment because this doesn’t happen often.
Your attempts to quickly get closer or more intimate with others might not be reciprocated because other people might get overwhelmed or confused when getting too much affection too soon.
Friction in your relationships with other people might also be frequent because they may feel threatened by your attempts of getting a lot of attention.
As it happens with other personality disorders, you might not realize how some of your behaviors could lead to relationship difficulties.
You may believe the other person is the problem, or that you haven’t found the right friends or romantic partner yet. You could even seek professional help to improve your relationships without realizing your role in these problems.
But once you do, often with the help of a therapist, you can begin managing your emotions and adapting your behaviors.
In time, recovery is possible, and you can improve the quality of your relationships.
Extroversion is a personality trait. An extrovert is a person who’s usually described as outgoing and sociable because they enjoy interacting with people and are full of energy.
This is opposed to an introvert who, even if they enjoy relating with others, prefer to have as much or more time by themselves.
Too much interaction with other people might make the introvert uncomfortable, as too much time by themselves might upset the extrovert.
Someone with HPD, on the other hand, has an insatiable need to get other people’s attention.
Even though there’s a need to connect, you actually need others to acknowledge you all the time with HPD.
This may lead you to experience long-standing difficulties relating to yourself (identity and self-esteem) and connecting to other people (intimacy).
Sometimes, some personality disorder symptoms overlap with each other, particularly if they all fall into the same cluster.
For example, both people with HPD and people with narcissistic personality disorder (NPD) enjoy having a lot of attention.
But, among other differences, someone with NPD wants the type of attention that comes from veneration and reverence. This is consistent with their own elevated view of themselves.
Someone with HPD, on the other hand, wants any attention, particularly the one that might give them a sense of appreciation or connection, but not necessarily veneration.
The first step toward change is recognizing that the root of your problems with other people is related to some of your behaviors.
This can be a hard step to overcome. Seeking the help of a mental health professional can help.
Psychotherapy is the most effective method of treatment for HPD. The main goals of this therapy are:
- reducing emotional distress
- developing adaptive coping and social skills
- improving self-esteem
- helping you understand your role in stressful situations
- helping you become aware of your emotions and actions
These are general goals. As you commit to your treatment, you can start participating in goal setting more actively with your therapist.
A few psychotherapy styles are effective for treating HPD. Some of them are:
- psychodynamic therapy
- cognitive behavioral therapy
- interpersonal therapy
- dialectical behavioral therapy
- group and family therapy
In some cases, some of the emotional states associated with HPD might be treated with medication, such as antidepressants and mood stabilizers.
In general, you can lead a functional and productive life, particularly if you seek the help of a mental health professional.
A professional’s guidance will help you gain insight into your condition and how you can develop several coping mechanisms to improve your relationships and self-image.
HPD is characterized by a long-standing pattern of attention-seeking behaviors and fluctuating emotionality.
These behaviors aren’t a personal choice but rather symptoms of a mental health condition that only a professional can diagnose.
It’s possible to treat HPD. Psychotherapy is often the most effective way. People with HPD who seek professional help can learn coping skills that improve their self-esteem and relationships.
If you or a loved one would like support in getting a diagnosis or treating HPD, these resources might be a good starting point:
- American Psychiatric Association
- American Psychological Association
- National Alliance on Mental Illness (NAMI)
- National Institute of Mental Health
- U.S. Department of Health & Human Services
- Project Air
- NAMI Support Groups
- Depression and Bipolar Support Alliance (DBSA) Online Support Groups
- DBSA Local Support Groups