Histrionic Personality Disorder

Some individuals need to be the center of attention and attraction from time to time, wanting to keep the spotlight on themselves. However, if this need for attention and being the center of attraction turns into an extreme want for "all eyes on me" and a craving for other people's approval, they can be described as 'dramatic' or 'theatrical.' These individuals may have nearly an impossible capacity to maintain a genuinely healthy relationship with other people and lack empathy, display an exaggerated range of emotions, or even act inappropriately in a group setting to attract the crowd towards them. Such people fall under the group of personality disorders in cluster b and are said to suffer from a histrionic personality disorder.

What is the Meaning of Histrionic Personality Disorder (HPD)?

A histrionic personality disorder is characterized by constant attention-seeking, seductive behavior, and overdramatic display of themselves. Individuals with this condition overreact to an emotional state and situation, resulting in impaired relationships and interpersonal conflicts. His histrionic word refers to being "dramatic" or "theatrical." Individuals with this disorder can feel unappreciated and uncomfortable when they are not the center of attraction. They may act seductively or inappropriately in social situations, occupational settings, or professional relationships. They are lively and dramatic and are found to be charming at the beginning of the friendship or relationship due to their enthusiasm, openness, or flirtatiousness. To keep the attention on themselves, they may act in an uncontrolled manner, such as crying uncontrollably over an incident or having an exaggerated emotional display of temper. These acts embarrass people they are with, creating an issue in their relationships.

Superficial emotions and manipulative behavior distinguish a histrionic personality disorder. In addition, attention-seeking behavior usually begins during early adulthood when an individual's personality begins to form. Individuals with this disorder have intense instability in emotions and a flawed self-image. Their self-esteem depends on acceptance and approval from their group and people around them and never on a feeling of self-worth.

Symptoms of an Individual with This Disorder

Individuals with this disorder may seem charming and have good social skills. However, they use the skills to manipulate others and grab their attention. Symptoms of histrionic personality disorder are −

• Dressing proactively or inappropriately exhibiting seductive of flirtatious behavior

• Rapid changes of emotions

• Uncomfortable unless they are the center of attention

• Constantly seeking approval and reassurance

• Obsessed with their physical appearance

• Sensitive to criticism or rejection

• Easily influenced by others

• Rash decision making and not thinking before acting

• Acting in a dramatic as if performing before and group of audience.

• Shallow emotions with difficulty in managing them

• Self-centered and lack empathy

• Attempts or threats suicide for attention

People with histrionic personality disorder, previously called hysterical personality disorder, are emotional and typically described as emotionally charged and seeking a center of attention. Their extreme, exaggerated emotions and moods complicate an individual's life. Individuals with this order can try to draw attention to themselves by exaggerating their illnesses, such as fatigue or physical symptoms. They obsess about their looks and how other individuals perceive them. They often wear bright clothes with attention-grabbing colors and styles.

Theories Explaining Histrionic Personality Disorder

The psychodynamic perspective was originally formed to explain cases of Hysteria. Psychodynamic theorists believe that an individual with this histrionic personality disorder in their childhood was in an unhealthy relationship with their parents, who were cold and controlling. This left them feeling unloved and created a fear of abandonment. Individuals defended these deep-seated fears of loss by learning defense mechanisms and how to behave dramatically to gain attention and protection. They would often scream and cry, which made people protect and take care of them.

Cognitive theorists believe that individuals slowly adapt to becoming less interesting daily in their surroundings, leading them to become self-focused, self-centered, and emotional. Some theorists of this approach proposed that individuals with this disorder generally assume that they are incapable of taking care of themselves and need constant support from others to meet their needs.

The sociocultural approach believes cultural rules and expectations partly generate this disorder. Modern culture promotes girls to retain their youth and dependence as they age. The histrionic personality's arrogant, theatrical, and selfish behavior could be an exaggeration of femininity as contemporary society once defined it. Studies based on a few investigations revealed that Histrionic personality disorders were diagnosed less frequently in Asian and other cultures that oppose open sexuality and more frequently in Hispanic American and Latin American cultures that tolerate open sexuality.

Comparing Historic Personality Disorder and Borderline Personality Disorder

Important points are −

• Both disorders involve erratic, out-of-control emotions and require attention. Individuals with these disorders are impulsive and have manipulative behavior.
• The difference between these disorders is that in borderline personality disorder, an individual may be triggered due to rejection or abandonment. However, individuals with histrionic personality disorder can be triggered by not feeling that they are getting enough attention.

Prevalence

About 2-3% of the population, women are four times more likely to get diagnosed with this disorder than men. Individuals suffering from this disorder tend to be ego-syntonic; they do not consider their behavior abnormal and struggle to find any issue within themselves, thus, leading to misinterpretation or underdiagnoses.

Treatment and Management

A histrionic personality disorder is challenging as many individuals do not find any problem within themselves or pretend to have improved during treatment only to please their therapist.

• Psychotherapy is effective in treating this disorder and helps reduce symptoms and improve the relationship process.
• Group Therapy and family therapy are not recommended as people with this disorder may seek attention, exaggerate their symptoms, and become triggered in a group atmosphere.
• Medication no FDA-approved medication for the treatment of this disorder is used. However, medicines such as anti-depressant and mood stabilizers help reduce the symptoms.
• Alternative therapy such as mindfulness breathing, yoga, Tai Chi, and biofeedback is helpful to people with this disorder. They work by helping individuals control their inner feelings and, in return, positively affect their impulsivity and emotional reactivity. Exercising regularly, avoiding alcohol or substance abuse, and sleeping well have been found to help.

Conclusion

A histrionic personality disorder is a mental condition characterized by patterns of exaggerated emotion and attention-seeking behavior. This disorder falls under cluster b of personality disorders, and these clusters of personality disorders are described as erratic and dramatic. Individuals with a histrionic personality disorder are often seen as flirtatious, seductive, charming, manipulative, lively, and impulsive. These people can be said to be the life of the party and maybe vibrant. They demonstrate mood swings and shallow emotions. Treatment and coping skills help individuals maintain healthy relationships and minimize their symptoms.