Symptoms and Treatment – Forbes Health



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People with histrionic personality disorder (HPD) can sometimes be called “dramatic” because they may be prone to exaggerated displays of emotions. But beneath the perceived theatrics of this state of mental health lies a deep need for attention and validation from others.

Here’s what you need to know about HPD, including signs and symptoms, risk factors, and available treatments.

What is histrionic personality disorder?

Histrionic personality disorder, sometimes called dramatic personality disorder, is a mental health condition believed to affect approximately 2% of the general population. People with HPD can act very emotionally and tend to exhibit persistent attention-seeking behavior, such as dressing or acting seductively in inappropriate settings, even with people for whom they have no romantic interest.

Often labeled as flirtatious, manipulative, quick-witted, and impulsive, people with HPD can be vulnerable to outside influence and dependent on others for constant validation.

Signs and Symptoms of Histrionic Personality Disorder

People with HPD can be triggered by feelings of rejection, competition or exclusion, says Sam Zand, DO, a clinical psychiatrist in Las Vegas and chief medical officer and co-founder of Better U. Patients can also react simply to not being the center of attention, he adds.

Common signs and symptoms of HPD include the following:

  • Very emotional and unstable behavior
  • A need to be the center of attention
  • A constant need for validation from others
  • Superficial emotions that change quickly
  • Inappropriate behavior or dress
  • Easily influenced
  • Concerned about his appearance
  • Inability to delay gratification
  • Strong reactions to criticism
  • Inclination to blame failures on others

HPD shares similar symptoms with other personality disorders, such as narcissistic personality disorder (NPD), borderline personality disorder (BPD), and dependent personality disorder (DPD). Although only a mental health professional, such as a psychiatrist or psychologist who specializes in treating personality disorders, can make a correct diagnosis, there are key ways to distinguish HPD from similar conditions.

  • Attention seeking behavior is a symptom of both HPD and NPD, the difference being that people with NPD crave attention that results in adulation, while those with HPD simply crave attention, be it good or bad. bad.
  • Intense emotions can be a symptom of both HPD and BPD. With borderline personality disorder, strong emotions result from an individual’s feelings of inadequacy and failure. People with HPD do not share these negative feelings about themselves.
  • Addiction is a problem with HPD and DPD. However, people with DPD are often shy and anxious in their addiction, while those with HPD are described as dramatic and uninhibited in theirs.

Causes of Histrionic Personality Disorder

Symptoms of HPD typically develop during childhood, although they can worsen in adulthood, says Dr. Zand. “Children often have unstable emotions, a distorted self-image, and often an overwhelming desire to be noticed,” he says. “But when there’s an inherent unlovingness or activation of bad behaviors growing up, we often lack the security and maturity to overcome those attention-seeking behaviors.”

Although there is no single cause of HPD, a combination of genetic and environmental factors may be at play. The following issues may contribute to an HPD diagnosis:

  • childhood trauma
  • Family history of psychiatric illness or substance abuse disorder
  • Growing up with inconsistent, dramatic, or boundary-struggling caregivers

Women are much more likely to be diagnosed with HPD. However, research suggests that the disorder may be underreported in males, as the characteristic hyper-attractive nature of HPD is considered more socially acceptable in males.

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Only a mental health provider, such as a psychiatrist or psychologist, can diagnose a personality disorder, although a general practitioner can refer individuals to mental health services.

According to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is the standard for psychiatric evaluation, individuals must display persistent attention-seeking behaviors and exhibit at least five of the following symptoms consistently in order to be diagnosed with HPD:

  • Need to be the center of attention
  • Inappropriate courtship behavior
  • Emotional lability and lack of depth
  • Relying on personal appearance to attract attention
  • Speech that lacks detail and substance
  • Theatrical and dramatic shows of emotions
  • Highly Suggestive Nature
  • Misunderstands the level of intimacy of relationships

How to Treat Histrionic Personality Disorder

“Whether [HPD] left untreated, it can affect our relationships, our self-confidence, our ability to thrive in social settings, and our ability to raise awareness of our strengths, weaknesses, and opportunities for growth,” says the Dr. Zand. A person with untreated HPD can also become addicted to coping with their symptoms, he adds.

Although there isn’t much research on the effectiveness of treatments for HPD, and the disorder can be difficult to treat in some people, a few options that currently show promise include:

  • Individual psychotherapy, such as cognitive-behavioral therapy (CBT) or internal family systems (also called part therapy, Dr. Zand says).
  • Drugs in tandem with psychotherapy. These include antidepressants and monoamine oxidase inhibitors (MAOIs), which are medications often used when more traditional medications don’t seem to be working.
  • Psychodynamic therapy, which emphasizes self-reflection and examination, and uses the patient-therapist relationship as a tool to increase self-awareness.
  • Ketamine therapy can also be used, Dr. Zand notes, as a way to “reset emotionally, cognitively, and behaviorally hard-wired patterns.”

Although HPD is a lifelong disease, many people find that proper treatment improves their symptoms. If you think you or a loved one may be showing signs of HPD, contact a mental health provider for advice. You might also consider speaking with your primary care physician for a referral for diagnosis.

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