Woman hugs sister as sun sets over city.Histrionic personality (HPD) is most often recognized by dramatic behavior, rapid shifts in emotion, high suggestibility, and attention-seeking acts. People with this condition feel uncomfortable or otherwise distressed when they are not the center of attention. They may try to draw the attention of others with flirtatious behavior, tantrums, enthusiastic outbursts, or gushing praise. 

The actions of a person with HPD can confuse their family and friends. Rapid changes in emotion can seem shallow. Flirtatious behavior can negatively affect professional bonds and friendships. Attempts to manipulate others to get attention can also cause harm to romantic relationships. People with HPD are often aware their actions have negative effects on themselves and others, but they might struggle to effectively manage emotions and make different choices. Depression can develop as a result of problems with work or relationships. 

There is help for histrionic personality. Professional support from a counselor or therapist can lead to improvement of symptoms. In therapy, you can also learn new skills to manage emotions and deal with situations in different ways. Therapy can also help treat depression and other co-occurring conditions. It’s especially important to reach out if you have severe depression or thoughts of suicide. Begin your search for a counselor here

Treatment for Histrionic Personality

The support of a therapist or counselor can be beneficial for people with HPD. Therapy can help people understand the reasons for their thoughts and behavior. Individuals in therapy can begin working toward positive changes, such as finding new ways to relate to other people. 

For therapy to be successful, an individual usually has to desire help. This generally means recognizing that what they experience is a mental health issue. With personality disorders, this often happens when the condition has strongly impacted a person’s life. For example, a person’s emotional outbursts may end a long-term friendship, forcing them to realize the negative consequences of their behavior.

Certain traits of histrionic personality can offer challenges in therapy. A person with HPD may try to flatter or flirt with the therapist to get approval. Because people who have HPD often become bored easily, it may be difficult to stick to something that follows a routine, like counseling. 

Depression occurs commonly with HPD, especially if people have a pattern of relationship difficulties or failed friendships. People who have histrionic personality and another condition, such as depression, may be more likely to seek help. 

Types of therapy that can help with HPD include:

  • Psychodynamic therapy: This approach helps people explore conflicts in their relationships. People can then work to change these conflicts to improve their relationships.
  • Group therapy: Working with other people who have similar mental health challenges can help people learn new ways of relating to others. They can also practice social and interpersonal skills. 
  • Family counseling: When a person’s mental health affects family members and partners, family and relationship counseling may be recommended. In counseling, partners and family members can also learn more about the mental health issue and how to offer support. 
  • Mindfulness practices: While mindfulness practices shouldn’t replace professional support, learning to be more mindful can help people manage emotions. Practicing mindfulness can be helpful when trying to keep from reacting in a certain way.

How to Help a Loved One with Histrionic Personality 

Personality disorders are mental health issues involving fixed patterns of thinking and behavior. These patterns can create difficulties at school, work, or in relationships. Even though a person’s actions may cause problems for them and other people in their lives, they might have a hard time making changes that lead to healthier interpersonal dynamics. 

When a loved one has HPD, it may sometimes be difficult to relate to them. It can be hard to understand their need to be the center of attention. If they lie or use manipulation to get sympathy, you may feel hurt or worried. 

It can help to remember that HPD is a mental health condition. A person’s HPD symptoms may be upsetting to you, but they also cause your loved one distress. While a diagnosis is not an excuse for any hurtful actions, it can explain why your loved one behaves a certain way. 

You can offer support to a loved one who has HPD by:

  • Setting boundaries. Have a discussion with the person about how you will respond to certain behaviors from now on. You might say something like, “I care about you, but I feel uncomfortable when you make scenes in public. If you throw a tantrum in public, I’ll go home.” 
  • Knowing when to distance yourself. It can be difficult to deal with histrionic personality issues on an ongoing basis. It is okay to take a break on occasion and spend some time caring for yourself.  
  • Telling them you care for them. It may help the person to know that even when you can’t give them your full attention, you still care for them. 
  • Encouraging them to evaluate their actions. Impulsivity and suggestibility are common traits in HPD. If your loved one tries to act on impulse (or another person’s suggestion), you can encourage them to consider what they’re doing and why. This can help them learn to think through their decisions. 
  • Keeping calm when they become excited or act in dramatic ways. It can help to offer a distraction if your loved one is considering an impulsive action.
  • Communicating. Be honest about your feelings. If your loved one upsets you, let them know calmly. If you have expressed a boundary about that action, stick to it. This can help your loved one know their actions affect others. 
  • Offering to go to couples counseling or family therapy. If your loved one wants to get help, show them you support their decision by offering to go with them. 

While support from friends and family can be invaluable, it cannot replace professional therapy. If your loved one’s histrionic personality is affecting their daily life, chances are they need treatment. A compassionate counselor can provide your loved one guidance. 
 
References: 

  1. Behavioral Tech. (n.d.). What is dialectical behavior therapy (DBT)? Retrieved from https://behavioraltech.org/resources/faqs/dialectical-behavior-therapy-dbt
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  4. Novais, F., Araújo, A., & Godinho, P. (2015). Historical roots of histrionic personality disorder. Frontiers in Psychology. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4585318
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  7. Skodol. A. (2018). Histrionic personality disorder (HPD). Merck Manuals. Retrieved from https://www.merckmanuals.com/home/mental-health-disorders/personality-disorders/histrionic-personality-disorder-hpd