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Mental Health and Wellness

Histrionic Personality Disorder

A histrionic personality disorder is a mental health condition characterized by dramatically exaggerated emotionality and attention-seeking behavior. Experts estimate that between 1% and 3% of people in the U.S. will be diagnosed with HPD throughout their lifetime—making it a relatively rare, though serious, mental health challenge.

Solara Mental Health understands the unique challenges that histrionic personality disorder presents and has created a specialized therapeutic program to promote long-lasting relief and recovery in the lives of those with HPD.

For those interested in learning more about histrionic personality disorder and the treatments available for themselves or a loved one, the sections below provide key information. What are the symptoms of HPD? What therapies are most effective for the treatment of HPD? And how can one best support a person struggling with a histrionic personality disorder?  These and other questions are fully addressed here.

What Is Histrionic Personality Disorder?

Psychiatric personality disorders are conditions in which an individual’s thoughts, feelings, perceptions, and/or behavior differ significantly from that of an average person.

Histrionic personality disorder (HPD)—also known as dramatic personality disorder—is one kind of personality disorder, marked by intense and unstable emotions, a distorted self-image, and an overwhelming desire to be noticed. People suffering from HPD often behave in dramatic or inappropriate ways to get the attention and approval of others.

The word “histrionic” means melodramatic or theatrical. Individuals with HPD are often described as being dramatic, excitable, volatile, erratic, and impulsive. Their behavior may also be seductive, flirtatious, charming, and manipulative.

The onset of histrionic personality disorder is generally in a person’s late teens or early 20s, and more women than men are diagnosed with the condition.

Characteristics & Symptoms of HPD

People with histrionic personality disorder typically project a “larger than life” persona. They can easily be the “life of the party,” and when they’re not the center of attention may feel disregarded or underappreciated. To draw attention to themselves, they often display excessive, superficial emotionality and sexualized flirtation.

Individuals suffering from HPD often don’t consider their behavior and ways of thinking to be problematic.

Symptoms of Histrionic Personality Disorder

Primary symptoms of HPD include:

  • Have a compulsive desire for attention
  • Constantly seek reassurance or approval
  • Express superficial, volatile, excessive emotions
  • Project a larger-than-life persona
  • Are persistently charming and flirtatious
  • Have hypersensitivity to criticism
  • Display manipulative behavior
  • Act in sexually provocative ways
  • Have a preoccupation with physical appearance
  • Wear bright-colored or revealing clothing to draw attention to themselves
  • Feel depressed or underappreciated when they’re not the center of attention
  • Display overly dramatic behavior that may be embarrassing friends and family
  • Act inappropriately sexually with most of the people they meet (even in the absence of any genuine sexual attraction)
  • Speak dramatically and express strong opinions with little evidence to support these opinions
  • Are gullible and easily influenced by others, particularly by the people they admire
  • Have trouble maintaining relationships and often seem shallow, fake, or insincere in interpersonal exchanges
  • Need instant gratification and become bored or frustrated very easily

Understanding a Histrionic Person

Personality disorders—including HPD—often come with profound levels of insecurity, instability, isolation, and emotional pain for the people living with these conditions.

Although specific symptoms may vary from one person to the next, personality disorders are typically characterized by the lack of a coherent identity or sense of self. People struggling with HPT or other personality disorders are prone to extreme reactions to perceived threats. And they tend to have difficulty accepting love and sustaining relationships.

For a person with histrionic personality disorder, their self-esteem is dependent on the approval of others—rather than coming from a true internal sense of self-worth. Because of this, such a person has an overwhelming desire to be noticed and will often behave inappropriately to get the attention they believe they need to bolster their sense of self.

These disorders can be particularly difficult for the family and friends of the person with an HPT diagnosis, who see their loved one suffering but don’t know how to help.

Personality Disorders Among Veterans

Personality disorders are fairly common among combat veterans. And many veterans diagnosed with PTSD  suffer co-occurring symptoms of other mental health conditions, including personality disorders such as HPT.

Solara Mental Health in San Diego, California, has a contract with VA insurance which allows them to provide affordable mental health services to veterans. Solara offers treatment for personality disorders—including histrionic personality disorder—to veterans in need. With authorization, Solara can also provide transportation, housing, and other accommodations for veterans.

Treatment Options for Histrionic Personality Disorder

The most common and effective treatment choice for histrionic personality disorder patients is psychological counseling.

However, most people with histrionic personality disorder (HPD) don’t believe that their ways of thinking or behaving are problematic—so they’re unlikely to seek this kind of treatment on their own. They also dislike routine and tend to exaggerate their feelings, both of which make following a mental health treatment plan more challenging.  

An individual with HPD might actively seek help if they’re also experiencing anxiety or depression—for instance, associated with a failed relationship or another life challenge linked directly or indirectly to the HPD symptoms.

Psychotherapy to Treat HPD

The most general goal of psychological therapy is to help a person uncover the root cause—the fears and motivations—associated with the HPD symptoms; and to help them learn to relate to themselves and others in more productive and positive ways.

The types of psychological therapy that have been found to be most effective for treating histrionic personality disorder include supportive therapy, cognitive behavioral therapy (CBT), and psychodynamic psychotherapy.

Supportive Psychotherapy 

People struggling with histrionic personality disorder who participate in supportive therapy are met with supportive compassion and empathy. In the context of a trusting therapeutic relationship, they are listened to deeply. They are encouraged to express themselves fully, and their concerns are taken seriously by the therapist.

They receive helpful information and advice and are reassured that things can get better, i.e. the HPD symptoms can be resolved, and their quality of life improved.

People with HPD who undergo supportive psychotherapy will likely experience an improvement in self-esteem, improve their capacity for emotional regulation and stress management, and cultivate new healthier coping mechanisms.

Cognitive Behavioral Therapy (CBT) 

Cognitive behavioral therapy (CBT) is a structured and goal-oriented form of therapy, in which the veteran takes an active role in the healing process.

With the support of the therapist, an individual learns to track their thoughts, feelings, beliefs, and behaviors. They explore which beliefs, behaviors, and thoughts cause suffering (i.e., HPD symptoms); and which are productive of genuine health and happiness.

CBT can help people with histrionic personality disorder transform the maladaptive behavior and cognitive processes that manifest as symptoms of the disorder. They’re able to unwind negative thoughts and behaviors and learn healthier thinking patterns and habits.

Dialectical behavior therapy (DBT), mindfulness-based cognitive therapy (MBCT),  acceptance and commitment therapy (ACT), and rational emotive behavior therapy (REBT) are offshoots of CBT that can also be useful in treating histrionic personality disorder.

Psychodynamic Psychotherapy 

Psychodynamic psychotherapy explores how a person’s current behavior and/or emotional distress is shaped, often unconsciously, by past experiences and behavioral patterns. For instance, the root cause of histrionic personality disorder may lie in an unresolved childhood trauma whose dynamics have been operating at a subconscious level.

The maladaptive thoughts, feelings, and behavior that characterize HPD are linked to past experiences and behavioral patterns formed in childhood. The individual with HPD is then guided and encouraged to explore thoughts, images, and ideas that were previously hidden in their subconscious mind. Through such self-examination, these old patterns can be released.

Medication to Treat HPD

While psychotherapy is the primary form of treatment for HPD, medications may in certain cases, also be prescribed, particularly to treat co-occurring disorders such as anxiety or depression.

While there’s currently no medication that can treat personality disorders directly, antidepressants, mood stabilizers, or antipsychotics may help to manage or decrease specific symptoms. This may enhance the effectiveness of psychotherapy, for someone diagnosed with HPD.

HPD Treatment at Solara Mental Health

Solara Mental Health—located in San Diego, California—provides residential mental health treatment to veterans who are struggling with different kinds of mental health disorders, including histrionic personality disorder. Solara has created a specialized therapeutic program to promote long-lasting relief and recovery in the lives of those with HPD.

Solara’s highly trained and compassionate therapists provide a wide range of innovative and effective veteran mental health services to help support the men and women who have honorably served their country.

A combination of individual psychotherapy, group therapy, holistic therapies, and psychiatric counseling allows Solara’s mental health professionals to develop comprehensive, individualized, and flexible treatment plans for each veteran—to effectively treat personality disorders including histrionic personality disorder, borderline personality disorder, dependent personality disorder, and narcissistic personality disorder.

Skilled therapists employ evidence-based therapies such as:

  • Integrative psychotherapy
  • Cognitive behavioral therapy
  • Dialectical behavior therapy
  • Eye movement desensitization reprocessing (EMDR)
  • Relational therapy

Body-mind holistic healing modalities include:

  • Biofeedback
  • Breathwork
  • Art therapy
  • Aquatic-based PTSD therapy
  • Mindfulness and meditation
  • Equine therapy
  • Yoga

The team at Solara recognizes that veterans’ personality disorder symptoms are a result of their illness—and not their true personalities. They take an in-depth and nuanced approach to personality disorder treatment, to help veterans release psychological wounds and regain a stable, unified sense of self.

To learn more about our treatments for HPD and how they can help you or a loved one, contact us today.

What Our Clients Say

Bradley

The therapists and counselors and really whole team were extremely beneficial to me and my understanding of my issues. The treatment plan they developed was exactly what I needed

R.M. – Father

If not for Solara Mental Health, I am almost positive that our daughter would not be as advanced in her treatment, and would not have the almost miraculous confident and positive outlook that she has.

M.P. – Father

Your program provided our daughter with the most masterful therapist we have ever encountered (and we have used many).  She has had an unbelievable ability to see the long-term trajectory of our daughter’s treatment and to approach her treatment in stages that fit where my daughter’s development was.  We can’t say enough positive about her.

Alex

I have never felt better than I do now, since completing your program. The truly caring and supportive staff and the intensive program changed my life. What a neat place to stay for treatment - I love Pacific Beach! I have learned skills and behavior to move forward with my life thanks to you.

Lauren

The Solara program is truly amazing. I’ve never had more clarity or more good energy in my entire life. The attention the physicians and the therapists gave me was outstanding. I feel like they truly understood and addressed my issues, which had consumed my life for years. Thank you all.

Bill

The program has given me the tools I needed to really gain stability. For the first time in years - maybe for as long as I can remember, actually, I’m learning how to cope and manage my stressors and triggers. I now believe that I can find some relief and happiness.

Watson Family

Solara’s program was such a positive experience for our mom (and for us)! She had become almost impossible to deal with. Your entire staff was phenomenally supportive and kind and patient with her. We feel like we’ve got our mom back, now.

Michelle Family

I want to thank you and the entire staff and support system at Solara for taking such good care of my sister. On behalf of my entire family, we want you all to understand that your patience and kindness stretches further than you can see… Thank you, again and again, from the bottom of my heart.

Terri

The Solara Treatment Program was a life-changing experience for me. To be able to heal in such a beautiful, peaceful environment, with such a terrific treatment team, was so amazingly positive. I have found my true self, again. I thank you and my family thanks you for helping me become the person I was meant to be.

Lynn

Even though I’m not religious, I realized when I got sober that for the first time in my life I wanted to explore my spiritual side. I benefited hugely from the individual spiritual sessions that I had with Chris. I’m really grateful for that aspect of the whole treatment experience.

Dad

We are so grateful to you for the treatment and care you provided our daughter. She is doing unbelievably well now thanks to your program. We will gladly tell anyone we encounter that needs treatment about the wonderful work you do at Solara.

Husband

Solara was truly a life-changing experience for me and for our children, because of what you did for my wife! The treatment team was phenomenally supportive and perfect for helping her with her anxiety and depression. We are all now moving forward to put our lives back together and it started with you all in Pacific Beach. Thank you for what you do.

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