Behind the Drama: Understanding Histrionic Personality Disorder

Some people thrive when all eyes are focused on them, but if this is followed by a deep sense of discomfort when the crowd disperses, there may be something more at play.

Many of us find some pleasure in occupying the spotlight from time to time, particularly if you are an extrovert who feels energised by the company and camaraderie of others. But what if you have a persistent need to be the center of attention? If you’re only at peace when all eyes are on you, then it’s likely that you are experiencing something beyond simple extroversion.

People with histrionic personality disorder (HPD) don’t just love being the focus of the room, they feel deeply uncomfortable when they are not. This drive for attention can result in dramatic and at times socially inappropriate behaviours that can actually make it difficult to build and maintain close relationships with others if left untreated. 

What is Histrionic Personality Disorder?

Histrionic personality disorder occurs when people tend to perceive situations solely in emotional terms, and behave in ways that draw attention towards themselves. This behaviour can be alternately perceived as entertaining and energetic, or inappropriate and over-the-top. The word “histrionic” means theatrical or dramatic, implying the type of exaggerated behaviour and responses seen in people with HPD. 

It is important to note that people living with HPD are not being intentionally manipulative or are even aware of the difference in their behaviour, but are responding to deep-seated and often unconscious ideas about how to gain positive responses from others. This is because the self-esteem of people with HPD is based largely on the approval and acknowledgement of others, rather than an innate sense of self-worth or value. 

Like many disorders, the exact causes of HPD are not known. However, researchers believe that both learned and inherited behaviours could be factors, as well as personality and psychological tendencies and individual coping mechanisms. Childhood trauma seems to also play a role in the development of HPD.

Understanding Symptoms of Histrionic Personality Disorder

Symptoms of HPD often become apparent in adolescence or in early adulthood, and can cause significant stress or challenge for the person experiencing them. Due to the nature of HPD, it can be hard for people to initially recognise that they may have a personality disorder, instead casting blame on others for the problems they experience. 

For those who do seek professional help, a mental health specialist will look for common symptoms of HPD, confirm that the patient has experienced these symptoms over a long period of time, and verify that they are facing problems because of these symptoms in order to make a diagnosis of HPD. Typically, a mental health professional will look for at least five of eight common symptoms. 

1. Tendency to dramatise

These symptoms are characterised by impulsive, showy behaviours in response to relatively minor events. Whether it’s audibly shivering and announcing that they are on the brink of hypothermia on a brisk autumn day, or sobbing uncontrollably over a perceived slight, these behaviours are hyperbolic and often performative.

2. Assuming closeness

People with HPD tend to feel an immediate closeness with others, even those they have just met. This can lead to sharing of intimate details, affectionate language or behaviour, or frequent contact with new or casual acquaintances that can seem overwhelming or fake.

3. Flirtatious behaviour

Persistent provocative or seductive behaviour isn’t actually an attempt to initiate a relationship, but another way to attract attention. However, this type of behaviour can be perceived as inappropriate in certain situations, such as in a professional setting.