Medically reviewed by Elle Markman, PsyD

Histrionic personality disorder (HPD) is a mental health condition characterized by excessively dramatic and attention-seeking behaviors. People with HPD have an intense need for attention and often display inappropriately seductive or flirtatious behavior to obtain it. They often struggle to maintain close relationships and may engage in impulsive and manipulative behaviors.

An estimated 2% to 3% of the United States population has HPD, which usually develops in late adolescence or early adulthood. Research suggests that people assigned female at birth and people assigned male at birth are equally affected.

Diagnosing HPD involves a comprehensive psychological evaluation by a mental health professional who assesses your symptoms and behavioral patterns. Psychotherapy (talk therapy) and medications are standard treatments for HPD. 

Cluster B Personality Disorders

Histrionic personality disorder is identified as a Cluster B personality disorder by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which sets a standard classification of mental disorders for mental health professionals in the U.S. Cluster B personality disorders are characterized by a pattern of intense, emotional, and impulsive behaviors. People with Cluster B personality disorders often struggle with impulse control. They have difficulty regulating their emotions and forming stable relationships with others.

HPD fits within this cluster due to its core symptoms of attention-seeking behavior, emotional volatility (intense emotions that can shift suddenly), and difficulty maintaining close relationships.

Other Cluster B personality disorders include:

Histrionic Personality Disorder Symptoms 

Symptoms of histrionic personality disorder typically involve a pattern of exaggerated and overly dramatic behavior, emotional instability, and a strong need for attention and approval from others. People with HPD are often enthusiastic, outgoing, and charming, especially when meeting new people. They might consider relationships closer or more meaningful than they actually are and might feel ignored if they feel like they're not receiving enough attention.

Common symptoms of HPD include:

  • A strong desire to be the center of attention
  • Exaggerating emotions and feelings for dramatic effect
  • Inappropriate flirtatious or sexually suggestive behavior
  • Intense emotions and moods that shift suddenly and seem insincere to others
  • Overconcern with physical appearance and following new trends 
  • Difficulty maintaining close relationships due to fear of abandonment or rejection
  • A tendency to be easily influenced by others
  • Frustration due to delayed gratification, which can lead to impulsive behaviors 
  • Difficulty accepting criticism or negative feedback
  • Boredom and craving new, exciting experiences 
  • Blaming mistakes or disappointments on others 


The causes of histrionic personality disorder are unknown, but genetic and environmental factors likely play a role.

  • Genetics: Histrionic personality disorder often runs in families, suggesting genetics may contribute to its development. Cluster B personality disorders as a whole tend to run in families, but they can manifest differently. For example, one family member might have HPD and another family member might have BPD. There also might be genetic links to anxiety, fear, and aggression.
  • Parenting style: A lack of boundaries, overindulgence, or inconsistent parenting may increase the risk of future HPD. Dramatic, erratic, or overly-sexual behavior by parents might also play a role. Children might see their parents modeling HPD behaviors and then develop the traits themselves. 
  • Trauma: Like other personality disorders, coping mechanisms for childhood trauma might contribute to symptoms.


Diagnosing histrionic personality disorder involves a comprehensive evaluation by a mental health professional, like a psychiatrist or psychologist. The main difference between a psychiatrist and a psychologist is that a psychiatrist can prescribe medication. Psychiatrists do not do psychotherapy.

The evaluation will involve the following:

  • An in-depth interview
  • A review of your symptoms
  • A review of your medical and mental health history

Many HPD symptoms can overlap with other personality disorders, so a healthcare provider will rule out other conditions to accurately diagnose HPD. 

A person must exhibit at least five of the criteria listed in the DSM-5 to receive a diagnosis of HPD:

  • Distress or unease when not the center of attention
  • Inappropriately seductive or provocative behavior
  • Rapidly shifting and shallow expression of emotions
  • Uses physical appearance to draw attention
  • Communicates with an excessively vague and grandiose style that lacks specificity or detail
  • Dramatic, theatrical, or exaggerated expression of emotion
  • Easily influenced by others or circumstances
  • Believes relationships to be more intimate than they are

People with histrionic personality disorder may not always recognize their behaviors as indicative of a personality disorder. As a result, they might not be diagnosed until later in life, after behavioral patterns have significantly interfered with their personal and professional lives.

Histrionic Personality Disorder Treatment

Treatment for histrionic personality disorder focuses on helping people gain awareness of their emotions and behavior, develop healthy communication and social skills, and improve their self-esteem. Treatment may involve psychotherapy and medication. 


Psychotherapy (talk therapy) is the primary treatment for HPD. Goals mirror the general treatment goals for all types of personality disorders.

These goals include:

  • Reducing distress
  • Helping people understand their problems as internal conflicts (conflicts in their own minds)
  • Decreasing behaviors that interfere with daily functioning and the ability to adapt to situations
  • Changing personality traits, such as distrust and manipulativeness, and developing more helpful ways of functioning and interacting with others

Types of psychotherapy that may be helpful for people with HPD include: 

  • Cognitive-behavioral therapy (CBT): Focuses on identifying and changing negative thought patterns and behaviors. CBT can help people with HPD develop healthier coping strategies, improve their interpersonal skills, and learn how to regulate their emotions.
  • Dialectical behavioral therapy (DBT): Structured therapy that incorporates mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. It includes individual and group therapy.
  • Psychodynamic therapy: Helps connect past experiences, like trauma or unresolved conflict, to present behaviors. By gaining insight into these underlying factors, people with HPD can better understand themselves and their relationships, improve their coping skills, and reduce symptom severity.
  • Interpersonal therapy: ​​Examines a person’s relationships and identifies thoughts and behaviors that may cause negative interactions with others. With this type of therapy, people with HPD can learn how to express their emotions and needs in healthy ways, improve their communication skills, and develop more fulfilling relationships. 


No medications are approved to treat histrionic personality disorder. However, some psychiatric medicines may help manage emotional dysregulation (inability to regulate emotions) and common co-occurring conditions like anxiety and depression.

Medicines that may be prescribed for HPD include:

  • Antidepressants like Prozac (fluoxetine) and Luvox (fluvoxamine) 
  • Antipsychotics like Risperdal (risperidone) and Abilify (aripiprazole) 
  • Mood stabilizers like Carbagen or Tegretol (carbamazepine) and Epilim or Depakote (valproate)

Related Conditions 

People with HPD have an increased risk of developing other mental health conditions, such as: 

  • Depression: Research shows that many people with HPD meet the criteria for major depressive disorder.
  • Anxiety disorders: People with HPD are at a significantly increased risk of developing anxiety disorders, including generalized anxiety disorder and panic disorder.
  • Substance use disorders: People with HPD may turn to drugs and alcohol as a way of coping with relationship challenges, stress, anxiety, and intense emotions.

Living With Histrionic Personality Disorder 

Living with histrionic personality disorder can affect how you feel, think, and behave. The intense emotions and need for attention and validation can make it challenging to maintain relationships and can significantly affect your quality of life.

Treatment is a long-term process, and living with HPD may require ongoing support and care from healthcare providers, family, and friends. Together, treatment and support can help people with HPD live productive and fulfilling lives.

Learning as much as possible about HPD is a valuable way to support some with the disorder. Recognizing that attention-seeking behavior and intense emotions are a manifestation of the condition and not a reflection of their character may help you cope during the more challenging times. Offering empathy and understanding while encouraging the person to seek treatment can also be helpful.

Supporting someone with HPD can be emotionally taxing, so set boundaries and practice self-care.

Frequently Asked Questions

What triggers histrionic personality disorder?

There are no specific triggers for histrionic personality disorder. It is believed to develop due to genetic and environmental factors. Childhood experiences, such as inconsistent or over-indulgent parenting, may also play a role in the development of HPD.

Does histrionic personality disorder get worse with age?

Without treatment, the symptoms of HPD can persist or worsen over time. Research shows that many older adults with HPD are alienated from family members due to their tendency to manipulate others. Treatment can help people with HPD learn to manage their symptoms and lead fulfilling lives.

What is the difference between narcissistic and histrionic personality disorders?

Narcissistic and histrionic personality disorders (NPD and HPD, respectively) are both Cluster B personality disorders and share some similar symptoms, such as excessive attention-seeking behavior and a need for admiration. However, people with NPD tend to lack empathy and have an inflated sense of self-importance, while people with HPD may have more rapidly shifting and intense emotions and a desire to be the center of attention.

Is histrionic personality disorder in the DSM-5?

Yes, histrionic personality disorder (HPD) is included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It is classified as a Cluster B personality disorder.

For more Health news, make sure to sign up for our newsletter!

Read the original article on Health.

2023-06-08T19:32:22Z dg43tfdfdgfd