Histrionic Personality Disorder (HPD) affects approximately 2 percent of the population.1 While it is diagnosed across genders, females are most often diagnosed with this disorder. Some of the “tells” that indicate a person may have HPD include excessive flamboyance in their behaviors, appearance, attire, and responses to those around them. They thrive on the attention of others and go out of their way to gain this attention from those around them. They embrace the role of “damsel/victim in distress” and play out this scenario under the most benign conditions.
Ironically, while their emotions are oddly shallow, they tend to be “emotional exhibitionists,” who act out feelings that they can’t truly experience. Their behavior reflects powerfully charged emotional states—from one end of the spectrum to the other. They may sob uncontrollably or exhibit disproportionately strong levels of glee or high spirits. There is no in-between and they will play to an audience with unbounded enthusiasm. Not only do individuals with HPD scale the heights of elation, but they can also sink to the depths of despair in the blink of an eye. Because they are “acting out” emotions, rather than “feeling” their emotions, they can zip from one intense display to another without missing a beat. They’ve often spent years working out their best reactions and they are responding to events around them from a playbook, not their hearts.
Because their energy is devoted to gaining the attention, and often sympathy, of others, they know how to project an image of themselves that grabs the spotlight they crave. Depending on their audience, they may rely on their well-developed powers of seduction and sexual attraction to get noticed and capture the gaze and interest of those around them.
Because individuals with HPD tend to bore easily, they may tire of routines, jobs, friends, and romantic partners quite quickly. Their careers may reflect multiple zig-zags and abrupt stops-and-starts as they tend to move from job to job with little regret over lost opportunities. Being fired is more fodder for their attention-seeking behaviors—they can get what they most desire—the attention and sympathy of others. Ditching a job, leaving co-workers, and just moving on doesn’t cause them the same concern as others, due to their inability to authentically experience their lives.
Maintaining authentic relationships is challenging for folks who suffer from HPD as they have spent a lifetime “playing” their feelings. This diminishes their ability to form intimate relationships, as they are typically incapable of being honest with others when they cannot be honest with themselves. Sadly, their lack of care for deep connections can leave friends and partners feeling frozen out and empty.
The histrionic paradox is that these individuals assume their relationships with others are much deeper and more intimate than they truly are. Because they have no understanding of self-intimacy or authenticity, they assume that even casual friends are “besties” or that all romantic relationships or casual hook-up partners are “soulmates.” Yet these relationships are often hollow, lacking real substance.
Sending out sexually charged signals and dressing in sexually provocative ways are part of the pattern for individuals with HPD. Not unexpectedly, these overt efforts to attract the sexual gaze of others can be experienced as a threat to friends whose partners may be the target of these efforts. This threat to the stability of their own relationships can lead these friends to “break up” with the person displaying these histrionic behaviors as an act of self-preservation and relationship protection.
Histrionic individuals tend to burn bridges in relationships, but they don’t necessarily mourn these losses the same way the folks they’ve left behind might. Former friends, ex-partners, and family members may show symptoms of depression and suffer from grief and isolation as they fall out of focus for the person with HPD. Histrionic individuals are able to let go of past failures and keep their eyes trained on their next potential conquest.
Kind of Narcissistic, but Kind of Not
Histrionic people crave the same level of attention that narcissists do, but the type of attention that satisfies a histrionic person is markedly different from what narcissists demand. Narcissists have inflated self-images which are maintained through shows of admiration and praise from others. Individuals with HPD often have low self-esteem, and their hunger for attention is satisfied whether they receive positive or negative attention. They may willingly make fools of themselves if it will get them the attention they crave; A narcissist, however, will do everything possible to avoid losing face as their self-image is everything to them.
Eight Symptoms of Histrionic Personality Disorder
Histrionic personality disordered individuals consistently engage in behaviors designed to attract the attention of others, whether they are viewed as the hero who deserves exaltation or the victim who needs rescue. To that end, they exhibit elevated levels of emotional dysregulation and use their emotional displays to attract the audience they need to feed their hunger for attention. According to the DSM-5, histrionic personality disorder is first exhibited in early adulthood and is diagnosed when five of these eight symptoms are exhibited:
- Is uncomfortable when they are not the center of attention
- Engages in inappropriate sexually seductive or provocative behavior to gain attention
- Displays rapidly shifting and superficial expression of emotions
- Consistently uses their physical appearance (make-up, clothing, body language) to draw attention to self
- Uses an excessively vague style of speech that lacks detail
- Engages in theatrical, performative behaviors and exaggerated expressions of emotion
- Is suggestible and easily influenced by others around them
- Considers relationships to be more intimate than they actually are