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Histrionic Personality Disorder Treatment

What is a Histrionic Personality Disorder?

Personality disorders are a set of conditions characterized by unstable or debilitating patterns of behavior and thinking. A histrionic personality disorder (HPD) is often characterized by exaggerated emotionality and dramatic behavior, as well as attention-seeking behavior.

It is important to note that a diagnosis of a personality disorder requires a degree of severity that causes dysfunction and disorder in a person’s life. A teen who acts a certain way for attention is not necessarily struggling with a personality disorder. But a teen who employs consistently manipulative behavior, ranging from charming to seductive, and is often inappropriate towards others – with behavior ranging from sexual promiscuity and exhibitionism to pathological lying or chronic embellishment – may fit the bill for histrionic personality disorder.

More than just theatrics and dramatics, teens who struggle with HPD will be much more likely to have serious relationship problems as a result of their behavior, whether it is the need to be at the center of attention at all times, or the higher likelihood of acting inappropriate towards others, even without any feelings of sexual attraction. Early diagnosis and treatment can help teens identify, understand, and cope with behavioral patterns that fit HPD, and learn to employ a healthier set of behaviors around others.

Histrionic Personality Disorder vs. Other Personality Disorders

A histrionic personality disorder is characterized as a dramatic or unstable personality disorder, a category shared with the conditions borderline personality disorder, narcissistic personality disorder, and antisocial personality disorder.

At times, histrionic personality disorder may be mistaken for narcissism. However, a key characteristic in histrionic personality disorder is that people with HPD are often extremely impressionable, in addition to being exceptionally outgoing and charismatic. They are likely to gravitate towards others and even fixate on certain people, pursuing a relationship aggressively before dropping it unceremoniously.

Teens with HPD are more likely to be suggestible, and even easily influenced by anyone they admire. In contrast, a narcissist is constantly convinced of the idea that they are the pinnacle of everything and everyone around them and would never see eye-to-eye with someone else. At best, in the eyes of a narcissist, you might make second place.

Teens with histrionic personality disorder also struggle with extreme emotionality and mood swings, but their condition is characterized separately from borderline personality disorder by the fact that their behavior ultimately stems from a need to be at the center of attention, rather than a general impulsivity and total lack of emotional regulation. While a person with histrionic personality disorder also suffers from an inconsistent self-esteem, they are much more reliant on others to develop any sense of self-esteem or self-worth, while patients with borderline personality disorder may fluctuate on their own self-worth.

As with other personality disorders, histrionic personality disorder often co-occurs with certain common mental health issues, particularly depression and other mood disorders, anxiety disorders, trauma-related conditions, and ADHD.

What Does Histrionic Personality Disorder Look Like?

Histrionic personality disorder requires a set of behavioral criteria to be confirmed before a diagnosis can be met. In most cases, a person must concurrently exhibit five of the following patterns of behavior among other people:

  1. Shallow conversations and speech. These include a propensity towards discussing topics with alarming vagueness or a shallow understanding, often giving off an attitude of insincerity.
  2. Dramatic and overly exaggerated behavior and emotions. These behaviors are often theatrical to the point that they can lead to second-hand embarrassment with friends and family members.
  3. Easily influenced by others. While often manipulative, teens with HPD are also easily swayed and highly suggestible.
  4. Must be at the center of attention. This can often be the cause of much conflict and dysfunction in a teen’s life.
  5. More likely to think a relationship is more serious than it is. This often leads teens with HPD to jump ahead a few steps, and rush things in a romantic pursuit with other people.
  6. Using suggestive, flashy, or unusual clothing to stand out and draw attention. While some kids are extroverted and love attention, a teen with HPD will take this to an uncomfortable extreme, whether it involves wearing inappropriate or provocative clothing, or trying to be the center of attention even when it is incredibly rude.
  7. Seductive or provocative behavior, even towards adults. This can range from clothing to behavior, including flirtatiousness and suggestive speech.
  8. Shifting emotions. This is a symptom shared with borderline personality disorder, in that teens with HPD may struggle with emotional control and regulation. However, while their behavior is dramatic, their shifting emotions can often appear shallow or fake – in other words, it can feel more obvious that they’re putting on a “show”.

Histrionic personality disorder is a somewhat controversial condition, in part because it can struggle to differentiate itself from conditions like narcissistic personality disorder and borderline personality disorder, and in part because its definition and history dates back to the concept of “hysteria” as a set of dysfunctional thought patterns and behaviors in women, as far back as ancient Greece.

While modern concepts of histrionic personality disorder have completely abandoned this line of thinking, and HPD is diagnosed in men and women alike, there is still some support for dropping it as a separate condition.

Is Histrionic Personality Disorder Treatable in Teens?

One of the difficulties with treating histrionic personality disorder, and most other personality disorders, is that it can be very difficult to convince a teen that their “personality” is dysfunctional, or that treatment can help.

There is no drug or fast-acting medication to combat histrionic personality disorder, or any other personality disorder. Instead, treatments are largely based on established behavioral therapy programs, involving the analysis and careful re-establishment of important social skills, and ways to identify and avoid displays of histrionic behavior.

Common treatments for histrionic personality disorder include cognitive behavioral therapy, group psychotherapy, psychodynamic individual therapy, and other therapeutic modalities that emphasize healthier social habits and behaviors. Get in touch with us at the Arrow House to learn more about how our residential treatment programs can help your teen cope with histrionic personality disorder.