Welcome to day 12 in the 31 Days of Mental Health. Yesterday, I was originally intending on writing a post on personality disorders. I didn’t and I didn’t even write a draft. However, since this 31-day series is raising awareness of the borad spectrum of mental illness, I thought I’d make use of the opportunity to discuss some disorders I’ve not been diagnosed with. Today, I’m writing about a disorder that my therapist at one point hinted at when discussing the possibility that I had imagined my dissociation: histrionic personality disorder. For your information: she never suggested I had this and, when my husband looked over the criteria to make his own judgment, he said I’m about the opposite of this.
Histrionic personality disorder (HPD) is a personality disorder characterized by a pattern of excessive emotionality and attention-seeking. Like all personality disorders, it sets on in early adulthood and is relatively stable across time and situations. People with HPD meet at least five of the following eight criteria:
- Is uncomfortable in situations in which he/she is not the center of attention.
- Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior.
- Displays rapidly shifting and shallow expression of emotions.
- Consistently uses physical appearance to draw attention to self.
- Has a style of speech that is excessively impressionistic and lacking in detail.
- Shows self-dramatization, theatricality, and exaggerated expression of emotion.
- Is suggestible, i.e., easily influenced by others or circumstances.
- Considers relationships to be more intimate than they actually are.
People with HPD are often referred to as “drama queens”. Though this was my first online nickname and many people agreed I was a real drama queen, I only meet one criterion of HPD (suggestibility) consistently now.
Histrionic personality diosrder is more common in females than males. It occurs in about 1.8% of the general population. Like most personality disorders, the presentation of HPD tends to become less pronounced as the affected person ages.
People with HPD are quicker to seek help than those with other personality disorders. However, this may reflect a symptom of their condition, because they exaggerate their symptoms and difficulty functioning. They also may display all emotions with the same depth of expression, unaware of the subtleties of emotional experience. People with HPD are also emotionally needy. Therefore, once in therapy, it’s hard for them to terminate treatment.
Therapy for HPD should usually be supportive, relatively short-term and solution-focused. It is unlikely that a therapist will be able to “cure” a HPD sufferer, so it doesn’t make sense to invest in long-term therapy.
People with HPD may exhibit suicidal behavior or make suicidal gestures. They may also self-harm. Though this might be an expression of their need for attention, suicidality and self-harm should always be taken very seriously. Even if the person is just crying out for help, death or serious bodily harm may occur. Like with all people who are suicidal or engage in self-injury, a safety contract may help establish boundaries while keeping the patient safe.