Histrionic Personality Disorder

 

Histrionic personality disorder (HPD) is a mental illness and part of “Cluster B” dramatic and erratic personality disorders. Cluster “B” disorders are characterized by being excessively emotional and dramatic, they make erratic decisions and have impulsive behavior. Among the other disorders that are a part of this cluster are antisocial personality disorder, borderline personality disorder, and narcissistic personality disorder. Individuals with Histrionic personality disorder tend to have excessive and unstable emotions. They always have the need to grab people’s attention and to be noticed by them, they lack self-worth and rely on the acceptance of others. Histrionic personality disorder can be genetic or a life event can trigger or have an effect on the development of the disorder.

Histrionic personality disorder was a development of the term hysteria that was first acknowledged in ancient Egypt in 1990 BC and symptoms and descriptions of the illness were written on the Kahun Papyrus which is considered to be the first and oldest medical gynecological manuscript. The term hysteria was used for the first time by Hippocrates.

From 354 to 430 AC, Augustine of Hippo, along with other theologians, was able to come to the conclusion that hysteria became known as a manifestation of demon possession. Moreover, Thomas Sydenham was able to conclude that hysteria was a more common illness in men than women, and if a patient is wealthy and cultured, they are more likely to be affected by it. The term Histrionic personality disorder started to appear in the 19^th century in 1845 when Ernst von Feuhtersleben was able to make a psychosocial description of HPB. Finally, Wilhelm Reich was the first psychoanalyst to grant a full descriptive psychoanalytic of the Histrionic personality disorder from 1897 to 1957.

Symptoms and treatment:

      People who have histrionic personality disorder tend to have good social skills; however, they usually use those skills to manipulate others so that they can be the center of attention. To be able to diagnose someone with histrionic personality disorder it requires meeting five (or more) of the following: being uncomfortable if they are not the center of attention. Dressing in a provocative way and flirting. Acting very dramatic and performative just to command people’s attention. Excessive sensitivity to people’s criticism or negativity. Being overly concerned with physical appearance and constantly seeking reassurance or approval. Being very self-centered and rarely showing concern for others. Rapidly shifting emotions. Threatening or attempting suicide to get attention.

In most cases, people suffering from this condition do whatever they can in order to draw attention to themselves through different strategies. If they do not get the attention that they seek, they may act unreasonably and make impulsive decisions. Their weakness is that they constantly need approval from other people, thus making them gullible and easily influenced. 

 

      People who have histrionic personality disorder usually exaggerate their feelings and dislike following a routine, this makes following a treatment plan very difficult. Most histrionic personality disorder patients think that they do not need therapy, but they might seek therapy if their anxiety and depression get too much. Psychotherapy is the most used type of therapy for treating histrionic personality disorder. Psychotherapy is a type of therapy that aims to alter how a person behaves in order to help them achieve a better and more stable life. The goal of psychotherapy is to help any individual discover what drives their thoughts and behavior. Since this approach is reassuring, encouraging, and non-threatening to histrionic personality disorders, it makes treating them much smoother. 

      The patients are encouraged to change overly dramatic speech for more reasonable speech. This helps to promote better communication with others. The patients learn to identify their attention-seeking patterns in order to control them and discover healthier ways to develop self-esteem, and eventually, the patient learns to relate to other people more positively. Sometimes medications, such as; antidepressants or antianxiety, are used with histrionic personality disorder patients.

      Group therapy and family therapy are very ineffective as people with histrionic personality disorder tend to desire to be the center of attention. Moreover, people with this disorder may display superficial emotions appearing insincere to those groups or family members participating in therapy simultaneously.