Everything You Need to Know about Histrionic Personality Disorder

Histrionic Personality Disorder: When it’s More than being a ‘Drama Queen’

Do you need the attention of others to validate yourself?

Well, you may have histrionic personality disorder.
The exact cause of histrionic personality disorder is not known, but many mental health professionals believe that both learnt and inherited factors play a role in its development.


What makes personality?

Your personality is deeply ingrained patterns of behaviour and the manner in which you perceive, relate to, and think about yourself and your world.

Genes play a significant role in the development of personality disorders, while instability or abuse during childhood may also increase your risk.

What is a personality disorder?

A personality disorder is an umbrella term for different personality types characterised by long-standing and enduring patterns of behaviour that cause chronic social dysfunction. They are usually diagnosed in adulthood. It is uncommon for them to be diagnosed in childhood or adolescence, because as child or teen you’re under constant and rapidly changing development. If a personality disorder is diagnosed in a child or teen, the features must have been present for at least one year.

According to the South African Depression and Anxiety Group (SADAG) almost 7 % of South Africans aged 20 years or older have a personality disorder.


The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association, is used to help define personalities.

The DSM-5 recognises 10 different categories of personality disorders that are grouped into three clusters:

  • Cluster A: The odd, eccentric cluster
  • Cluster B: The dramatic, emotional and erratic cluster
  • Cluster C: The anxious, fearful cluster.

HPD belongs to the group of dramatic and erratic personality disorders.

What is histrionic personality disorder?

Histrionic personality disorder (HPD) is a Cluster B condition, which also includes antisocial, borderline and narcissistic personality disorders.

HPD is associated with a distorted self-image and remains the only personality disorder to be openly related to physical appearance.


Histrionic personality disorder is more common in females and, like most personality disorders, HPD typically decreases in intensity with age, with many people experiencing a few of the most extreme symptoms between the ages of 40 and 50 years.

Behavioural and emotional traits of histrionic personality disorder:

1 Dramatic

People with histrionic personality disorder show exaggerated expressions of emotion.
They might also talk in a style of speech that is excessively dramatic, impressionistic and lacking in detail.

2 Emotional

People with HPD are highly emotional.

3 Erratic

Displays of of rapidly shifting and shallow expression of emotions are common in people with HPD.

4 Seek Attention

Seeking attention and approval from others is a hallmark of histrionic personality disorder.
People with HPD often appear charming in order to achieve this.

They are also usually uncomfortable in situations in which they are not the centre of attention, and can become depressed and upset when this is the case.
Isolation from friends may also occur due to their demands for constant attention.

5 Easily influenced

People with histrionic personality disorder are usually easily influenced by others or circumstances, and, therefore, often appear impulsive.

6 Manipulative

People with HPD are likely to try and control their partner through emotional manipulation or seductiveness, but also show dependency on them.

They also consistently uses physical appearance to draw attention to themselves.

7 Lack Self-awareness

People with histrionic personality disorder are often unaware of their actions, and they often act out a role of being a victim in their relationships.

They may also consider certain relationships to be more intimate than they actually are or experience potential difficulty reaching emotional intimacy in romantic or sexual relationships.

How is histrionic personality diagnosed and treated?

HPD is typically diagnosed by a psychologist or psychiatrist. A general practitioner is generally not trained or well-equipped to make any type of psychological diagnosis. Your doctor will refer you to a mental health professional for diagnosis and treatment.


People with personality disorders generally don’t seek out treatment until the disorder starts to significantly interfere or impact another person’s life.

Treatment of histrionic personality disorder involves long-term psychotherapy. Medication may also be prescribed to help with specific troubling and debilitating symptoms.


If you or someone you know suffers from a personality disorder and needs help, you can contact a trained counsellor between 8am-8pm Monday to Sunday, by calling the Pharma Dynamics’ toll-free hotline on 0800 20 50 26.


Want to find out more about other mental health conditions? You can follow this link.

You can also access more mental wellbeing tools at Let’s Talk.

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These articles are for information purposes only. It cannot replace the diagnosis of a healthcare provider. Pharma Dynamics gives no warranty as to the accuracy of the information contained in such articles and shall not, under any circumstances, be liable for any consequences which may be suffered as a result of a user’s reliance thereon.

The information the reader is about to be referred to may not comply with the South Africa regulatory requirements. Information relevant to the South African environment is available from the Company and in the Professional Information/Patient Information Leaflet/Instructions for Use approved by the Regulatory Authority.

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