What it is
Histrionic Personality Disorder involves a pervasive pattern of excessive emotionality and attention-seeking beginning in early adulthood. People with HPD often feel driven to be the center of attention and may use lively, dramatic, or flirtatious behavior to maintain connection. Beneath this, there’s frequently a strong need for approval and fear of being ignored. HPD is treatable—therapy can build stable self-worth and more balanced relationships.
HPD is distinct from simply being outgoing or expressive; impairment and persistent relational difficulties are key.
Common signs and symptoms
- Social style and emotions
- Uncomfortable when not the center of attention; rapidly shifting, shallow emotions
- Theatrical expression; impressionistic speech lacking detail (“it was amazing!”)
- Uses appearance or charm to draw attention; may seem inappropriately seductive in some contexts
- Relationships and decisions
- Highly suggestible; relationships perceived as closer than they are
- Seeks novelty and approval; may struggle with follow-through when excitement fades
- Impact
- Work/academic inconsistency, conflict over boundaries, exhaustion from “performing,” and unstable self-esteem
Co-occurs with depression, anxiety, substance use, and other personality traits.
Why it happens
- Temperament: high reward sensitivity, sociability
- Early environments that reinforced performance/appearance for approval or invalidated quieter needs
- Core beliefs: “I must be exciting/admired to be valued”; “Being ignored means I’m unworthy”
What helps
- Psychotherapies
- CBT: clarify values beyond attention; build distress tolerance when not in the spotlight; increase specificity in communication
- Schema Therapy: address entitlement/approval-seeking and abandonment schemas; strengthen stable self-concept
- MBT/psychodynamic therapy: deepen awareness of emotions and interpersonal patterns
- Skills and strategies
- Expand sources of self-esteem (competence, contribution, authenticity)
- Practice specificity: give concrete details, set realistic goals, follow through
- Boundary work in relationships; reduce reliance on flirtation/appearance for connection
- Mindfulness to notice urges to escalate drama and choose steadier responses
- Medications
- None for HPD itself; treat co-occurring depression/anxiety if present
Progress shows as steadier mood, more genuine connections, and satisfaction from substance rather than spotlight.
When to seek help now
- Repeated relationship or job disruptions tied to attention-seeking patterns
- Depression, anxiety, or substance use when attention wanes
- Risky behavior to gain approval or excitement
How to talk to a clinician
- “I feel I need attention to feel okay, and it hurts my relationships and goals. I’d like CBT/Schema Therapy to build stable self-worth, boundaries, and follow-through.”
Resources for readers in the USA
- Immediate help: 988 Suicide & Crisis Lifeline; Crisis Text Line (text HOME to 741741)
- Find care: Psychology Today (filter for personality disorders/CBT/Schema/MBT); FindTreatment.gov; NAMI HelpLine (nami.org/help)
- Low-cost/community: Open Path Collective; Community Health Centers (findahealthcenter.hrsa.gov); 211
- Insurance tips: Verify in-network therapy, session limits, prior authorization; copay/coinsurance, deductible, out-of-pocket max
Disclaimer: Educational information, not a diagnosis. If in crisis, use the resources above.