Learn about 5 common myths associated with histrionic personality disorder and the corresponding facts.

People with histrionic personality disorder (HPD) have an overwhelming desire to be noticed by others. Exaggerated behavior, speech and dress serve the purpose of gaining attention, which is the goal of a person with HPD. The often self-centered behavior of people with HPD can push away meaningful or long-term relationships.

It’s not always easy to tell fact from fiction when it comes to mental health disorders, and misconceptions can push people away or prevent treatment. Learn the facts about common HPD myths and help avoid the stigma associated with mental health conditions.

1. Myth: People with histrionic personality disorder have high self-esteem

Fact: People with histrionic personality disorder suffer from low self-esteem.

Although people with HPD may appear to have high self-esteem, this idea is incorrect. Loud dress and clothing, exaggerated speech and other attention-seeking behaviors can mislead many to believe that people with HPD are self-confident. Many may see someone with histrionic personality disorder as a dramatic person, uninhibited in their speech and behavior. However, this behavior does not equal self-assurance. People with HPD may desire to be the center of attention, but their self-esteem or self-worth is based on how others view them — not how they truly view themselves.

In fact, histrionic personality disorder is linked with low self-esteem and a sense of inadequacy. People with HPD are highly sensitive to criticism and view it as a form of rejection. Instead of viewing criticism as an opportunity to improve, a person with histrionic personality disorder can find it to be highly offensive and will actively avoid it. A person with HPD finds it difficult to be self-assured and will often rely on the praise or interest of others to build up self-worth. Because of this, they may be easily influenced or swayed by outside suggestions.

2. Myth: People with HPD lack empathy

Fact: People with HPD are capable of feeling empathy and other positive emotions.

Empathy is defined as the ability to understand and be sensitive toward another person’s feelings. When an issue is directly related to a person with HPD, they often find it difficult to see it from someone else’s viewpoint. This difficulty can be seen as a lack of empathy since it’s hard for people with histrionic personality disorder to read emotions that aren’t their own.

The idea that people with HPD lack empathy may also be based on their often self-centered behavior. Constant attention-seeking behavior can make it difficult for them to see the bigger picture in a relationship. A combination of self-centeredness and sometimes shallow or insincere speech can paint a negative picture.

Emotions, however, come in many forms and can be displayed in even more types of behavior. Sometimes described as highly volatile with their emotions, people with histrionic personality disorder can overreact or overexaggerate based on an obsessive concern of self. HPD emotions are strong, but there are positive emotions in this mix as well. People with histrionic personality disorder are more than capable of showing concern for other people, as long as the situation isn’t related to themselves. Therefore, they are not unfeeling people and can be capable of displaying empathy and other desirable qualities.

3. Myth: Histrionic personality disorder caused by genetics

Fact: While genetics are one risk factor for histrionic personality disorder, they don’t guarantee its development.

Research has shown that personality disorders originate in early childhood, with genetic and environmental factors each playing a role. Many studies, including family, twin and adoption studies, have linked genetics to personality disorders. Studies conducted on twins show that differences in genes can cause differences in traits. One twin study estimated a 67% heritability for histrionic personality disorder. Heritability is a measure of variances in a trait and how it can be attributed to genetics. Although that estimate is high, environmental factors can change the outcome of such a statistic. To date, no genetic association has been directly attributed to the development of HPD.

Personality disorders are complex mental health disorders that are widely studied, but no two people are exactly the same. However, certain temperaments and adverse environments can help foster the development of personality disorders. Although these factors don’t guarantee the development of a disorder, they are definite risk factors.

Some common environmental factors and causes of histrionic personality disorder include:

  • Traumatic events
  • Child abuse
  • Neglect
  • Inconsistent parenting
  • Anxiety
  • Learned behavior that is maladaptive

4. Myth: Histrionic personality disorder affects men and women equally

Fact: Histrionic personality disorder is diagnosed more often in women.

Personality disorders can be seen in around 30.8 million Americans and HPD is seen in about 1.8% of the population. While both men and women can be affected by the condition, histrionic personality disorder is diagnosed in women much more often. Some believe this is because women appear to be more agreeable when it comes to seeking treatment, which means more women receive a diagnosis in comparison to men.

Some scholars focus on the idea that certain personality disorders and diagnostic criteria include traits that are associated with gender roles, such as masculinity and femininity. Feminine men may display more features of personality disorders that are usually associated with women. Histrionic personality behavior is often described in words that are linked to the feminine sex, such as “seductive” or “drama queen.” However, one study found that a person with histrionic personality disorder can express behavior in a masculine or feminine way.

5. Myth: People with histrionic personality disorder can’t lead normal lives

Fact: People with HPD can function well and find fulfillment professionally and socially.

Nearly 4 million people are diagnosed with histrionic personality disorder. With treatment, many have found healthy ways to deal with their feelings. Even without treatment, people with HPD typically function well at work or in their realm of activity. The real issue lies in their interpersonal relationships with others, romantically and otherwise. Histrionic personality disorder treatment is therefore focused on improving and managing emotional reactions and expectations. This gives people with HPD helpful strategies to address their maladaptive behavior and develop stronger connections with others.

Some common forms of therapy that can prove helpful to those living with HPD include:

  • Cognitive behavioral therapy: Provides methods and practical skills to cope with negative emotions
  • Psychodynamic therapy: Can identify underlying reasons for the disorder with the goal of minimizing negative emotional reactions
  • Mind-body practices: Holistic therapies that focus on mindfulness can encourage self-control in emotionally charged situations
  • Group therapy: Can provide a community of support and offer role play that can help in real-life situations

Living with histrionic personality disorder doesn’t have to be intolerable or a life sentence. With proven methods of support and treatment, many have found life to be fulfilling and successful. Remember, mental health conditions shouldn’t define a person. Help beat the stigma associated with mental health disorders with compassion and accurate information.

If you or someone you know is living with histrionic personality disorder and coping with its negative effects by using alcohol or drugs, give us a call at The Recovery Village. One of our specialists can discuss a treatment plan that is appropriate for you. We believe everyone should have the opportunity for a normal life, and we are here to help make that possible.

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Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more
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Medically Reviewed By – Dr. Karen Vieira, PhD
Dr. Karen Vieira has a PhD in Biomedical Sciences from the University of Florida College of Medicine Department of Biochemistry and Molecular Biology. Read more

Ma, G., Fan, H., Shen, C., Wen, W. “Genetic and Neuroimaging Features of Per[…]s: State of the Art.” Neuroscience Bulletin, June 2016. Accessed May 21, 2019

Torgersen, S., et. al. “A twin study of personality disorders.” Comprehensive Psychiatry, November 2000. Accessed May 21, 2019.

National Institute on Alcohol Abuse and Alcoholism. “Landmark Survey Reports the Prevalence o[…]n the United States.” August 2, 2004. Accessed May 21, 2019.

Klonsky, E., Jane, J., Turkheimer, E., Oltmanns, T. “Gender Role and Personality Disorders.” Journal of Personality Disorders, October 2002. Accessed May 21, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.