Histrionic vs Narcissistic Personality Disorder

Histrionic personality disorder (HPD) and narcissistic personality disorder (NPD) are both mental health conditions characterized as personality disorders. These disorders involve ongoing or repeated thoughts, behaviors, perceptions, and feelings that are not consistent with societal norms and that interfere with long-term functioning.

Personality disorders are further classified into one of three groups, including cluster A, cluster B, and cluster C. Histrionic personality disorder and narcissistic personality disorder are both cluster B personality disorders, and while there are similarities between these two conditions, there are some key differences.

Learn more about what makes them different, why these differences are important, treatment options, and more.

Differentiating Traits

Since HPD and NPD are both cluster B personality disorders, they are similar. However, there are differences. These differences are important because they impact:

• How people with each condition think and behave
• How their relationships are affected
• The risks of other challenges
• The effectiveness of different treatment options

While people with narcissistic personality disorder and histrionic personality disorder both like to be the center of attention, they differ in the type of attention they require.

• People with narcissistic personality disorder have a need to be admired and get positive attention that is in line with their inflated sense of self-worth. They struggle with lack of attention or negative attention.
• People with histrionic personality disorder, on the other hand, seek attention in general, regardless of the type of attention.

Additionally, people with histrionic personality disorder, compared to people with narcissistic personality disorder, are more likely to develop dependent relationships. They are also less dismissive of others. This may relate to empathy, as people with HPD are generally more capable of feeling empathy and can be sensitive to others. People with NPD, in contrast, are often limited in their capacities to feel emotional empathy and their ability to process cognitive empathy is dysfunctional.

HPD and NPD Together

It is possible for the same person to experience both histrionic personality disorder and narcissistic personality disorder at the same time. This is called comorbid personality disorders.

People with narcissistic personality disorders often struggle with other conditions as well. More specifically, additional personality disorders are often seen with NPD, and HPD is one of the most common personality disorders to be comorbid with NPD.

Both conditions may also occur with other mental health conditions, such as depression.

Histrionic vs Narcissistic: Treatment and Outlook

Personality disorders are treatable, but they are not all treated in the same ways. Even though NPD and NPD are both cluster B personality disorders and are similar, different treatment options tend to be more effective for each. More specifically, they can both be treated with psychotherapy (talk therapy) provided by a mental health professional such as a psychologist or psychiatrist. However, the specific psychotherapeutic interventions may be different for each condition.

Additionally, medications are sometimes used to treat certain symptoms that are often associated with personality disorders such as depression, but there are no medications currently available to specifically treat personality disorders.

Treatment for NPD

Narcissistic personality disorder is treated with psychotherapy. Certain approaches to psychotherapy including mentalization-based therapy, transference-focused psychotherapy, self-psychology, and schema-focused psychotherapy have been applied for this condition. The treatment can be provided by a mental health professional such as a psychologist or psychiatrist.

Treatment for HPD

Histrionic personality disorder is also treated with psychotherapy. Supportive psychotherapy and psychodynamic psychotherapy approaches are the types of talk therapy used for this condition. Group therapy and family therapy may be used, but may sometimes be problematic around the patient's attention-seeking behaviors. The treatment can be provided by a mental health professional such as a psychologist or psychiatrist.

Summary

Histrionic personality disorder and narcissistic personality disorders are two different mental health conditions that are both classified as cluster B personality disorders.

While they have many similarities, such as a desire to be the center of attention and relationship challenges, there are some traits that set them apart. People with NPD expect admiration because they have an inflated sense of self-worth, while people with HPD crave general attention to avoid feelings of discomfort.

These two conditions can occur together. They are both treated with talk therapy, but different approaches may be emphasized.

A Word From Verywell

Personality disorders can be challenging both for the people with the personality disorders and those close to them. If you or someone you know is experiencing symptoms of a personality disorder such as NPD or HPD, you are not alone. Help is available. Both of these conditions, along with other personality disorders, are treatable. Reach out to a healthcare professional such as a primary care provider or psychologist for support.