How Histrionic Personality Disorder Is Treated

People living with histrionic personality disorder (HPD) have unstable emotions and a distorted self-image. Their self-esteem depends on the approval of others. They often behave dramatically to get attention.

Psychotherapy is the first-line treatment for histrionic personality disorder. Sometimes medications are prescribed to help with distressing symptoms like depression and anxiety. People with this personality disorder often don't think anything is wrong. Therefore, the first step toward getting better is admitting that you need help.

young woman talking to a counselor

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Prescription Medications

Your doctor may prescribe antidepressants, mood stabilizers, or antipsychotic medications to help with the mood swings, anger, anxiety, and depression that come with this mental health disorder.

Medications that can be used to treat histrionic personality disorder include:

  • Antidepressants: These drugs can help with symptoms like depression, anxiety, insomnia, impulsivity, self-harm behaviors, and emotional instability. Examples include Prozac (fluoxetine), Norpramin (desipramine), Elavil (amitriptyline), and Luvox (fluvoxamine).
  • Mood stabilizers: These medications can improve impulse control and emotional lability (abrupt, exaggerated changes in mood), and include Lamictal (lamotrigine), Tegretol (carbamazepine), Topomax (topiramate), Depacon (valproate), and lithium.
  • Antipsychotics: Antipsychotic drugs can be used for emotional dysregulation (emotional responses that are overly intense). Examples include Risperdal (risperidone), Abilify (aripiprazole), Zyprexa (olanzapine), and Haldol (haloperidol).

Therapies

Psychotherapy, or talk therapy, is the treatment of choice for histrionic personality disorder. The goal of treatment is to help you uncover and become more aware of the motivations and fears associated with your problematic thoughts and behaviors and help you learn how to relate to others in more positive ways.

Supportive Therapy

Supportive therapy is often recommended for people with histrionic personality disorder because this approach is encouraging, reassuring, and nonthreatening. This type of psychotherapy can help you reduce emotional distress, improve self-esteem, and enhance coping skills through attentive and sympathetic listening.

Psychodynamic Therapy

Psychodynamic therapy has also been found to be a successful treatment for histrionic personality disorder. The goal is to help you resolve underlying, unconscious conflicts so you can understand yourself and your behaviors better.

You may be encouraged to substitute excessively dramatic speech for a more adaptive action or behavior so you can better communicate with others. You will also learn to recognize the ways in which hypersexual, attention-seeking behaviors are not helpful, and discover new, healthier ways to develop self-esteem.

Alternative Treatments

You and your medical providers can discuss which alternative treatments may be effective for helping with your symptoms.

For example, for depressive symptoms, alternative treatments can include:

  • Saint-John's-wort, which is an herbal remedy sometimes used to treat depression
  • Omega-3 fatty acids, which are nutrients found in some plants and fish like salmon and tuna that are necessary for healthy brain functioning
  • SAM-e (S-adenosylmethionine), which is a natural compound found in the body that's involved in the synthesis of neurotransmitters that help regulate hormones, such as serotonin and dopamine
  • Folic acid, which is a synthetic form of folate (a B vitamin) that helps make genetic material and may increase the effectiveness of antidepressants in some individuals
  • 5-HTP (5-hydroxytryptophan), which may help increase levels of the neurotransmitters associated with mood regulation, including sertonin

You shouldn't begin any new alternative treatments without first discussing them with your doctor because supplements can have side effects and interfere with medications or other supplements you're taking.

Lifestyle 

Lifestyle changes that support your overall health are recommended. This includes the basics of self-care, such as:

  • Establishing consistent and healthy eating and sleep schedules
  • Exercising on a regular basis
  • Maintaining a healthy weight
  • Avoiding drugs and alcohol 
  • Seeking help from trusted friends and family to keep you on track

Since histrionic personality disorder is tied to a low self-esteem, practicing strategies that can help you build a healthy sense of self-worth may also help with this condition. These may include:

  • Challenging negative beliefs you have about yourself
  • Reminding yourself of your positive qualities
  • Asking people around you to tell you what good qualities they think you have
  • Building positive relationships and spending less time with people who make you feel bad
  • Practicing being kind to yourself
  • Learning to say no to others
  • Taking on new challenges in which accomplishing your goals can help you feel good about yourself

How to Seek Help

If you or a loved one are struggling with histrionic personality disorder, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database.

Summary

Histrionic personality disorder is characterized by a low sense of self-worth and unhealthy, dramatic ways of interacting with others. Treatment centers on helping people with this mental health disorder recognize their behaviors and come up with healthier ways of communicating with others. Building a stronger sense of self-worth by challenging negative self-beliefs can also help.

A Word From Verywell

Personality disorders don’t define you or your relationships with others. If you’ve noticed that you’re struggling in certain areas—or if multiple people have mentioned a similar overly dramatic or inappropriate behavior in you—it's time to assess whether you need help and how you’d like to proceed.

If you want to establish healthier relationships with others, you may want to start by talking to a mental health professional, who can get to the root of the issue and prescribe an effective treatment plan for your needs.

Frequently Asked Questions 

How do you deal with someone with histrionic personality disorder?

Dealing with someone with histrionic personality disorder may come down to helping them recognize that they need help and encouraging them to seek treatment. You can help them remain committed to their treatment plan and practice strategies to raise their self-esteem, such as by reminding them of the good qualities they have.

How do you cope with histrionic personality disorder?

Coping with histrionic personality disorder requires psychotherapy and sometimes medications, depending on what symptoms you have. Since people with this mental health disorder tend to rely on others' approval and usually have low self-esteem, practicing strategies to build self-confidence can also help.

What causes histrionic personality disorder?

It's not clear what the exact cause of histrionic personality disorder is. However, researchers believe that it's associated with both genetic and environmental factors, including early childhood trauma and other developmental experiences.

At what age do signs of histrionic personality disorder appear?

People can begin to show signs of histrionic personality disorder in their teenage years, but it may be difficult to initially distinguish symptoms of the disorder from those associated with the ups and downs of adolescence.

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5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cleveland Clinic. Histrionic personality disorder. Updated January 23, 2018.

  2. Novais F, Araújo A, Godinho P. Historical roots of histrionic personality disorder. Front Psychol. 2015 Sep 25;6:1463. doi:10.3389/fpsyg.2015.01463

  3. Kellett S. A time series evaluation of the treatment of histrionic personality disorder with cognitive analytic therapy. Psychol Psychother. 2007 Sep;80(Pt 3):389-405. doi:10.1348/147608306X161421

  4. Winchester Hospital. Health Library. Folate. Updated 2019. 

  5. National Health Service. Raising low self-esteem. Updated February 6, 2020.