Psychologist Carly Dober explains Histrionic Personality Disorder

Psychologist Carly Dober breaks down a disorder that is often mistaken for narcissism in men. She says it’s not a character flaw but a call for understanding and support.

When people hear the word histrionic – which means theatrical or overly dramatic – they often picture someone who’s ‘too much’, too loud, too dramatic, too emotional.

What many don’t realise is that Histrionic Personality Disorder (HPD) is a legitimate and complex mental health condition, not just a label for attention-seeking behaviour.

As a psychologist, I often find that HPD is misunderstood, misdiagnosed, and deeply stigmatised, especially as it presents differently in men and women.

So let’s break it down.

Histrionic Personality Disorder is characterised by intense, rapidly shifting emotions, a distorted self-image, and an overwhelming desire to be noticed.

People with HPD often rely heavily on others for approval and self-worth, and they may act in dramatic or inappropriate ways to gain attention, even when they’re not fully aware they’re doing it.

Histrionic personality disorder is often misunderstood.

The word histrionic only reinforces the common misconceptions.

There’s so much more happening beneath the surface.

Someone with HPD may:

•Crave being the centre of attention and feel low or anxious when they’re not

•Display exaggerated emotions that feel overwhelming or shallow

•Embarrass others with public outbursts or over-the-top behaviour

•Constantly seek reassurance and approval

•Be extremely flirtatious or sexually provocative, even without attraction

•Dress to stand out think bold colours or very revealing outfits

•Speak in dramatic tones or voice strong opinions without backing them up

•Think their relationships are more intimate than they actually are

•Get bored easily and become frustrated when they aren’t stimulated

Getting bored is one of 11 traits someone must have.

•Struggle to maintain long-term, deep relationships

•Many of these behaviours are normal, healthy and point to variations in human expression when they are not impacting your quality of life and your functioning.

For someone who may be struggling with HPD, these behaviours will be having a significant impact on their quality of life.

Despite how some of these behaviours might be impacting them or those around them, many with HPD don’t see their behaviour as an issue. It often feels like simply being expressive or ”charming” when in fact, it can cause significant strain in relationships and emotional health.

Like most personality disorders, HPD doesn’t have a single cause, but rather a combination of influences:

•Genetics: It often runs in families, suggesting a hereditary component.

•Childhood trauma: Early loss, abuse, or instability can shape emotional development.

•Parenting styles: Over-indulgence, inconsistent boundaries, or exposure to dramatic or inappropriate behaviour can contribute.

•Emotional invalidation: If children are only rewarded for attention-grabbing or performative behaviour, they may grow into adults who feel unsafe being emotionally authentic.

Historically, females have been diagnosed more frequently with HPD, often due to gender biases in mental health. In contrast, men with similar behaviours may be misdiagnosed with narcissistic personality disorder, or overlooked entirely.

Psychologist Carly Dober breaks down histrionic personality disorder.

The clinical guide to assessment and diagnosis that psychologists and psychiatrists use- the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) acknowledges this gender bias. HPD is likely more gender-equal than once believed, but men often express symptoms differently and may fly under the diagnostic radar.

Although HPD can feel challenging both for the individual and those around them it is manageable with the right support.

Psychotherapy is the first-line treatment and can be incredibly helpful in building self-awareness, emotional regulation, and healthier relationship skills.

Common therapy approaches include:

•Psychodynamic Therapy: Explores unconscious patterns, often rooted in childhood, to help the individual understand their emotional world.

•Cognitive Behavioural Therapy (CBT): Helps identify and shift distorted thought patterns and unhelpful behaviours.

•Supportive Psychotherapy: Focuses on building self-esteem, emotional stability, and healthy coping mechanisms.

•Group Therapy: Can be powerful for people with HPD as seeing their behaviours reflected in others often provides the kind of insight and feedback they wouldn’t otherwise recognise.

Histrionic Personality Disorder isn’t about being “too much.” It’s about emotional pain masked by performative behaviour, a deeply rooted need for connection, attention, and validation that was often unmet in early life. If you or someone you care about resonates with these symptoms, it’s not a character flaw. It’s a call for understanding and support.

With the right therapeutic guidance, individuals with HPD can develop more grounded self-worth, healthier relationships, and an emotional world that feels more like home.

Have questions or think you may be struggling with similar traits? Talking to a trained psychologist can help clarify what’s going on, and where to start.

Carly Dober is a psychologist based in Melbourne.

Originally published as Psychologist Carly Dober explains Histrionic Personality Disorder