Personality disorders are mental health conditions that cause an individual’s way of thinking, feeling, and behaving to deviate from the societal norm. People suffering from personality disorders experience extreme distress and difficulty in functioning which leads to interpersonal relationship issues, a distorted view of the world around them, and a shifting self-image.

According to the National Library of Medicine, “a personality disorder arises when one develops an inflexible and intransigent pattern of maladaptive thinking and behaving, which significantly impairs social or occupational functioning and can cause interpersonal distress.”[1]

According to the Substance Abuse and Mental Health Administration, anywhere from 35% to 65% of people who struggle with addiction also meet the criteria for a personality disorder.[2]

One of the types of personality disorders that have been found to co-occur with substance abuse is known as histrionic personality disorder (HPD). People with this mental health condition display attention-seeking behaviors and struggle with strong emotional swings.

What is Histrionic Personality Disorder (HPD)?

Histrionic personality disorder (HPD) belongs to the “Cluster B” category of personality disorders. Mental health conditions belonging to this category are characterized by dramatic, volatile, excitable, or unpredictable thinking and behavior. HPD in particular is marked by a pattern of exaggerated emotions and attention-seeking behaviors.

People who struggle with this condition feel an innate need to be the center of attention. This occurs because their self-esteem is tied to the approval of others, rather than stemming from inner feelings of self-worth. This may cause individuals with a histrionic personality disorder to act in inappropriate or problematic ways to receive attention.

The causes of this mental health condition are not fully known due to a lack of understanding surrounding all forms of personality disorders. However, studies have found that a few factors contribute to the development of HPD, including:

A genetic predisposition
Childhood trauma
Parenting styles during childhood that lacked boundaries, consistency, or were over-indulgent

Symptoms of Histrionic Personality Disorder

People who suffer from histrionic personality disorder display a lengthy pattern of overly emotional and attention-seeking behaviors. Oftentimes, the symptoms of HPD begin in someone’s late teen years or early adulthood.

People with this illness tend to suffer from interpersonal relationship conflicts due to the overdramatizing of situations. It is important to note that individuals with HPD are easily influenced by others due to their need for outside approval.

The symptoms of histrionic personality disorder include:

Feeling underappreciated or depressed when one is not the center of attention
Having shallow and rapidly shifting emotions
Behaving dramatically and being extremely emotionally expressive
Having a “larger than life” presence
Behaving in a charming and flirtatious manner
Being overly concerned with one’s physical appearance
Using their physical appearance to draw attention to themselves through bright colored or revealing clothing
Acting sexually or flirtatiously with people when they first meet them, whether they are attracted to them or not
Speaking dramatically and with strong opinions but remaining vague about facts or details
Being gullible and easily influenced by others
Viewing relationships with others as closer than they are
Appearing shallow or fake to others, causing difficulty maintaining friendships and relationships
Needing instant gratification and becoming bored or frustrated easily
Constantly seeking approval and reassurance from others

What Causes Comorbid Substance Abuse and Histrionic Personality Disorder?

Because individuals with HPD seek validation and attention from others, they act impulsively when they feel ignored or neglected. Oftentimes, these individuals begin abusing drugs or alcohol to seek attention from the people around them. This is extremely dangerous, as they tend to display the more risky behaviors associated with drug addiction such as injecting substances or experiencing frequent overdoses.

Additionally, individuals with histrionic personality disorder feel extreme levels of depression or unworthiness when they do not receive the attention they seek. Their behaviors often lead them to lose interpersonal connections, causing their depression to become severe. In these cases, people with HPD may abuse substances to self-medicate feelings of sadness, emptiness, or despair.

In either case, the co-occurrence of histrionic personality disorder and addiction is extremely dangerous. Individuals suffering from HPD and a substance use disorder are at an increased risk of experiencing the severe consequences of addiction such as jail time, overdoses, and developing blood-borne diseases as a result of injecting drugs.

How Often Do Addiction and HPD Co-Occur?

Research regarding histrionic personality disorder and addiction is minimal. However, there is a wider range of information surrounding personality disorders and substance abuse in general.

Important statistics on personality disorders (PD) and substance use disorders (SUD):[3,4]

While PDs affect 10 to 14% of the normal population, 34 to 73% of individuals in addiction treatment suffer from a PD.
16% of individuals with a PD and SUD suffer from antisocial PD
13% of individuals with a PD and SUD suffer from borderline PD
Co-occurring alcohol use disorder and histrionic PD occur more often in women than men
Alcohol use disorder is more common among individuals with histrionic PD (29.1%) or antisocial PD (28.7%)

With that being said, individuals with HPD or other forms of personality disorders are at an increased risk of developing an addiction. This makes it imperative for these individuals to seek professional treatment for both drug or alcohol abuse and mental health.

Finding Help for Histrionic Personality Disorder and Addiction

Histrionic personality disorder and addiction commonly co-occur. Suffering from a comorbid personality disorder and substance use disorder can complicate an individual’s recovery journey. Thankfully, dual diagnosis treatment programs are equipped to treat both conditions simultaneously.

If you or a loved one suffer from HPD and addiction, professional dual diagnosis treatment is vital. Contact Addiction Intervention today for more information on how to find a dual diagnosis treatment program near you.

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