Histrionic vs. Borderline Personality Disorder

What Is Histrionic Personality Disorder (HPD)?

People with histrionic personality disorder (HPD) struggle with low self-esteem and are dependent on the approval of others, similar to dependent personality disorder. These feelings give them an intense desire to be the center of attention. They may engage in dramatic, provocative, or inappropriate behaviors in an attempt to be noticed.

Although research shows that women are more likely to be diagnosed with histrionic personality disorder than men, the condition isn’t necessarily more common in women. Women may be more likely to display overt symptoms or seek treatment for the condition.

Symptoms of HPD

Many people with this cluster B personality disorder have strong social skills and can charm the people around them. It’s their distorted thought patterns and erratic behavior that can make it difficult for them to form and maintain close relationships with others.

Signs of HPD include:

• Experiencing discomfort when not the center of attention
• Engaging in provocative or dramatic behavior
• Frequent mood swings
• Over-the-top displays of emotion
• Seeking reassurance or validation from others
• Extreme sensitivity to criticism or rejection
• Impulsive behavior
• Easily influenced by others
• Shallow or insincere emotions
• Caring deeply about physical appearances
• A lack of concern for others
• Believing that relationships with others are closer than they actually are

What Is Borderline Personality Disorder (BPD)?

Borderline personality disorder (BPD) can make it difficult for people to regulate their emotions. This can lead to impulsive or destructive behaviors and interfere with the ability to have healthy relationships with others. Many people with BPD have an intense fear of abandonment and a tendency to view others in a black-and-white manner. Their views are often in absolutes — that is, they tend to see people as all good or all bad. Renowned American psychologist Theodore Millon identified four types of BPD:

• Petulant BPD
• Discouraged BPD
• Self-destructive BPD
• Impulsive BPD

People who live with BPD can struggle with negative thoughts and are at increased risk for self-harm and suicidal behaviors. Borderline personality disorder symptoms typically appear during young adulthood. While some BPD symptoms can improve with age, BPD still has the potential to be a devastating condition, especially without the proper BPD treatment.

Symptoms of BPD

One of the main characteristics of borderline personality disorder is emotional instability. The way that people with BPD feel about themselves and others can change rapidly, often with little to no warning.

Common BPD symptoms include:

• Struggling to regulate emotions (emotional dysregulation)
• Strong fear of abandonment
• Self-destructive and impulsive behaviors
• Inconsistent self-image
• Jealousy tendencies
• Difficulty maintaining relationships
• Paranoid ideation and suspicious thoughts
• Frequent and intense mood swings
• Explosive and intense anger
• Feelings of emptiness
• Suicide ideation and thoughts of self-harm

Similarities

Borderline and histrionic personality disorder have many similar symptoms. Mood swings, impulsive behavior, and emotional outbursts are strongly associated with both conditions. Due to the overlap in symptoms, though, patients may initially be misdiagnosed when they seek treatment.

Further complicating the process of getting an accurate HPD or BPD diagnosis, HPD and BPD often coexist with other mental health conditions, such as anxiety disorders. Studies also show that women are significantly more likely to be diagnosed with HPD or BPD. Since both conditions can cause tremendous damage to interpersonal relationships, anyone who shows symptoms of either condition should seek professional treatment as soon as possible.

Differences

Although you’ll find many shared symptoms when comparing histrionic personality disorder vs BPD, it’s the motivations behind the behaviors that you’ll find to be very different. 

Mood swings and emotional outbursts are associated with both personality disorders, but people with BPD may feel and express emotions more strongly. HPD, by contrast, is typically associated with shallow emotions. People with BPD can exhibit emotional responses that tend to be very deep and intense.

Even though low self-esteem is a hallmark of HPD, people with this condition generally can’t and don’t believe anything is wrong with them, meaning they’re unlikely to seek treatment on their own.

Treatment Options for BPD vs HPD

It’s common to treat both borderline personality disorder and histrionic personality disorder through a combined approach of psychotherapy and medication.

BPD

Dialectical behavioral therapy (DBT), a type of talk therapy that was designed for people with BPD, is an evidence-based treatment with a strong record of success. Other types of BPD therapy that may be recommended for treating those with BPD include:

• Cognitive behavioral therapy (CBT)
• Schema-focused therapy
• Mentalization-focused therapy

Currently, the Federal Drug Administration (FDA) has not approved any specific BPD medication. However, certain types of medications, such as antidepressants or mood stabilizers, might be beneficial in helping people with BPD regulate their emotions and reduce the severity of symptoms. The right medications can improve functioning, allowing people to benefit from other forms of treatment like therapy.

HPD

Although it can often be difficult to persuade someone with HPD to seek help, it’s possible to manage and reduce symptoms with the proper histrionic personality disorder treatment.

Psychotherapy is the main form of treatment for HPD, but some patients may be prescribed medication if they have comorbid (existing at the same time) symptoms of anxiety or depression.

One-on-one therapy sessions can be very helpful for those with HPD, but group therapy has the potential to make some symptoms worse. Since people with HPD are generally driven to seek attention, they might try to sabotage group treatment sessions, wanting the spotlight on them rather than on others in the group. Supportive therapy is often recommended for those with HPD, as is insight-oriented therapy. Talk therapy can make people more aware of their own behaviors and help them relate to others.

Get Professional Help for BPD or HPD with Talkspace

It’s easy to see the many similarities when comparing histrionic personality disorder vs BPD. Even though some of the symptoms of these conditions overlap, an accurate diagnosis is essential for treatment. If you or a loved one has shown symptoms associated with either condition, it’s important that you seek professional help.

Talkspace offers online therapy and psychiatry services, making it possible for you or a loved one to get the care that you need in a convenient, safe, and affordable setting. Treatment can give you insight into your behaviors, help you manage your condition, and dramatically improve your quality of life. Don’t hesitate to reach out for expert help today.