Histrionic Personality Disorder (HPD) And Addiction

Histrionic personality disorder is a Cluster B personality disorder where people seek attention and may exhibit emotional volatility.

People that have HPD can become uneasy, anxious, or depressed when their need for attention is not met.

Some people with HPD may engage in risky drug or alcohol use to get attention. Others may use substances to manage the effects of shifting moods caused by HPD.

When substance use disorders co-occur with personality disorders like HPD, it can be challenging to appropriately diagnose substance use. HPD does not tend to interfere with recovery from addiction.

Read more about co-occurring personality disorders and addiction

What Is Histrionic Personality Disorder?

Histrionic personality disorder (HPD) generally impacts a person’s ability to regulate emotions and is highlighted by constant attention-seeking behavior (both positive and negative attention).

Estimates place nearly 2% of the United States’ population in the category of HPD. It is more common in women than in men.

While it is not known for certain what causes HPD, some suggest that it can occur from early exposure to dysfunctional environments where the development of normal adaptive patterns does not happen.

In these environments, seeking attention is perceived as normal. Genetics may also play a role in HPD.

Symptoms Of Histrionic Personality Disorder

All Cluster B personality disorders are marked by the presence of some combination of unpredictable behavior or thoughts and hyper-emotional or dramatic behavior.

Some symptoms of HPD include:

• constant attention-seeking behavior
• shallow, rapidly changing emotions
• excessive emotional or dramatic outbursts
• exhibiting risky behavior including gambling, binge eating, spending sprees
• engaging in sexually provocative behavior for attention
• excessive concern for appearance
• dramatic, strong opinions that are unsupported by fact or reason
• easily influenced by others
• false perception of close relationships with others

Signs Of Drug Or Alcohol Abuse

People with HPD may use a range of substances as a means of escape or as a method of getting attention.

It may be difficult to notice signs of drug and alcohol abuse in people with HPD because of some overlapping baseline behaviors like mood swings and engaging in risky behavior.

Signs of drug or alcohol abuse may include:

• changes in behavior or mood swings
• lack of control over drug or alcohol use
• engaging in risky behavior
• withdrawing from friends or family
• neglecting physical health
• showing poor hygiene
• relying on daily drug or alcohol use for normal functioning
• lying about or hiding substance use

What Causes Co-Occurring Addiction And Histrionic Personality Disorder?

Factors that may influence substance use in people with HPD may relate to the individual’s need for attention. Engaging in risky drug-related behavior may be used to draw attention.

Alcohol use in people with HPD may be used to calm fears of abandonment.

Similarly, marijuana and other drugs may be used as an escape from social situations where the person isn’t getting the attention that they desire.

How Common Is Substance Abuse And Histrionic Personality Disorder?

Research regarding substance abuse and HPD is not conducted as widely as other personality disorders. Still, select studies have demonstrated strong links between HPD and alcohol use.

Histrionic personality disorder and addiction statistics:

• According to some studies, between 22% and 40% to upwards of nearly 80% of studied patient groups with alcoholism had a co-occurring personality disorder.
• Of personality disorders studied, the correlation between people with alcohol dependence and HPD was more prevalent in women.
• Of all people in a survey of people with personality disorders, people with HPD had the greatest prevalence of alcohol use disorder (29.1%).

The prevalence of select substance use in people with HPD in one 12-month survey showed a significant association between HPD and alcohol abuse:

• Any alcohol use disorder: 29.1%
• Alcohol abuse: 7.8%
• Alcohol dependence: 21.3%
• Any drug use disorder: 12.8%
• Any drug abuse: 5.8%
• Any drug dependence: 7.0%

What Are The Most Effective Treatments?

Treatment for dual diagnosis HPD and substance use disorder is less complicated than with other personality disorders since HPD does not tend to complicate addiction treatment.

In general, treatment for addiction may include pharmaceutical therapies in a detox and rehabilitation setting.

Therapies can help people with co-occurring HPD and substance use disorder to:

• understand their attention-seeking behaviors
• communicate more honestly
• learn how to interact more appropriately with others

Because people with HPD typically have normal social skills and can stay employed, their progress with substance use treatment is not generally impeded by factors involving HPD.

Finding Dual Diagnosis Treatment For Addiction And Histrionic Personality Disorder

While identifying a substance use disorder in a person with HPD may be difficult, this dual diagnosis does not tend to interfere with a person’s success in rehab.

If you or a loved one are struggling with substance use and co-occurring mental health factors, we can help you find the right path forward.

Call our treatment specialists to learn more about the inpatient and outpatient dual diagnosis treatment programs for your specific needs. We’re here to help. Get started today.

Written by the Addiction Resource Editorial Staff