How Histrionic Personality Disorder Differs From Narcissistic Personality Disorder

During the civil defamation lawsuit unfolding between Johnny Depp and his ex-wife Amber Heard, a psychologist testified that, after reviewing mental health records and conducting 12 hours of interviews with Heard, the actress met the criteria for both borderline personality disorder and the lesser known “histrionic personality disorder” (HPD). But while you may be familiar with some of the more commonly diagnosed personality disorders, such as paranoid, narcissistic, or obsessive-compulsive, what does it mean to have histrionic personality disorder?

What is histrionic personality disorder?

The word histrionic means “overly theatrical or melodramatic.” Personality disorders are categorised into three clusters: Cluster A, Cluster B, and Cluster C. HPD is a member of “Cluster B” disorders which are, according to the Mayo Clinic, “characterised by dramatic, overly emotional or unpredictable thinking or behaviour.” (The other disorders in Cluster B are: antisocial, borderline, and narcissistic.) According to the Mayo Clinic, typical symptoms of HPD include:

• Constantly seeking attention
• Excessively emotional, dramatic or sexually provocative to gain attention
• Speaks dramatically with strong opinions, but few facts or details to back them up
• Easily influenced by others
• Shallow, rapidly changing emotions
• Excessive concern with physical appearance
• Thinks relationships with others are closer than they really are

In the words of Dr. Shannon Curry, the clinical and forensic psychologist in the Depp-Heard defamation lawsuit, HPD is associated with “drama and shallowness,” and a need to be the centre of attention. As reported by Newsweek, “that means Heard is heavily concerned with image, prone to treating others with cruelty, unable to admit responsibility for wrongdoing, and prone to externalizing blame.”

While many people with HPD have good social skills, they often use those skills to manipulate others. As WebMD writes, “their self-esteem depends on the approval of others and does not arise from a true feeling of self-worth. They have an overwhelming desire to be noticed, and often behave dramatically or inappropriately to get attention.”

How does HPD differ from narcissistic personality disorder?

While they are both Cluster B, attention-seeking personality disorders, people with HPD and NPD differ in the type of attention they seek. Where those with NPD have a need for positive feedback and admiration to feed their inflated sense of self-worth, those with HPD seek any kind of attention, even if its negative.

According to VeryWell Health, HPD sufferers are “willing to be viewed as fragile or dependent to get attention,” may use their sexuality to gain the limelight, and “display rapidly shifting and shallow expression of emotions.” They also are more likely to develop dependent relationships. Those with NPD, by contrast, are less emotionally expressive, use sex for personal gain, and are more dismissive of others.

Both mental health conditions are treatable with psychotherapy.