Histrionic vs Borderline Personality Disorder – Differences

Histrionic Personality Disorder

It is a mental condition in which people act in a very dramatic and emotional way which draws attention to themselves. According to the DSM, individuals with histrionic personality disorder (HPD) are constantly seeking reassurance and approval, are incredibly self-centered, and engage in inappropriate seductive behavior across a wide variety of contexts.

An estimated 1 percent of the population suffers from HPD, and it is more frequently diagnosed in women. Scientists have found that histrionic personality disorder appears mainly in females and males with above-average physical appearances.


Usually, people who experience symptoms:

  • threaten or attempt suicide to get attention;
  • become upset unless they are the center of attention;
  • have shallow or fake relationships;
  • dress seductively and/or provocatively;
  • are self-centered and rarely demonstrate concern for others;
  • engage in flirtatious or sexual behavior;
  • are impulsive;
  • rapidly shift emotions;
  • have trouble finishing and starting projects;
  • are easily bored;
  • act very theatrically and dramatically as if in front of an audience;
  • low tolerance for frustration;
  • are sensitive to criticism;
  • are easily influenced by others;
  • constantly seeking approval and reassurance;
  • overly concerned with physical appearance;
  • exaggerate expressions and emotions, while being insincere.


People with this disorder are at high risk of suffering from depression as HPD affects a sufferer’s romantic and social relationships and how they react to failure and loss.

Other associated conditions include:

  • other psychiatric disorders in patient and family members;
  • depression;
  • substance abuse;
  • anxiety disorders;
  • post-traumatic stress disorder;
  • anorexia;
  • body dysmorphic disorder;
  • somatization disorders;
  • panic disorder.


Although the exact cause of HPD is unknown, there are a few factors which seem to increase the risk, such as:

  • variations in chemistry and brain structure;
  • being diagnosed during childhood with a conduct disorder;
  • chaos and instability in the family during childhood;
  • physical, verbal, or sexual abuse during childhood;
  • low social and economic status;
  • low educational level;
  • a family history of personality disorders.


Medical doctors can diagnose HPD by looking at the patient’s:

  • psychological evaluation;
  • overall appearance;
  • behavior.


Common treatments include:

  • group therapy – it is a form of psychotherapy which involves one or more therapists working with a few people at the same time;
  • cognitive-behavioral therapy – it is a talking therapy which can help you manage your problems by changing the way you behave and think;
  • psychodynamic therapy;
  • psychotherapy – it helps you heal and learn more constructive ways to deal with the problems within your life.


Left untreated, the disorder can cause problems in the affected individual’s personal life. HPD can improve with talk therapy and occasionally with medicines.

Borderline Personality Disorder (BPD)

It is a mental health condition that creates behavioral, mood, and relationship instability. In addition, the disorder includes the inability to cope with impulsive behavior, strong emotions, and serious disruptions in relationships and friendships.

Borderline personality disorder is a Cluster B personality disorder in the Diagnostic and Statistical Manual of Mental Disorders.

It is more prevalent in females and affects around 1.6% of the general population.


Common symptoms include:

  • a stress-related paranoia which comes and goes;
  • frequent, intense displays of anger;
  • ongoing feelings of emptiness;
  • intense fear of being abandoned or alone;
  • suicidal behavior or threats of self-injury;
  • up and down moods, usually as a reaction to interpersonal stress;
  • intense and unstable relationships;
  • risky and impulsive behavior, like – gambling, having unsafe sex, or binge eating.

Notes – for most people with the disorder, symptoms begin during their teenage years, then improve during adult life. In addition, the symptoms cause major impairments, like – an inability to keep a job.

Not everyone with BPD experiences every symptom.


According to the data, people with the disorder have a previous history of neglect, abuse,  or separation during childhood. In addition, they have experienced stressful events during adulthood or adolescence. However, many individuals with the disorder haven’t been through any neglect, abuse, or extreme stress.

Risk Factors

Common risk factors include:

  • personal history of physical, emotional, and/or sexual abuse;
  • being female;
  • a family history of this disorder or other mental health disorders;
  • personal history of substance addiction or use;
  • exposure to chaotic or stressful environments during childhood;
  • separation from caregiver early in life;
  • history of past trauma.


A healthcare professional will diagnose this disorder by:

  • asking about family medical histories, including any history of mental illness;
  • performing a careful and thorough medical exam;
  • completing a thorough interview.


Medicines have less of a role in treating the disorder, however, group therapy can sometimes be helpful.

Bottom Line – Histrionic vs Borderline Personality Disorder (BPD)

The histrionic personality disorder is considered one of the dramatic personality disorders and is characterized by excessive attention-seeking and by an exaggerated display of emotions. It is diagnosed 4 times more often in females than in males. The precise causes of HPD are not known, however, environmental and genetic factors are thought to play an important role. HPD typically starts in late teens or early 20s.

Borderline personality disorder (BPD) causes suferrers to have mood swings and unstable emotions. According to statistics, an estimated 1.6% of American adults have BPD in any given year, according to the National Institute of Mental Health. Common symptoms of the disorder include the following:

  • unstable career goals, plans, and aspirations;
  • having a distorted sense of self (how one feels about one’s self);
  • having a dysfunctional or unstable self-image;
  • hostility;
  • feelings of boredom, isolation, and emptiness;
  • difficulty feeling empathy for others;
  • impulsive, self-destructive, risky, and dangerous behaviors, including drug or alcohol abuse, reckless driving, and having unsafe sex;
  • strong feelings of worry, anxiety, and depression;
  • intense, highly changeable moods which can last for a few days or just for several hours;
  • a persistent fear of rejection and abandonment;
  • a history of unstable relationships that can change drastically from intense hate to intense love.