“In a room, the person who talks the most is often the one who is least listened to.”
Flashy clothes, exaggerated gestures and expressions, endless stories… We all know someone who never leaves the spotlight. For them, being the center of attention is not just a choice but a deep-seated need. These individuals are often labeled as “drama queens,” a term used to describe people who tend to exaggerate events and cannot stand being the center of attention. However, what is often overlooked is whether these behaviors are merely attention-seeking acts or manifestations of an underlying psychological disorder. Because behind some of these “dramas” lies a very real and clinical picture known as Histrionic Personality Disorder.
What Is Histrionic Personality Disorder?
Histrionic Personality Disorder is characterized by a persistent need for attention, exaggerated emotional responses, and the use of seductive or dramatic behaviors to gain others’ approval. According to the diagnostic criteria of the American Psychiatric Association, this disorder typically emerges after adolescence and becomes more prominent in adulthood, occurring more frequently in women (APA, 2013). Individuals with this personality pattern define themselves largely through the reactions of others rather than their own internal values. As a result, when they are not the center of attention in a given setting, they may feel uneasy and even withdraw, initiating a passive form of attention-seeking through silence, sad looks, or dramatized stories.
According to the American Psychiatric Association (APA, 2013), a diagnosis of Histrionic Personality Disorder requires the presence of at least five of the following symptoms:
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Experiencing great pleasure in being the center of attention and continuously seeking it,
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Rapid changes in emotions and superficiality,
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Using physical appearance to draw attention,
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Exhibiting excessively dramatic, theatrical, or exaggerated emotional expressions,
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Being easily influenced by others (suggestibility),
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Perceiving relationships as more intimate than they actually are.
These symptoms do not merely occur occasionally; they can also significantly affect a person’s social, occupational, and emotional functioning.
What Lies Beneath These Behaviors?
The basis of Histrionic Personality Disorder is deep psychological roots that extend back to childhood. According to psychoanalytic theory, these individuals are those who received inconsistent attention from their parents during childhood, sometimes rewarded with excessive love and sometimes ignored and neglected (Horowitz, 1984). This unpredictable pattern of caregiving leads the child to equate love with attention. As a result, the individual grows up with a persistent need for approval and admiration in adulthood.
According to cognitive therapy approaches, individuals with Histrionic Personality Disorder tend to develop core beliefs such as:
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“I am only valuable if I attract attention.”
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“If I’m not liked, I will be abandoned.”
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“If I don’t impress others, I won’t be loved.”
These underlying beliefs often lead the person to adopt manipulative behaviors in social settings (Beck et al., 2004).
As If Always on Stage…
People with histrionic traits often speak in a way that lacks detail but is filled with emotion. They might cry while telling a story, then suddenly burst into laughter. They’re usually comfortable with physical contact even with people they’ve just met—hugging, holding hands, or sharing personal information. Rather than genuine closeness, these actions are often attempts to speed up connection and gain affection or attention from others.
They also tend to place a strong emphasis on physical appearance. Seductive clothing choices or attention-grabbing posts on social media can be part of how this disorder shows itself. Compared to women, men with histrionic traits may express these behaviors in more subtle or socially “acceptable” ways. To get noticed or gain approval, they might exaggerate traditional masculine roles—flirting, building overly muscular bodies through excessive gym time, or acting overly “macho.” Even though these behaviors can appear confident on the surface, they are often driven by a deep need for validation, a fragile sense of self, and an underlying feeling of worthlessness.
Treatment and Recovery: From the Stage of Emotions to Real Life
Histrionic Personality Disorder is a treatable condition, though the therapeutic process often requires time and patience. Cognitive Behavioral Therapy (CBT), psychodynamic approaches, and schema therapy can help individuals recognize and modify the dysfunctional patterns underlying their behavior (Beck & Freeman, 1990). The main goal of therapy is to assist the individual in uncovering the deeper emotions that lie beneath their constant need for attention and dramatic reactions. Through this process, the person can begin to rebuild a sense of self-worth that is not dependent on external approval, develop more effective coping strategies, and establish healthier, more balanced relationships.
Final Words
Of course, not every exaggerated emotional response or desire for attention indicates a personality disorder. However, if such behaviors are persistent and begin to negatively impact a person’s life, relationships, or overall functioning, seeking professional help is important. Histrionic Personality Disorder is not merely “drama” or an overly expressive personality—it is a real psychological condition rooted in a deep need for approval and a fragile sense of self, requiring understanding and support. Recognizing the silent cry behind the sparkle on stage is the most important step to take for the mental health of both individuals and society.
References
American Psychiatric Association, DSM-5 Task Force. (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). American Psychiatric Publishing, Inc.
https://doi.org/10.1176/appi.books.9780890425596
Beck, A. T., & Freeman, A. M. (1990). Cognitive therapy of personality disorders. Guilford Press.
Beck, A. T., Freeman, A., & Davis, D. D. (2004). Cognitive therapy of personality disorders (2nd ed.). The Guilford Press.
Horowitz, M. J. (1984). Personality styles and brief psychotherapy. Bloomsbury Academic.