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Dual Diagnosis: Histrionic Personality Disorder and Addiction

Dr. Alan Weiner MD

Medically reviewed by

Dr. Alan Weiner, MD

February 25, 2019

Many individuals who struggle with an addiction to drugs or alcohol also suffer from mental illness. It is important to find a treatment program that focuses on treating both the addiction and any underlying mental health disorders in order to ensure that every individual has the best possible chance at recovery.

“About a third of all people experiencing mental illnesses and about half of people living with severe mental illnesses also experience substance abuse,” according to the National Alliance on Mental Illness (NAMI). When two disorders occur together, this occurrence is called a dual diagnosis. Dual diagnoses require appropriate recognition of the conditions and adequate treatment for each disorder. Otherwise, each disorder may affect the other and can greatly affect a person’s ability to overcome addiction and manage a mental health condition. This is true for the dual diagnosis of histrionic personality disorder and addiction.

What Is A Dual Diagnosis?

A dual diagnosis means that a person experiences two disorders at the same time. This is also called comorbidity or, more commonly, co-occurring disorders. While either substance abuse (addiction) or mental health disorders can occur first, each may affect the other. A person may turn to drugs or alcohol to cope with the strain of a mental health condition. Someone affected by substance abuse may gain new symptoms of anxiety or depression. The best help for someone suffering with a dual diagnosis is treatment. Comprehensive treatment at an inpatient rehab center is still the best method for treating addiction, and can assist you in finding an appropriate treatment center.

What Is Histrionic Personality Disorder?

Histrionic personality disorder is a condition which belongs to a group of dramatic personality disorders known as “Cluster B” disorders. People with this disorder experience intense, unstable emotions, as well as skewed self-images. These altered experiences result in dramatic or inappropriate behavior; histrionic literally means overly theatrical or melodramatic.

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What Characterizes Histrionic Personality Disorder?

People affected by this disorder tend to have very low self-esteem. They depend on the approval of others for a sense of self-worth. This desire for approval can be quite urgent, and can drive them to seek attention by any means—often with dramatic behavioral outbursts.

Some of the common symptoms which may be experienced by a person who has this disorder are:

  • Discomfort or dissatisfaction unless the person is the center of attention
  • Inappropriate dress or intentional flirtatious or seductive behavior
  • Quick emotional shifts
  • Flair for the dramatics: overtly exaggerated emotions and expressions, while remaining insincere
  • Preoccupation with self-appearance
  • Seeks approval of others on a constant basis
  • Is gullible or highly impressionable
  • Extremely sensitive to criticism and/or disapproval
  • Gets bored or frustrated easily; needs constant mental and emotional stimulation
  • Tends to start many projects without finishing them
  • Tends to make hasty, rash decisions
  • Tends to be self-centered, and may show little concern for others
  • Due to this disorder, may have troubles with personal relationships
  • May threaten or attempt suicide for attention

What Causes Histrionic Personality Disorder?

As the U.S. National Library of Medicine explains, causes for histrionic personality disorder are unknown. Though genes and events in a person’s childhood may play a role, there is not enough research for the causes of this disorder yet.

Who Is Affected By Histrionic Personality Disorder?

Though anyone can be affected by it, women are more affected by the disorder than men. The disorder tends to show up in most people by their late teens the to early twenties. The U.S. National Library of Medicine reports that “doctors believe that more men may have the disorder than are diagnosed.”

How Is Histrionic Personality Disorder Affected By Addiction?

Because of the nature of histrionic personality disorder, those affected by it may have difficulty in relationships or may have a hard time coping with a major loss in life or failures. Both of these complications can lead to increased risk of depression or anxiety. These mental health conditions are often linked to a dual diagnosis with substance abuse. When a person suffers from a dual diagnosis, he or she experiences twice the hardship.

Dual diagnosis can be difficult to diagnose and treat. Mental health disorders and addiction each come with a complex set of symptoms which require proper care. With dual diagnosis, one disorder may be recognized and treated while the other is left untreated and continues to affect the recovery of the individual.

What Are The Symptoms Of Addiction?

Symptoms vary for different types of substance abuse. Some of the common signs may be:

  • Behavioral changes
  • Drawing back from friends and family
  • Drawing back from activities; lacking interest in things which would normally be considered fun
  • Increasing drug use, and being unable to stop use when desired
  • Seeking the use of drugs by risky means
  • When a person feels he or she needs to use substances to get through the day
  • Developing tolerance to the effects of the substance
  • Experiencing withdrawal symptoms when not taking the substance

What Are The Consequences Of Addiction?

Many people who are afflicted with addiction can experience adverse health effects and diseases which are affected by their addiction, as stated by the National Institute on Drug Abuse (NIDA). Some of these include cancer, cardiovascular disease, stroke, and mental disorders. Long-term drug abuse can cause severe damage to certain parts of the body. For example, alcohol abuse can severely damage the liver; many substances can have dire consequences for the digestive system. While health side effects vary among substances, the results of drug abuse on the body are not good ones.

How To Get Someone Help For Addiction

Treatment for mental health conditions like histrionic personality disorder can involve counseling or therapy. The U.S. National Library of Medicine states that most people with the disorder are fully functional in their daily lives. Addiction, however, can have more intense treatment needs.

People with addiction may form a physical dependence to their substance of choice. This can make recovery difficult due to a harsh withdrawal process. Withdrawal can be overwhelming with symptoms ranging from cravings to headaches, to nausea, to seizure (in extreme cases). When a person is ready for treatment, he or she will first have to undergo detoxification, a process which allows toxins to exit the body. This can be incredibly intense, and should rarely be attempted alone.

Inpatient rehab centers can help with the detoxification period, the staggering withdrawal that follows, and treatment. Having supportive individuals to provide care, help with medications, and to assist in building a life of abstinence can make a world of difference for recovery success. Rehab facilities may offer a combination of treatment approaches from medication-assisted therapy (MAT) to cognitive behavioral therapy to alternative therapies, such as adventure or wilderness therapy. Whatever your treatment needs, our inpatient rehab centers provide comprehensive care for you or your loved one.

Find The Help You Need Today

Half of all people with severe mental illnesses also suffer from addiction. If this is you or your loved one, there is hope in treatment. At, we can direct you to one of our experts who can give answers to your concerns and questions. Contact us today for more information on our rehab centers, to learn about treatment options, or to speak with one of our experts.

National Alliance On Mental Illness - Dual Diagnosis

National Institute On Drug Abuse - Addiction And Health

Psychology Today- - Histrionic Personality Disorder -

Substance Abuse And Mental Health Services Administration - Co-occurring Disorders

U.S. National Library Of Medicine - Dual Diagnosis

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