If you were to add up all of the psychological ailments that Americans complain of, the snapshot that emerges is a nation full of ninnyhammers (basket-cases, nut-jobs, psychos). Ten million suffer from Seasonal Affective Disorder. Fourteen million are alcoholics. Fifteen million are pathologically socially anxious. Fifteen million are depressed. Three million suffer panic attacks. Ten million have Borderline personality disorder. Twelve million have "restless legs." Five million are obsessive/compulsive. Two million are manic-depressive. Ten million are addicted to sex. If you consider wild-card afflictions like Chronic Fatigue Syndrome, and you factor in room for overlap (people suffering from more than one problem), you'll conclude that about 77% of the population is a mess. Throw in a few new quantifiable disorders, and everyone in the country will be officially and justifiably nuts.In short, Americans are turning into annoyingly self-absorbed hypochondriacs. Authorities on the subject are somewhat split, it seems. While some diagnosed subjects are genuinely suffering from these disorders, others, it's believed, are simply justifying their anti-social behavior because they can. Go ahead and cry, says the prevailing psychological wisdom. Any trifling discomfort you may experience has been legitimized. If you're rude, short-tempered, impatient, deviant, or maladjusted, there is a diagnosis that acquits your conduct.
Perhaps you know someone that is impaired by one of these pathological ailments. And perhaps it's legitimate. I myself have been recently exploring a personality disorder called histrionic personality disorder (HPD), or hysterical personality disorder. HPD is a personality disorder which involves a pattern of excessive emotional expression and attention-seeking. These individuals are lively, dramatic, enthusiastic, and flirtatious. They may be inappropriately sexually provocative, express strong emotions with an impressionistic style, and be easily influenced by others.
This disorder occurs more frequently in women than in men, but the literature differentiates HPD according to gender. Women with HPD are described as self-centered, self-indulgent, and intensely dependent on others. They are emotionally labile and cling to others in the context of immature relationships. Females with HPD over identify with others, commonly assuring people that "[they] are the only people I feel comfortable with, or can talk to"; they project their own unrealistic, fantasied intentions onto people with whom they are involved. They are emotionally shallow and have difficulty understanding others or themselves in any depth. Selection of marital or sexual partners is often highly inappropriate. Pathology increases with the level of intimacy in relationships. These individuals are inclined to exploit physical symptoms such as sickness and fatigue, behavior associated with their incessant need for attention.
People with this disorder are usually able to function at a high level and can be successful socially and at work. However, histrionic personality disorder may affect a person's social or romantic relationships or their ability to cope with loss or failure. They often fail to see their own situation realistically, instead tending to dramatize and exaggerate. Responsibility for failure or disappointment is usually blamed on others. They may go through frequent job/life changes, as they become easily bored and have trouble dealing with frustration. Because they tend to crave novelty and excitement, they may place themselves in risky situations. All of these factors may lead to greater risk of developing depression.
The cause of this disorder is unknown, but childhood events and genetics may both be involved. Little research has been conducted to determine the biologic sources of this disorder. Psychoanalytic theories incriminate seductive and authoritarian attitudes by fathers of these patients.
The symptoms include:
- Constant seeking of reassurance.
- Excessive dramatics with exaggerated displays of emotions.
- Excessive sensitivity to criticism or disapproval.
- Inappropriately seductive behavior.
- Excessive concern with physical appearance.
- A need to be the center of attention (self-centeredness).
- Low tolerance for frustration or delayed gratification.
- Rapidly shifting emotional states that may appear shallow to others.
- Tendency to believe that relationships are more intimate than they actually are.
- Make impulsive decisions with little regard to the affect on others.
- The need to create drama or crisis in their lives to achieve significance/attention
Diagnostic criteria:
The Diagnostic and Statistical Manual of Mental Disorders, a widely used manual for diagnosing mental disorders, defines histrionic personality disorder as a pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
1. is uncomfortable in situations in which he or she is not the center of attention
2. interaction with others is often characterized by inappropriate sexually seductive or provocative behavior
3. displays rapidly shifting and shallow expression of emotions
4. consistently uses physical appearance to draw attention to self
5. has a style of speech that is excessively impressionistic and lacking in detail
6. shows self-dramatization, theatricality, and exaggerated expression of emotion
7. considers relationships to be more intimate than they actually are.
A mnemonic that can be used to remember the criteria for histrionic personality disorder is PRAISE ME:
P - provocative (or seductive) behavior
R - relationships, considered more intimate than they are
A - attention, must be at center of
I - influenced easily
S - speech (style) - wants to impress, lacks detail
E - emotional labiality, shallowness
M - make-up - physical appearance used to draw attention to self
E - exaggerated emotions - theatrical
Treatment:
Because of the lack of research support for work on personality disorders and long-term treatment with psychotherapy, the empirical findings on the treatment of these disorders remain based on the case report method and not on clinical trials. On the basis of case presentations, the treatment of choice is psychotherapy aimed at self-development through resolution of conflict and advancement of inhibited developmental lines. Group therapy is not recommended for those with HPD because it often perpetuates histrionic behavior because the person then has an audience to play off of.
- Family therapy
- Medications
- Alternative therapies
Associated Conditions:
- Depression
- Anxiety disorders
- Panic disorder
- Somatization disorders
- Anorexia
Hopefully this will assist you in identifying abnormal behavioral patterns among people you know. To find out more in your quest, you may investigate Borderline personality disorder, Hysteria, or Narcissistic personality disorder.
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