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Personality disorders receive a lot of attention, usually not in a good way.
Most commonly we hear about Narcissistic Personality Disorder.
I'm certain that almost everyone could point out a number of Narcissistic Personality Disorder characteristics, but sometimes it gets confused with a personality disorder that is much less often talked about- Histrionic Personality Disorder.
It certainly doesn't have as catchy a title as narcissism, but they have multiple similarities.
So, how you do tell the difference, and what even is Histrionic Personality Disorder?
First, it's good to have an understanding of what constitutes a personality disorder in general.
A personality disorder is a category of mental disorders that covers multiple different diagnoses.
Narcissism, Histrionic, Paranoid, Borderline... these are all types of personality disorders because they all share specific characteristics.
What are these commonalities?
1) It's an enduring pattern of inner experience/ behavior that is very different from the person's culture
2) It's stable over time
3) It's pervasive across many types of interactions and is inflexible
4) It begins in adolescence or early adulthood
The criteria are very important because like nearly every diagnosis almost everyone experiences similar symptoms once in a while, so being extra attentive to the idea that personality disorders are enduring, pervasive, and inflexible is very important.
I'm going to list some traits and I want you to guess what disorder those traits belong to.
1) Enjoys being the center of attention
2) Exaggerates how close they are with select people
3) Will manipulate others to get what they want
The truth is these traits belong to both Narcissistic and Histrionic Personality Disorders.
This is why it can be difficult to figure out which one is which and why focusing on the similarities can lead to a major misdiagnosis.
IMPORTANT: Everyone exhibits these traits from time to time which is why it's so important to remember the defining features listed above: it is stable over years and years, is it pervasive across all types of encounters and interactions, and is it always inflexible.
So, if the expression is that similar, that is if how the person acts looks the same from the outside, how do you tell the difference?
The most important aspect of telling the difference when the outward expressions are very similar is looking at the internal motivation.
Asking the question, "why?" is often the only way to know the difference between Narcissistic and Histrionic Personality Disorder.
The primary motivation for Narcissists is validation that they are superior.
Looking at the traits listed above, each of those is motivated by the desire to be seen as more important and better than anyone else around.
The attention they seek is for their superior accomplishments or abilities; the people they are "close" with are recognized as skilled, powerful, or otherwise well-respected; manipulation is used to achieve this feeling of superiority.
Histrionic Personality Disorder, however, is motivated purely by receiving attention.
Attention for attention's sake- whether it's in a positive light or not the main goal is to have everyone's eyes and ears on them.
This is often achieved by dressing or acting sexually provocatively and using physical appearance to draw attention.
The expression of emotion is likewise to get attention; quick changes in overly dramatic or theatrical expression.
Lastly, they are highly suggestible and will quickly swap emotional states depending on who is around or what is happening in order to maintain the attention of others.
We have now covered what constitutes a personality disorder: stable over time, pervasive, and inflexible.
We have dissected the similarity between two often conflated personality disorders, Narcissistic and Histrionic.
And, we have assessed how to tell the difference: Narcissists are motivated by superiority over others, and Histrionics are motivated to have as much attention as possible.
Personality disorders can be very difficult to deal with and constitute a heavy weight for loved ones.
Understanding what personality disorders are and being able to tell the difference can make positive change and growth a real possibility.
As ALWAYS, this is not an exhaustive description of either disorder and is NOT intended for diagnostic purposes.
All information provided is to inform and provide insight into the nuances of mental health disorders and provide a starting place to understand how motivations in behavior are often as important (and in some cases more important) than the behavior itself.
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