Distinguishing Drama from Turmoil: Histrionic vs. Borderline Personality Disorder

Personality disorders are categorized into three distinct clusters:

  • Cluster A
  • Cluster B
  • Cluster C

Cluster B includes histrionic personality disorder and borderline personality disorder.

A borderline personality disorder is a personality disorder characterized by impulsivity. Someone with borderline personality disorder will have an inability to control their emotions, along with relationship problems and low self-esteem.

Histrionic personality disorder is a personality disorder characterized by a severely distorted self-image. Someone with histrionic personality disorder will have no internal sense of self-worth or self-esteem and will instead derive their self-esteem from the approval they get from others. In order to achieve approval from others, they engage in inappropriate or dramatic behavior to get attention. 

It is important to understand the differences between histrionic borderline personality disorder and other personality disorders so that you can get the correct diagnosis and the most effective treatment.

Paranoid Personality Disorder Treatment

Histrionic vs. borderline personality disorder

-Understanding Histrionic Personality Disorder (HPD)

Histrionic personality disorder is a personality disorder characterized by excessive emotionality and attention-seeking behaviors. In many cases the foundation of this condition is people who are uncomfortable in situations where they are not the center of attention. People are generally characterized by provocative or inappropriate sexual behavior. They can only display shallow and rapidly changing emotions. 

They’re also consistently dedicated to their physical appearance and overly concerned with their physical appearance, as they use that to get attention and compliments from other people. They will be very theatrical and exaggerated in their expressions, especially in terms of their emotions or how they get attention in Social situations. 

-Understanding Borderline Personality Disorder (BPD)

Borderline personality disorder was a term that began in 1983. When you look at borderline personality disorder vs. histrionic disorder, what you’ll see is that someone with borderline personality disorder has a pattern of instability in terms of their relationships and self-image. There is also a highlighted impulsivity that usually starts in early adulthood and affects several areas of daily life.

People who struggle with borderline personality disorder will go out of their way to avoid being rejected and, in many cases, to avoid perceived rejection. It’s not uncommon for people to have intense perceptions of separation or rejection that affect their emotions and behaviors as well as self-image. Any environmental change is something to which someone with borderline personality disorder is highly sensitive, and it can cause intense feelings of fear or anger.

-Differentiating Between Histrionic and Borderline Personality Disorders

With histrionic personality disorder vs. borderline, there is a significant difference in terms of the core emotions behind any action.

For example:

People who struggle with borderline personality disorder have an intense fear of abandonment and rejection, which usually stems from an incorrect and misguided belief that they are a bad person. Someone who has borderline personality disorder might feel:

  • Like they are a child living around other adults
  • Like they don’t know what it is they want or don’t want, what it is they actually like or don’t like because everything is too tied up in trying to avoid rejection
  • Like they can’t understand their emotions and they are overwhelmed by how quickly they change
  • Like bad things happen to them because there’s something wrong with them and they are a bad person

It’s not uncommon for someone to be very terrified of being alone and to always try and have other people around them, even by threatening self-harm or suicide to keep people near them.

By comparison, someone with a history of personality disorder might go to extreme lengths and be inappropriate, but they don’t do so because of a fear of abandonment or rejection but rather because they need to be validated and build their self-worth based on the approval they get from other people or the attention they get through bad behaviors.

People who struggle with a history of personality disorder are uncomfortable when they are not the center of attention, so they might:

  • Try to draw attention to themselves with enthusiasm or flirtatiousness
  • Always try to be the life of the party
  • Make up stories or create a scene if they see that they are not the center of attention in order to bring attention back to themselves 
  • Direct inappropriately sexual or provocative behavior toward people with whom that relationship is inappropriate like a therapist, A boss, or other people in a social circle in order to get attention
  • Spend a lot of time and money on clothes and grooming in order to get compliments and remain the center of attention
  • Get easily upset if someone makes a critical comment about how they look or if they believe that a photograph of them was unflattering

-Treatment Approaches for Histrionic Personality Disorder (HPD)

Psychotherapy is the main treatment for histrionic personality disorder. The goal of treatment is to help individuals with HPD better understand the fears they have and their motivations for the way in which they behave.

Group Therapy Discussion

Group Therapy

Group therapy is a way for people with histrionic personality disorder to meet other people who have the same disorder and to see how their behaviors look when reflected toward them. It’s also a great chance to share with other people and learn from them, particularly about emotional distress, problematic relationship patterns, or self-examination.

Cognitive Behavioral Therapy

Cognitive behavioral therapy is a goal-oriented form of therapy that gives people a chance to look at their thoughts and emotions and examine the relationship between them. This is also a chance to adopt healthier thought patterns related to self-esteem and behaviors, and do away with some of the impulsivity of histrionic personality disorder.

Supportive Psychotherapy

Supportive psychotherapy can improve self-esteem, manage symptoms, and boost coping skills. This type of psychotherapy provides individuals with histrionic personality disorder the opportunity to examine the patterns of behavior they utilize and the relationships they have in a way that can identify harmful behaviors and replace them with positive ones.

-Treatment Approaches for Borderline Personality Disorder (BPD)

Psychotherapy is the main treatment for borderline personality disorder. With histrionic vs. borderline personality disorder, there is some difference in terms of the precise psychotherapies that are used.

Dialectical Behavioral Therapy

One of the primary therapies for BPD is dialectical behavior therapy (DBT). With this therapy, individuals learn how to control their emotions, reduce self-destructive behaviors, improve relationships, better understand the factors that influence self-image and emotions, improve communication, and manage stress.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is another common treatment for BPD which can help individuals better identify negative thought patterns about things like self-esteem which can directly influence behaviors. cognitive behavioral therapy also helps you change core beliefs that improve your self-esteem, self-worth, and relationships by reducing self-destructive behaviors.

Family Therapy

Family therapy is a form of group therapy that is useful for borderline personality disorder because it can help those closest to you recognize how your disorder works, better learn how to provide emotional support at home and determine which strategies can reduce any of the harmful symptoms.


As of right now, there are no FDA-approved medications to individually treat borderline personality disorder. However, working with a professional psychiatrist can provide you with an appropriate diagnosis as well as potential medication for specific symptoms like anxiety or depression.

-Challenges in Differential Diagnosis

Impulsivity and inappropriate behaviors are hallmarks of both conditions, so there are challenges in getting a differential diagnosis for histrionic personality disorder vs. borderline personality disorder.

For example, with borderline personality disorder, someone needs to display impulsivity that can be potentially damaging in at least two areas, including:

  1. Binge eating
  2. Reckless driving
  3. Substance abuse
  4. Sex
  5. Spending

Someone struggling with histrionic personality disorder might display what looks like impulsive behaviors in some of these areas by way of things like inappropriately sexual or provocative behaviors when interacting with other people and consistently changing physical appearance in order to be the center of attention. 

In some cases, these personality disorders can coexist with other personality disorders or with other mental health disorders, which is why it’s important to get a correct diagnosis from a professional.

Summing up

Overall, there are several distinctions between borderline personality disorder vs. histrionic. What matters most is that you get an accurate diagnosis and personalized treatment approaches. Your treatment should be something that is agreed upon with a professional psychiatrist and is tailored to your individual needs.