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Histrionic Personality Disorder Symptoms, Causes, Treatments
Written by WebMD Editorial Contributors
In this Article
- What Are the Symptoms of Histrionic Personality Disorder?
- What Causes Histrionic Personality Disorder?
- How Is Histrionic Personality Disorder Diagnosed?
- How Is Histrionic Personality Disorder Treated?
- What Complications Are Associated With Histrionic Personality Disorder?
- What Is the Outlook for People With Histrionic Personality Disorder?
- Can Histrionic Personality Disorder Be Prevented?
Histrionic personality disorder is one of a group of conditions called "Cluster B" or "dramatic" personality disorders. People with these disorders have intense, unstable emotions and distorted self-images. For people with histrionic personality disorder, their self-esteem depends on the approval of others and does not arise from a true feeling of self-worth. They have an overwhelming desire to be noticed, and often behave dramatically or inappropriately to get attention. The word histrionic means "dramatic or theatrical."
This disorder is more common in women than in men and usually is evident by adolescence or early adulthood.
What Are the Symptoms of Histrionic Personality Disorder?
In many cases, people with histrionic personality disorder have good social skills; however, they tend to use these skills to manipulate others so that they can be the center of attention.
A person with this disorder might also:
- Be uncomfortable unless they are the center of attention
- Dress provocatively and/or exhibit inappropriately seductive or flirtatious behavior
- Shift emotions rapidly
- Act very dramatically, as though performing before an audience, with exaggerated emotions and expressions, yet appears to lack sincerity
- Be overly concerned with physical appearance
- Constantly seek reassurance or approval
- Be gullible and easily influenced by others
- Be excessively sensitive to criticism or disapproval
- Have a low tolerance for frustration and be easily bored by routine, often beginning projects without finishing them or skipping from one event to another
- Not think before acting
- Make rash decisions
- Be self-centered and rarely show concern for others
- Have difficulty maintaining relationships, often seeming fake or shallow in their dealings with others
- Threaten or attempt suicide to get attention
What Causes Histrionic Personality Disorder?
The exact cause of histrionic personality disorder is not known, but many mental health professionals believe that both learned and inherited factors play a role in its development. For example, the tendency for histrionic personality disorder to run in families suggests that a genetic susceptibility for the disorder might be inherited. However, the child of a parent with this disorder might simply be repeating learned behavior. Other environmental factors that might be involved include a lack of criticism or punishment as a child, positive reinforcement that is given only when a child completes certain approved behaviors, and unpredictable attention given to a child by their parent(s), all leading to confusion about what types of behavior earn parental approval. Personality disorders also usually develop in relation to individual temperament and psychological styles and ways people learn to cope with stress while growing up.
How Is Histrionic Personality Disorder Diagnosed?
If signs of this personality disorder are present, the doctor will begin an evaluation by performing a complete medical and psychiatric history. If physical symptoms are present, a physical exam and laboratory tests (such as neuroimaging studies or blood tests) may also be recommended to assure that a physical illness is not causing any symptoms that may be present.
If the doctor finds no physical reason for the symptoms, they might refer the person to a psychiatrist, psychologist, or other licensed behavioral health professional who may use specially designed interview and assessment tools to evaluate a person for a personality disorder.
How Is Histrionic Personality Disorder Treated?
In general, people with histrionic personality disorder do not believe they need therapy. They also tend to exaggerate their feelings and to dislike routine, which makes following a treatment plan difficult. However, they might seek help if depression -- possibly associated with a loss or a failed relationship -- or another problem caused by their actions causes them distress.
Psychotherapy (a type of counseling) is generally the treatment of choice for histrionic personality disorder. The goal of treatment is to help the individual uncover the motivations and fears associated with their thoughts and behavior, and to help the person learn to relate to others in a more positive way.
Medication might sometimes be used as treatment for other conditions that might also be present with this disorder, such as depression and anxiety.
What Complications Are Associated With Histrionic Personality Disorder?
Histrionic personality disorder can affect a person's social, professional, or romantic relationships and how they react to losses or failures. People with this disorder are also at higher risk than the general population to suffer from depression.
What Is the Outlook for People With Histrionic Personality Disorder?
Many people with this disorder are able to function well socially and at work. Those with severe cases, however, might experience significant problems in their daily lives
Can Histrionic Personality Disorder Be Prevented?
Although prevention of the histrionic personality disorder might not be possible, treatment can allow a person who is prone to this disorder to learn more productive ways of dealing with situations.
Histrionic Personality Disorder Treatment | Psych Central
Histrionic personality disorder can affect many aspects of your life, but with treatment, it’s possible to manage your symptoms.
If you frequently feel the need to be the center of attention, and it’s affecting your life and the way you see yourself, you may have histrionic personality disorder (HPD).
HPD behavior patterns include attention-seeking and exaggerated emotions. If you have HPD, people may often describe you as:
With therapy and self-care, you can manage the symptoms of HPD and move toward a better quality of life.
Mental health experts prefer to talk about symptom management and treatment rather than a “cure.”
If you have HPD, you likely feel better about yourself when you have the approval of others. Psychotherapy (talk therapy) can help you shift this mindset.
Therapy helps you develop skills that strengthen your self-esteem. It will also help you live your life without worrying about whether other people will be impressed.
Therapy aims to uncover and address why attention from others makes you feel better about yourself and help you develop techniques to manage and shift these feelings and behaviors.
Some causes of HPD include:
- childhood trauma or adverse experiences in childhood can lead people to develop attention-seeking behavior as a coping mechanism
- learned behaviors from your childhood environment and relationships
Though you can’t change your genetics, your therapist can help you uncover how your past may have shaped how you feel and act now.
Because personality disorders are lifelong, you may want to return to therapy in the future after you’ve completed a set of sessions.
Your symptoms will respond best to therapy when you’re an active participant and willing to build a rapport with your therapist.
Cognitive behavioral therapy
Cognitive behavioral therapy (CBT) helps you identify and change dysfunctional thinking patterns. Research has shown that CBT can be highly effective for personality disorders.
CBT is goal-oriented, structured, and focused on the present day. Participants do homework as part of their treatment.
Psychodynamic therapy is more flexible and open-ended, and it doesn’t include homework. It aims to connect your past experiences to your present behaviors.
If you have a personality disorder rooted in experiences from your childhood, psychodynamic therapy can help shed light on this connection.
Interpersonal therapy (IPT) examines your current relationships.
Like CBT, IPT helps you identify maladaptive thought patterns — specifically when they apply to how you interact with others.
If troubling relationships cause you to experience depression symptoms, IPT can help you change how you participate in those relationships, such as by helping you improve your communication skills.
Looking for a therapist?
- Find a Therapist: Mental Health Resources for Everyone
- American Psychiatric Association’s Find a Psychiatrist tool
- American Psychological Association’s Find a Psychologist tool
- National Alliance on Mental Illness (NAMI) Helplines and Support Tools
- National Institute of Mental Health’s Helpline Directory
- Therapy in Color
- Therapy for Black Girls
- The National Asian American Pacific Islander Mental Health Association
- Therapy for Latinx
Medications are not a standard treatment for personality disorders. Also, experts say the Food and Drug Administration (FDA) has not approved medications for HPD.
Doctors sometimes prescribe medication for accompanying conditions, such as depression or anxiety. Various medication options fall into several classes, depending on how they affect your brain.
Research suggests that several medications often used for other conditions may help with affective dysregulation in HPD:
- antidepressants, often used for depression
- mood stabilizers, often used for bipolar disorder
- antipsychotics, often used for schizophrenia
Scientists say these medications can be helpful for people with these other conditions, but there’s not much research on their effectiveness in people with HPD.
Practicing self-care in addition to your therapy sessions can help you heal and improve your well-being.
Here are some essential elements of self-care:
- Getting enough sleep. Sleep is an important part of your physical and mental health. If you’re not sleeping well, now is an excellent time to focus on making a consistent sleep schedule. Sleep hygiene tips like a screen cut-off time can also help.
- Exercising regularly. Fitness can help improve sleep, reduce stress levels, and increase your overall health and well-being. The Centers for Disease Control and Prevention (CDC) recommends engaging in activities that increase your heart rate for at least 150 minutes a week and strength training at least twice a week. Every little bit helps.
- Practicing mindfulness. Consider using other stress-reduction techniques such as relaxation exercises, mindfulness training, yoga, and reducing stress triggers in your life.
- Eating nutritious food. Self-care wouldn’t be complete without nutrition. You can start small if it’s easier: Try adding one or two healthy foods to your diet a week while reducing portions of less-healthful indulgences, such as foods that are highly processed or contain added sugar.
The diagnosis process begins with a doctor learning about your medical history and doing a physical exam. They’ll do this to rule out any physical condition that might be causing your symptoms.
Next, your doctor can refer you to a mental health professional to see whether you have a personality disorder.
It’s important that you consult with a specialist specifically trained in this area. This is why your family doctor will recommend that you talk with a psychiatrist or psychologist.
Their expertise helps them identify the correct diagnosis as several personality disorders feature dramatic and emotional behavior. They include:
- histrionic personality disorder
- narcissistic personality disorder
- borderline personality disorder
The psychiatrist or psychologist will compare your symptoms to criteria described in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).
Criteria for diagnosis
Consider asking yourself if you experience patterns of behavior that fit into some of the following categories:
- attention-seeking behavior: such as inflating stories or trying to “one-up” other people
- seductive behavior: flirting or dressing provocatively in situations where it’s not appropriate
- fluctuating emotions and extreme reactions: rapid changes in mood and reactions that seem extreme to others given the context
- boastful speech that isn’t necessarily true: pretending to be knowledgeable but missing details to back up your claims
- prioritizing physical appearance: trying to make an impact with fancy clothing, accessories, or hairstyles
- dramatic behavior: for example, exaggerated emotional reactions
- easily suggestible: following trends or adopting mindsets without thinking very much about those choices
- exaggerating relationship statuses: behaving as though a personal connection is deeper than it really is
Mental health professionals diagnose HPD in people who have a history of symptoms from at least five of these categories.
If you have HPD, treatment is available.
You can learn skills to support your self-esteem without the need for approval from others. Your therapist can help you learn techniques to set personal boundaries and help regulate your emotions.
In between sessions, practicing self-care will support your treatment and overall well-being.
Remember, you are important whether or not you’re the center of attention.
Some of your behavior with HPD may create challenges, but it doesn’t have to define you. There is support available for diagnosis and treatment when you’re ready.
Personality disorder: treatment, symptoms, diagnosis
- Causes of personality disorder
- Symptoms of disease
- Principles of treatment
- Licenses and certificates
- Photo of clinic
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Personality disorders are a fairly large group of mental illnesses with different symptoms and course. They are distinguished by a tendency to a chronic, recurrent course, the patient's unwillingness to see a doctor, the desire to hide any clinical manifestations of a personality disorder. nine0003
Specialists of the medical center "Dependence 24" will conduct a comprehensive examination, make an accurate diagnosis. The treatment prescribed by our doctors will allow you to get rid of the main symptoms of the disease.
Causes of personality disorders
The etiology of the disease has not yet been fully elucidated. In modern psychiatry, there are several different theories that explain the appearance of signs of the disease. These are:
- Genetic causes. The role of hereditary factors is great in schizotypal personality disorder. It is assumed that the pathogenetic mechanisms of the development of this form of the disease are similar to those in schizophrenia. nine0006
- Comorbid mental illness. It is believed that personality disorder is one of the symptoms of a number of mental illnesses. In some patients, the pathology progresses and more pronounced signs appear over time, while others remain in such a borderline state for years.
- Psychological experiences. The relationship of personality development with the characteristics of upbringing, relationships with parents paid great attention to such masters of psychiatry as Z. Freud, K.G. Jung, A. Adler. The essence of their theory boils down to the fact that experienced unrest, fears in childhood lead to serious mental disorders in adolescents and in adulthood. In such cases, the basis of treatment is psychotherapy. nine0006
- Social environment. It is assumed that certain subspecies of personality disorders are associated with the peculiarities of upbringing and the situation in the family as a whole. If a child considers antisocial behavior to be the norm, such attitudes persist as they grow older.
Symptoms of disease
The first manifestations of a personality disorder usually occur in adolescents, less often in childhood, but the symptoms are fully “revealed” closer to 20–25 years. Clinical manifestations of the disease cover all areas of psycho-emotional experiences, thinking, behavior in society. The patient is not capable of a flexible response to ongoing events, cannot fully perceive himself and others, build any relationship with them. nine0003
Typical depression, anxiety. But unlike neurosis or, for example, depression, the patient perceives everything that happens to him as something quite normal. A person does not consider himself ill, categorically refuses medical care, which significantly complicates treatment.
There are several main clinical varieties of the disease:
- Paranoid. Accompanied by pathological suspicion, tension, inability to relax, emotional rigidity. Often these symptoms are harbingers of schizophrenia. nine0006
- Schizoid. Complete self-absorption is characteristic, it is extremely difficult (and in principle it is not necessary) for people with such a diagnosis to establish social contacts, therefore they prefer work that does not involve intensive communication. They do not seek to communicate with relatives, they are indifferent to what is happening around. Schizoids cannot openly express their emotions and desires, they experience them inside. Such people are very lonely, extremely rarely start a family, and various sexual disorders are characteristic. nine0006
- Dissocial. The main symptom is an uncontrollable desire to enjoy at any cost, but at the same time, a person avoids work, activities that require effort on his part with all his might. Falsehood, resourcefulness, manipulations are typical (often - threats to commit suicide, complaints about deteriorating health). Adolescents suffering from this disease often run away from home. The patient looks quite healthy and satisfied with life, turns into a joke any talk about the need for treatment. But under the guise of external well-being lies tension, anxiety and irritability, which often becomes the cause of the development of alcoholism and drug addiction. nine0006
- Emotionally unstable. It is manifested by short-term sudden episodes of loss of self-control, which is expressed in unjustified aggression (during an attack, a person can break something, hit another). Subsequently, the patient regrets his behavior, asks for forgiveness, blames himself for what happened.
- Border. It is characterized by unstable self-esteem, a tendency to conflict, imbalance, irresponsibility. Demonstrative suicide attempts are possible (but there are clearly no serious intentions to commit suicide). nine0006
- Hysterical. Patients at any cost seek to attract attention to themselves through inappropriate behavior, simulation of serious illnesses. Indifference on the part of others causes outbursts of anger, accusations, irritability.
- Obsessive-compulsive. Accompanied by a pathological preoccupation with order, the desire for control, the desire to achieve perfection in the work performed. But at the same time, the paucity of the emotional sphere is also noted.
- Dissociative (multiple personality disorder). It is extremely rare. A person has the impression that several personalities "live" in him at once, which differ from each other in character, habits, demeanor, etc. nine0006
In the diagnostic examination of patients with personality disorders, various questionnaires and questionnaires are used, however, the diagnosis is complicated by the tendency of patients to distort the clinical picture, hide or vice versa, exaggerate individual symptoms.
The main criteria for the diagnosis of pathology are:
- Behavior and perception of the surrounding reality differs from those accepted in society. But at the same time, the peculiarities of religion, national culture, etc. are taken into account. nine0006
- Mental state leads to inadequate actions, incorrect awareness of reality.
- Identified mental disorders persist for a long time.
- No organic diseases. To do this, we give a referral for EEG, tomography, dopplerography of the brain, prescribe additional clinical tests, in some cases it is necessary to exclude the use of narcotic substances.
Principles of treatment
The doctors of our clinic warn that you should not expect a quick result. In some forms of pathology (for example, in multiple personality disorder), drug treatment plays a minor role. But if anxiety and anxiety are too pronounced, the patient may be prescribed anxiolytics, antipsychotics, and lithium-based drugs. With emotionally unstable, hysterical and borderline disorder, antidepressants, “mild” sedatives, have a good result. But because of the risk of side effects, they are prescribed only for a short time to stop signs of exacerbation. nine0003
In those situations where drugs can be dispensed with (as well as to enhance their effect), the specialists of the Addiction 24 medical center prefer individual or group psychotherapy. Psychotherapeutic treatment is aimed at:
- analysis of the patient's behavior;
- correction of relationships with other people;
- training in self-control, methods of correct way out of conflict situations;
- patients' awareness of their own emotional problems, etc. nine0006
If you have any questions about the methods of treatment, examination of patients with personality disorders, call us around the clock at 8 (495) 182-66-66. All our services are provided on a confidential basis. If necessary, a visit by a doctor to the house is possible.
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Licenses and certificates
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Kazantsev Alexey Vladimirovich
Experience: 30 years
Head physician of the clinic, psychiatrist-narcologist of the highest category, psychotherapist
Portnov Alexander Sergeevich
Experience: 22 years
Brynzar Konstantin Sergeevich
Experience: 6 years
Gamaev Anton Evgenievich
Work experience 30 years
As a narcologist with many years of experience, I want to note the seriousness of the problem of beer alcoholism. The risk of developing dependence on beer is no less than on strong alcohol. With the systematic use of beer, the body adapts to the toxic effect and begins to require larger portions for pleasure. The disease develops gradually, so the addict himself does not notice the changes and does not consider himself an alcoholic. We know how to help you, how to cope with beer alcoholism. Therapy in our clinic is possible in a hospital or at home, with a guarantee of anonymity. nine0003
Aleksey Vladimirovich Kazantsev
Head physician of the clinic, psychiatrist-narcologist of the highest category, psychotherapist
Work experience 30 years
I want to address the relatives of patients undergoing treatment for alcoholism at home. Do not need self-activity. Trying to "strengthen" the therapeutic effect, family members often use folk remedies that allegedly relieve cravings for alcohol. The effectiveness of non-traditional methods is not confirmed by medical research. The safety of the interaction of decoctions and tinctures with medicines has not been proven. An incorrect combination can cause severe intoxication, confusion, and an allergic reaction. Outpatient treatment of alcoholism in our clinic does not need an imaginary reinforcement of folk recipes. We conduct patients according to a personal program, making every effort for a successful result. nine0003
Portnov Alexander Sergeevich
Experience 22 years
Based on professional experience, I believe that one of the reasons for the breakdown after coding is the patient's deliberately false consent. Agreeing under pressure from relatives, a person does not understand and does not accept his illness, and therefore sooner or later returns to his former way of life. To avoid relapse, the duration of the encoding must be used to motivate treatment. The main thing is to convince them to ask for help. We will help you deal with addiction. Our psychotherapy sessions will help you strengthen your sobriety mindset and get sincere consent to a full course of treatment for alcoholism. nine0003
Zhanna Viktorovna Makhobey
I would like to draw attention to the problem of female alcoholism. The weaker sex is more prone to psychological dependence on alcohol due to vegetative lability, emotional instability, and increased sensitivity to traumatic events. At the same time, it is more difficult for a woman to admit dependence and trust a doctor. Therefore, the problem requires a delicate approach to the solution. Patients of our clinic can count on understanding and support. We will keep treatment confidential from the employer, colleagues, friends and relatives. nine0003
Zdanovich Aleksey Anatolyevich
As a family psychologist, I want to remind you that alcoholism is not a problem of an individual, but of the whole family. Life with an alcoholic person turns into a nightmare for his loved ones. The illness of one family member leads to co-dependence of relatives, destroys fundamental family foundations and values. A chance to change the situation is given by family psychotherapy and family counseling. Comprehensive psychological assistance to families in our clinic is one of the leading areas of work. Our doctors have already helped thousands of people not only to get rid of alcoholism, but also to restore harmonious family relationships. nine0003
Group B personality disorders: features, treatment and more
Personality disorders are a type of mental health condition. They can lead to permanent, long-term, and unhealthy patterns of thinking, feeling, and behaving.
There are three main groups of personality disorders: Cluster A, Cluster B, Cluster C.
Each cluster has several unique properties that are used to classify symptoms. Within three clusters, 10 personality disorders are grouped. There are four personality disorders in cluster B, including:
- antisocial personality disorder
- borderline personality disorder
- histrionic personality disorder
- narcissistic personality disorder
Personality disorders from different groups can be diagnosed.
Each personality disorder has its own unique symptoms or characteristics. According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), symptoms should:
- have had a seizure in adolescence or early adulthood
- be stable over time
- lead to personality problems or impairment
Antisocial personality disorder
People with antisocial personality disorder exhibit disrespect and violations of other rights. Anger and manipulation are used for personal gain. They may mistreat other people, lie, or cheat for these personal gains. They are also more prone to stealing. However, as a rule, they do not repent of their deeds. nine0003
People with antisocial personality disorder also have an increased risk of drug or alcohol addiction.
Borderline personality disorder
People with borderline personality disorder often have unstable personal relationships. It can also affect how you view yourself. Symptoms include:
- impulsive behavior
- chronic feelings of emptiness
- chronic feelings of abandonment
- intense rage attacks
- reckless behavior
People with this disorder may also exhibit suicidal behavior.
Read more: Please don't get me wrong, I have borderline personality disorder »
Histrionic Personality Disorder
People with Histrionic Personality Disorder often strive to be the center of attention. They may engage in a variety of attention-demanding behaviors, often in socially unacceptable situations. This behavior may include:
- provocative interactions
- theatrical expressions
- false sense of closeness
People with this disorder have an increased risk of suicidal gestures.
Read more: Understanding why people cut themselves off, hide and how to help themselves »
Narcissistic Personality Disorder
People with this personality disorder believe they are superior to others. Symptoms include:
- extremely negative reaction to criticism
- heightened self-esteem
- preoccupation with grandiose thoughts of success
- excessive need for admiration
- strong sense of entitlement
People with this disorder often exhibit a lack of empathy and may use personal relationships to improve their self-esteem.
Causes and risk factors
Personality disorders are likely caused by a combination of genetics and environmental factors.
Jedan study she found a strong association between borderline personality disorder and a history of sexual trauma. More studying, they found an association between children who were verbally abused by their mothers and various personality disorders, including borderline and narcissistic personality disorders.
A recent review also found similarities in the anatomical features of the brains of people with personality cluster B. This suggests that brain development may also contribute to these disorders. nine0003
Ostrazhivanye found a significant association between cluster B personality disorder and family history. Having parents or siblings with a personality disorder increases the risk of developing the disorder.
It is important not to diagnose yourself or others if you see signs of a personality disorder. A personality disorder should only be diagnosed by a qualified mental health professional.
Mental health professionals use the DSM-5 to diagnose personality disorders and other mental health conditions. To be diagnosed, people must meet the criteria listed for the specific disorder. nine0003
You will probably need to have several sessions with a therapist before being officially diagnosed. During your meeting, they will ask you various questions about your life, many of which may make you feel very personal. It is important to be open and honest with your mental health professional. This will help them make an accurate diagnosis.
According to the DSM-5, you must meet the following requirements to be diagnosed with cluster B personality disorder:
- Symptoms first appeared in early adulthood.
- If you are under 18, you must have had symptoms for at least one year.
- Symptoms must not be the result of other disorders or specific stressful situations.
Your doctor may want to talk to family members to help you understand your symptoms. This is because it can be difficult to recognize the symptoms in oneself. Your doctor will not share what you have told them with your family members, nor will he share with you what your family members have shared. nine0003
Treatment will likely involve a variety of methods and will require your commitment. Your doctor may recommend trying something new during treatment. And you may need to continue seeing your doctor even after your symptoms improve.
Psychotherapy is usually a key part of any treatment plan. This is sometimes called talking therapy.
During psychotherapy, you will have the opportunity to express your thoughts and feelings in a non-judgmental environment. People with Group B personality disorders may find it difficult to establish a comfortable relationship with a therapist. You should not take this as a sign that the therapy is not working. nine0003
Your doctor may recommend both dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT).
DBT is used to teach new skills and encourage change. It can be group or individual lessons.
CBT focuses on problem solving and teaches skills to identify problematic thoughts and beliefs.
No drugs approved by the US Food and Drug Administration for the treatment of personality disorders. Some medicines may be helpful if your doctor uses them to suppress some of the symptoms, or to treat a psychiatric or psychiatric disorder that occurs at the same time. The most commonly used medications include:
- mood stabilizers
- anti-anxiety drugs
Talk to your doctor about possible side effects and let him know if your symptoms do not improve or worsen. You should also avoid using drugs or alcohol while taking these medicines as they may increase the risk of side effects.
Helping a loved one
If a family member or friend has been diagnosed with a personality disorder, be supportive and open. Tell them impartially when they violate your boundaries. They may not always fight for social cues, but a little guidance can help them identify behaviors that may be affecting their condition. nine0003
If you think a person with group B symptoms is a danger to themselves or others, call your local emergency services.
People with cluster B personality disorders often have difficulty maintaining healthy relationships and may exhibit emotional and impulsive symptoms. Treatment for this condition is possible with medication, although you may need a combination of treatments, including therapy and, in some cases, medication. nine0003
If you think someone is in imminent danger of harming themselves or harming another:
- Call 911 or your local emergency number.