Difference between Borderline and Histrionic

Key Difference: Borderline Personality Disorder (BPD) is a mental condition in which people experience reckless and impulsive behavior, unstable moods and relationships. BPD patients usually suffer brief psychotic mood swings that often change in minutes or hours. Histrionic Personality Disorder (HPD) is a mental disorder in which people are more emotionally vulnerable and require constant approval from their peers. They are also associated with inappropriately seductive, dramatic, flirtatious, exaggeration, manipulative and self-indulgence behavior.

There are different types of medical conditions that can affect the mind and personality of a person. These are known as mental disorders and can often disrupt a person’s life and activities. These conditions often have similar symptoms and can even co-exist with each other. Hence, they become difficult to diagnose and treat. Borderline and Histrionic personality disorders are two conditions that are often confusing for many people. People suffering from Borderline are more reckless, while histrionic patients are more emotionally vulnerable and require constant approval.

Borderline Personality Disorder (BPD) is a mental condition in which people experience reckless and impulsive behavior, unstable moods and relationships. The disorder was not considered as a medical condition until the 1980s, when the Diagnostic and Statistical Manual for Mental Disorders, Third Edition (DSM-III) listed this condition as a medical diagnosable illness. BPD patients usually suffer brief psychotic mood swings that often change in minutes or hours. Experts state that people suffering from BPD also often suffer from other mental disorders such as depression, anxiety disorders, substance abuse, eating disorder, suicidal behaviors, etc. The overlapping of these disorders makes it difficult to properly diagnose and treat the disease.

According to research, BPD is known to occur three times more in women than in men. In women, the disorder is believed to co-occur with depression, anxiety and eating disorders. In men, it co-occurs with substance abuse and personality disorder. The disorder usually begins at a young age during adolescence or early childhood. Some childhood experiences have also been known to cause or trigger the disorder. Causes for the disorder include history of childhood trauma, brain abnormalities, genetic predisposition, neurobiological factors, environmental factors, executive function, family environment, self-complexity and thought suppression.

According to the DSM Fourth Edition, for a person to be diagnosed with BPD, they must exhibit at least five of the following symptoms: Extreme reactions of panic, depression, rage, etc., intense and stormy relationships, unstable self-image, impulsive and reckless behavior, suicidal tendencies, self-harming behavior, feelings of emptiness, uncontrollable anger and rage,  paranoia, losing touch with reality, etc.

BPD has been unofficially divided into four subtypes by American psychologist, Theodore Million. He proposes that an individual diagnosed with the disorder can be classified into one oof the four categories depending on their symptoms. Wikipedia lists the four subtypes as:

  • Discouraged borderline — including avoidant, depressive or dependent features
  • Impulsive borderline – including histrionic or antisocial features
  • Petulant borderline – including negativistic (passive-aggressive) features
  • Self-destructive borderline – including depressive or masochistic features

Psychotherapy has been a proven to help treat patients with BPD. It has shown to help relieve some symptoms. Different types of therapy that are used include cognitive behavioral therapy, dialectical behavior therapy, and schema-focused therapy. Cognitive behavioral therapy (CBT) helps people identify and change core beliefs and behaviors that the patient may have about themselves along with addressing mood, anxiety problems and suicidal behaviors. Dialectical behavior therapy (DBT) focuses on helping the patient being aware and attentive to the present situation and allowing them to control and take charge of their emotions. Schema-focused therapy combines CBT with other forms of therapy and focuses on altering the way the patient views themselves. Medications are also used along with psychotherapy to relieve certain symptoms. Other treatments that have shown positive effect includes an omega-3 healthy diet for women.

Histrionic Personality Disorder (HPD) is a mental disorder in which people are more emotionally vulnerable and require constant approval from their peers. They are also associated with inappropriately seductive, dramatic, flirtatious, exaggeration, manipulative and self-indulgence behavior. Histrionic disorder is considered to be more commonly diagnosed in women compared to men. Men that exhibit similar symptoms are often diagnosed with narcissistic personality behavior. People suffering from HPD are actually pretty successful and high-functioning individuals that are social and outgoing. They also are constantly the center of attention and will do anything, including wear bright and obnoxious clothing, make loud noises and say almost anything to keep the attention to themselves.

HPD patients are fast to excite and fast to burn out. For instance, they will fall in love fast and will also take it hard when the relationship ends. They may also seek treatment for clinical depression when their relationships die. People suffering from HPD also constantly change jobs as they can quickly become bored and frustrated. They also crave excitement and can also place themselves in risky situations to acquire it. HPD can be caused by childhood trauma such as death or illness in the family. It can also be caused by distant attitudes of parents, where the child may not have received the love and attention that he/she may require. Genetics is also considered as one of the causes for the disorder.

Psychology Today lists the symptoms of HPD as:

  • Constantly seeking reassurance or approval
  • Excessive dramatics with exaggerated displays of emotion
  • Excessive sensitivity to criticism or disapproval
  • Inappropriately seductive appearance or behavior
  • Overly concerned with physical appearance
  • Tendency to believe that relationships are more intimate than they actually are
  • Self-centeredness, uncomfortable when not the center of attention
  • Low tolerance for frustration or delayed gratification
  • Rapidly shifting emotional states that appear shallow to others
  • Opinions are easily influenced by other people, but difficult to back up with details
  • Being easily influenced by other people
  • Blaming failure or disappointment on others

Psychologist Theodore Million classifies the disorder into six subtypes. Wikipedia lists the subtypes as:

  • Appeasing: features of dependent personality disorder and obsessive-compulsive personality disorder
  • Disingenuous: features of antisocial personality disorder
  • Infantile: features of borderline personality disorder
  • Tempestuous: negativistic (passive-aggressive) features
  • Theatrical: overtly dramatic, romantic, and attention-seeking
  • Vivacious: the seductiveness of the histrionic mixed with the energy typical of hypomania

Psychotherapy is one of the most effective ways to treat the disorder. Cognitive therapy is one of the therapies that are used when dealing with HPD. Medication may also be used in order to treat some symptoms such as depression.

 

Borderline

Histrionic

Definition

Borderline personality disorder is a disorder during which a person exhibits unstable moods, behavior and relationships. They are also associated with reckless behavior and suicidal tendencies.

Histrionic personality disorder is a medical condition in which a person exhibits excessive emotionality, need for approval, attention-seeking and seductive behavior. They have a high need for attention and will do anything to acquire it.

Symptoms

Extreme reactions, intense relationships, impulsive decisions and behavior, suicidal tendencies, extensive mood swings, feelings of emptiness, intensive and uncontrollable anger.

Constantly seeking reassurance or approval, excessive dramatics with exaggerated displays of emotion, excessive sensitivity to criticism or disapproval, inappropriately seductive appearance or behavior, overly concerned with physical appearance, tendency to believe that relationships are more intimate than they actually are, self-centeredness, uncomfortable when not the center of attention, low tolerance for frustration or delayed gratification, rapidly shifting emotional states that appear shallow to others, opinions are easily influenced by other people, but difficult to back up with details.

Causes

History of childhood trauma, brain abnormalities, genetic predisposition, neurobiological factors, environmental factors, executive function, family environment, self-complexity and thought suppression

Childhood trauma, death in the family, lack of love as a child and genetics are some of the causes of HPD.

Types

BPD has been unofficially been divided into four types by Theodore Million: Discouraged borderline, Impulsive borderline, Petulant borderline and Self-destructive borderline.

Million divides HPD into six subtypes: Appeasing, Disingenuous, Infantile, Tempestuous, Theatrical and Vivacious.

Treatment

Psychotherapy, Medications, mental health services.

Psychotherapy

Image Courtesy: askdrrobert.dr-robert.com, mindsetmasterymadeeasy.com

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