While narcissistic personality disorder and histrionic personality disorder share some characteristics, the full range of symptoms is quite different. Treatment for both often includes professional support and medication.

Our personalities define a large part of who we are and shape how we interact with ourselves and the world around us. For people with personality disorders, personality traits can have more significant effects on an individual’s behaviors, relationships, and more.

Historiotic personality disorder and narcissistic personality disorder are two similar disorders known as Cluster B personality disorders. Cluster B personality disorders are characterized by emotional, dramatic, and erratic thoughts and behaviors.

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While histrionic and narcissistic personalities share some traits, there are significant differences between the two. Below, we compare histrionic and narcissistic personalities and cover the differences and similarities in symptoms and treatment.

What’s the difference between narcissistic and histrionic personalities?

Cluster B personality disorders, histrionic personality disorder, and narcissistic personality disorder share some traits. For example, people with these conditions may think and act in exaggerated, emotional, and unpredictable ways.

However, there are some notable differences between the clinical features seen in these two conditions:

Historic personality disorder involves emotionally disorganized behavior and excessive attention-seeking, whether that attention is positive or negative.

Narcissistic personality disorder involves an inflated view of oneself, a lack of empathy for others, and a desire for admiration and validation.

People with narcissistic personality disorder thrive on attention, but the main difference between the two conditions is the type of attention and the reason for the attention.

People with narcissistic personality disorder typically seek positive attention as a way to validate their sense of self-worth and tend to avoid negative attention or criticism.

People with narcissistic personality disorder have a strong desire for any type of attention. They may sometimes use harmful behaviors to get it.

Historic vs. Narcissistic Behaviors

Attention-seeking behavior is just one aspect of histrionic personality disorder and narcissistic personality disorder. Other symptoms of these conditions vary, and there is a clinical distinction between the behaviors associated with histrionic personality disorder and narcissistic personality disorder.

Historic Personality Disorder

Historic personality disorder symptoms typically begin in early adulthood. Some of the most common behaviors include:

Historical and dramatic expressions of emotions

• Appearing uncomfortable when not receiving attention
• Acting provocatively or inappropriately toward others
• Using physical appearance to attract attention
• Speaking in a vague or almost childish manner
• Following the influence of others more easily
• Taking a very important view of relationships

Engaging in just one or two of these behaviors does not mean that someone has a histrionic personality disorder.

A diagnosis of histrionic personality disorder requires that someone consistently engage in at least five of these behaviors, and these behaviors affect their functioning and relationships.

Narcissistic Personality Disorder

Narcissistic personality disorder also develops in early adulthood. Some of the behaviors that define it include:

• Feeling an exaggerated sense of self-importance
• Senses of entitlement
• Acting arrogantly or superiorly toward others
• Seeking attention and admiration from others
• Fantasizing about things like success or power
• Exploiting others to achieve their own goals
• Lack of the ability to show empathy toward others
• Feeling jealous of what others have

Exhibiting narcissistic traits occasionally does not necessarily mean that a person meets the diagnostic criteria for narcissistic personality disorder.

Like narcissistic personality disorder, a diagnosis of narcissistic personality disorder also requires that a person consistently engage in at least five of these behaviors over a longer period.

Treatment Options for Histrionic vs. Narcissistic Personality Disorder

Treatment is similar for histrionic personality disorder and narcissistic personality disorder. It typically involves therapy and medication.
Psychotherapy

Psychotherapy, also known as talk therapy, is an effective treatment option for personality disorders such as borderline personality disorder and narcissistic personality disorder.

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Talk therapy can teach you more about how your condition affects your thoughts and feelings, and how those feelings affect your behaviors. Over time, this can allow you to better manage your feelings and change behaviors that affect your ability to function.

There are several types of psychotherapy approaches, but some may be helpful for borderline personality disorder and narcissistic personality disorder, including:

• Psychoeducation
• Cognitive behavioral therapy (CBT)
• Dialectical behavior therapy (DBT)
• Dynamic psychotherapy
• Transfer-focused therapy

Medications

There are no medications approved to specifically treat personality disorders, including borderline personality disorder and narcissistic personality disorder.

However, some medications can help with symptoms of these disorders, such as mood swings, impulsivity, or even anxiety.

Some of the most common medication options include:

• Antidepressants
• Anti-anxiety medications
• Mood stabilizers
• Antipsychotic medications

Takeaway

Historic personality disorder (HPD) and narcissistic personality disorder (NPD) share some similar traits, especially when it comes to attention seeking. However, there are significant differences that set them apart.

It can be difficult for people with a personality disorder to recognize that they have it and may need help. But with the right support and treatment, someone with a personality disorder can improve their daily life and relationships with others.