Image illustration: by The Cut; Images: Getty Images
since the beginning Johnny Depp’s defamation trial is underway v. Amber Heard — which relates to a 2018 op-ed she wrote that identified herself as a sexual violence survivor (which did not mention Depp) — the public was told a massive amount of testimonies regarding their past relationship, including allegations of abuse (from both parties) and drug use.
This week, a psychiatrist appointed by Depp’s team saw that Heard suffers from Histrionic Personality Disorder (HPD) and borderline personality disorder (BPD). Although Heard had previously disclosed to the court the diagnosis of PTSD by a different psychiatrist, Depp’s team psychologist, Shannon Curry, alleged that Heard was “severely exaggerating” her PTSD symptoms. curry argue that as a result of the combination of HPD and BPD, Heard was prone to be “interactive” as well as “dramatic, erratic, and unexpected.”
Heard’s attorney later attempted to cast doubt on these diagnoses, stating that Curry was not board-certified. While BPD is a widely accepted diagnosis, HPD is somewhat more controversial. Heard has not testified or publicly commented on Carey’s diagnoses yet.
While mood disorders such as depression or bipolar disorder are defined by features and symptoms that tend to ebb and flow, personality disorders are “more a condition than a trait,” says Thea Gallagher, a clinical psychologist at NYU Langone Health. Whereas a person with depression or anxiety can usually recognize their symptoms and differentiate their “normal” versus their depressed/anxious self, a person with a personality disorder knows life only through the lens of that disorder. “Their way of seeing themselves, seeing the world, and acting in the world is so rigorous, and so extreme that it causes them a great deal of trouble in many areas of life,” explains Francis Mondemore, Director of The Mood. Disorder Clinic at Johns Hopkins Bayview Medical Center and author of Borderline personality disorder: new reasons for hope.
Most personality disorders don’t treat With Medications, there are no FDA approved medications for use. Psychotherapy is usually the recommended treatment for people with personality disorders. Group B personality disorders, which include BPD and HPD, are thought to affect Between 1 to 6 percent of the general population. What causes personality disorders is a topic of ongoing research, but Endoscopy has been done Genetic factors, childhood trauma or abuse, and high reactivity (sensitivity to stimuli) may be factors.
Histrionic personality disorder, Mondemore says, is characterized by an urgent need to be the center of attention as well as dramatic influence.
Like borderline personality disorder, histrionic personality disorder falls under an umbrella known as “group B” personality disorders, which also includes antisocial personality disorder and Narcissistic personality disorder. In general, group personality disorders are characterized by “high and unstable emotions, distorted self-images, and difficulty in relationships,” says Gallagher.
By contrast, the Diagnostic and Statistical Manual of Mental Disorders defines group A personality disorders as Is characterized by “Eccentric thinking or behavior”; They include paranoid personality disorder, schizotypal personality disorder, and schizotypal personality disorder.
Mondemore says that while three out of four group B personalities (antisocial, narcissistic, and borderline) share a common thread — a “fairly damaged sense of self” — histrionic personality disorder also does not fit into the group. While better understood group B disorders have a clear and devastating impact on people’s lives, it has been difficult for psychologists to agree on whether and how HPV disrupts the lives of people diagnosed with the disorder.
Psychologists may diagnose patients with personality disorder through a series of clinical interviews and questionnaires, such as Structured Clinical Interview for DSM Disorders (SCID), says Gallagher. These questionnaires are usually designed to assess whether someone “endorse” or agrees with a view of a particular personality disorder.
Mondemore, for his part, is concerned about diagnoses being made through the Diagnostic and Statistical Manual of Mental Disorders. “The DSM was developed as a research tool,” he says – criteria for specific diagnoses are useful for researchers and practitioners who want to study a specific disorder. “The DSM is not intended to be a clinical tool to help a physician make a diagnosis and develop a treatment plan,” he adds. “If a particular diagnosis doesn’t point you in a particular direction in terms of treatment, it’s not going to be terribly helpful.”
HPD is one example, he says; Although psychotherapy is the primary treatment model for group B personality disorders, HPD is poorly understood, meaning that no specific types of treatment are necessarily recommended. By contrast, Mondemore says, “For BPD, there’s actually more research, and a specific type of psychotherapy has been developed to treat that.” Another issue with diagnosing personality disorders is that, according to the DSM, many of them have overlapping criteria.
The word “theatrical” sounds like “hysterical” for a reason. “The older term for histrionic personality disorder was histrionic personality disorder, and that had a lot to do with outdated, misogynistic attitudes toward women,” Mondemore says. Although the disorder has been given a new name in an attempt to get away from those connotations, Mondemore says the roots of sexual diagnoses are still visible — not least because it is a diagnosis given primarily to women.
“These people are said to have shallow emotions, and are often courteous,” he says. “Again, there’s kind of a sexist judgment out there.” Symptoms typically associated with HPD “beg the question whether there is a gender explanation for certain behaviors,” Gallagher says. However, she adds, there are gender differences in other disorders as well — women are more likely to have anxiety, and men are more likely to have narcissistic personality disorder, for example.
Mondemore says HPD is an outdated diagnosis for other reasons, too. “The things that are said to characterize the disorder are very vague,” he explains. “It involves a tremendous amount of judgment. It’s just a diagnosis that people have walked away from, so I’m actually a bit surprised it came out at all.”