More than just a social anxiety disorder, avoidant personality disorder (AVPD) is marked by shyness and sensitivity to criticism. It often involves behaviors of social inhibition, feelings of inadequacy, and negative reactions to rejections. ¹
Naturally, such a condition can cause varying problems in day-to-day life. Furthermore, since symptoms of AVPD often replicate that of anxiety disorders, mental health professionals may initially have problems with diagnosis.
Throughout this article, we’re going to take a deeper look at AVPD, its symptoms, and what you can do for treatment. At the end, we invite you to ask further questions.
Avoidant Personality Disorder Symptoms
As a Cluster C personality disorder, people with AVPD often experience anxiety and fear when it comes to social situations. Naturally, this may initially confuse some with a social anxiety disorder. However, the conditions are quite different.
And these differences can be observed in AVPD symptoms: ¹ ²
- Anhedonia (lack of pleasure in activities you once enjoyed)
- Avoid sharing feelings or developing intimate relationships
- Desire to be well-liked
- Difficulty making decisions
- Fear of saying or doing the wrong thing
- Feelings of inadequacy
- Inability to initiate social contact
- Lack of trust in others
- Low self-esteem
- Misinterpretation of situations or events
- No close friends
- Not assertive
- “People-pleaser” (avoiding conflict)
- Rejection fears
- Self-isolation (or social inhibition)
- Sensitive to criticism or disapproval
- Social anxiety
- Tense demeanor
- Unwilling to try new things
- Very self-conscious
- Viewing yourself as socially inferior (or inept)
Naturally, the combination of these symptoms can lead to depression which brings a host of other symptoms. The most notable of these is suicidal ideation.
Suicide and Crisis Lifeline
Do you struggle with suicidal thoughts? If so, it’s important to seek help immediately. In cases of emergency, call 911 or go to your nearest emergency room. In other cases, you can reach out to the Suicide and Crisis Lifeline at 988.
What’s the Difference Between Avoidant Personality Disorder vs. Social Anxiety Disorder?
Since symptoms of AVPD and social anxiety disorder (SAD) overlap, there can be some confusion between the two. Most notably, people with AVPD and SAD feel rejection and the judgment of others.
However, the key difference between the two is people with SAD struggle with high levels of anxiety. In turn, they become extremely fearful of social situations. ³
On the other hand, people with AVPD aren’t driven by anxiety as much as feelings of worthlessness.
Still, a person may receive a diagnosis with both disorders, depending on their circumstances. However, most mental health professionals consider AVPD a more severe form of social anxiety. ⁴
What Causes Avoidant Personality Disorder?
While researchers aren’t 100% sure what causes AVPD, they believe the following factors play a major role:
- Emotional abuse (especially during childhood)
- Lack of affection (or nurture) from parents or caregivers
- Previously experienced harsh criticisms or ridicule
- Rejection from peers
It’s been observed that people with AVPD experienced shyness during childhood and adolescence. In many regards, they simply never outgrew this shyness. For this reason, shy children are more at risk of growing into adults with AVPD. ⁵
Avoidant Personality Disorder Risk Factors
Since people with AVPD tend to spend more time in isolation, they’re less likely to seek out the necessary treatment. Furthermore, people with this condition often struggle to develop relationships. In turn, this can make it difficult to create a support system to help them through treatment.
However, this isn’t to say people with AVPD don’t want relationships. In fact, many long for a connection with others. ⁶ But due to the nature of this condition, such connections can be extremely difficult to make.
Avoidant Personality Disorder Diagnosis
AVPD has been outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Therefore, psychologists, psychiatrists, and other mental health professionals are able to make a diagnosis of the condition.
Since AVPD is typically observed in adults, it’s not common for children to receive a diagnosis. In cases of childhood shyness, most psychologists agree this will be overcome later in life.
In order for an AVPD diagnosis, you must show consistent signs of social avoidance, sensitivity to criticism and rejection, as well as feelings of inadequacy. These signs must be displayed by four of the following criteria: ⁷
- Avoiding occupational activities (namely out of fear, disapproval, or rejection).
- Reluctant to become involved with others (unless you’re sure they like you).
- Avoiding intimate relationships (namely out of fear of ridicule or humiliation)
- Fears and inhibitions in new social situations (due to feelings of inadequacy)
- You feel as though you’re socially unappealing, inferior, or inept.
- You’re hesitant to try new things (namely out of fear of embarrassment).
Avoidant Personality Disorder Treatment
AVPD is one of the most difficult personality disorders to treat due to the nature of the condition. Since people with AVPD avoid social situations, they’re less likely to seek out treatment (or remain on treatment). Furthermore, they may develop other mental health conditions, such as anxiety and depression.
Still, treatment options are available – namely in the form of medication and psychotherapy. If done as a mental health professional directs, many have overcome AVPD symptoms.
Currently, no medication has been approved for the treatment of AVPD. However, you may receive a prescription for other medications if you struggle with another disorder.
For example, depression is common among people with AVPD. Therefore, you may receive a prescription for antidepressants in order to relieve depression symptoms.
More commonly, people with AVPD will be recommended various forms of talk therapy. The most common include:
- Cognitive behavioral therapy (CBT)
- Psychodynamic therapy
- Schema therapy
CBT is the most common of these and in many regards, the most effective. Through this form of talk therapy, you’ll develop an understanding of negative thinking patterns, where they’re coming from, and how to overcome them. ⁸
In order to further the results of CBT, you may also participate in schema therapy. This helps you develop therapeutic techniques with a focus on relationships. The goal is to help you re-establish previous beliefs on other people – namely, through re-engineering childhood experiences. ⁹
While avoidant personality disorder comes with its challenges, it is possible to overcome them. If you or someone you love struggles with the condition, it’s key to seek treatment as soon as possible. Early intervention will not just prevent the condition from further developing, it will also ensure you or your loved ones don’t fall victim to self-isolation.
Still have questions about avoidant personality disorder?
We invite you to ask them in the comment section below. If you have any further knowledge to share – whether personal or professional – we’d also love to hear from you.
¹ Psychology Research and Behavior Management: Avoidant personality disorder: current insights
² ScienceDirect: Individual Differences and Personality
³ National Institute of Mental Health (NIMH): Social Anxiety Disorder: More Than Just Shyness
⁴ Oxford University Press: Evolutionary Psychopathology: A Unified Approach
⁵ Development and Psychopathology: Predictors of withdrawal: Possible precursors of avoidant personality disorder
⁶ Journal of Clinical Psychology: Struggling to be a person: Lived experience of avoidant personality disorder
⁷ Merk Manual Professional Version: Avoidant Personality Disorder (AVPD)
⁸ The Journal of Psychotherapy Practice and Research: Psychotherapy of Personality Disorders
⁹ U.S. National Library of Medicine: Effectiveness of Group Based Schema Therapy in the Treatment of Personality Disorders