Avoidant Personality Disorder
Often being verbally mistaken and incorrectly referred to as "being Antisocial," Avoidant personality disorder is characterized by feelings of extreme social inhibition, inadequacy, and sensitivity to negative criticism and rejection. Yet the symptoms involve more than simply being shy or socially awkward. Avoidant personality disorder causes significant problems that affect the ability to interact with others and maintain relationships in day-to-day life. An estimated 2.1% of Americans has avoidant personality disorder.
AVPD is one of a group of conditions called “Cluster C” personality disorders. They involve anxiety and fear. Personality disorders are lasting patterns of behavior that are out of touch with cultural norms (how we’re expected to act) and develop in childhood or adolescence. They cause distress for the person with the condition and/or those around them.
But what’s the difference between avoidant personality disorder and social anxiety?
Avoidant personality disorder and social anxiety disorder (SAD) share similar features and behaviors. But they’re distinct conditions.
Social anxiety disorder (social phobia) happens when you have an intense and ongoing fear of being judged and watched by others. This leads people with SAD to avoid social situations.
People with AVPD also avoid social situations and relationships. But it has more to do with their low self-esteem than with anxiety. Anxiety is the core feature behind SAD, but it doesn’t have to be present with AVPD
Researchers once thought that AVPD was a severe form of SAD. But studies show that roughly two-thirds of people with AVPD don’t meet the standard diagnostic criteria for SAD according to the DSM-5.
But a person can have both AVPD and SAD. People with both conditions have more severe symptoms than those with just one.
Symptoms
The main sign of avoidant personality disorder is having such a strong fear of rejection that you choose isolation over being around people. This pattern of behavior can vary from mild to extreme.
Other signs and behaviors of avoidant personality disorder include:
Having a poor self-image, seeing themselves as inadequate and inferior.
Being overly concerned about criticism or disapproval.
May be reluctant to become involved with others unless they know for sure that others will like them.
Experiencing extreme anxiety (nervousness) and fear in social settings and relationships. This may lead them to avoid activities or jobs that involve being with others.
Being shy and self-conscious in social situations due to a fear of doing something wrong or feeling embarrassed.
Tending to exaggerate potential problems or misinterpret feedback as negative.
Seldom trying anything new or taking chances.
Treatment Options
Treating personality disorders is difficult because people with these conditions have deep-rooted patterns of thinking and behavior that have existed for many years. However, people with avoidant personality disorder tend to be good candidates for treatment because the condition causes them significant distress. And most people with AVPD want to develop relationships. This desire can be a motivating factor for people with AVPD to follow their treatment plans, which will likely include psychotherapy and, potentially, medication.
Treatment for people with this condition is most effective when family members are involved and supportive.
Psychotherapy for AVPD
Psychotherapy (talk therapy) is the treatment of choice for personality disorders. The goal of treatment is to help you uncover the motivations and fears associated with your thoughts and behavior. In addition, you can learn to relate to others more positively.
Two specific types of psychotherapy that can help people with AVPD include:
Psychodynamic therapy:
This type of therapy focuses on the psychological roots of emotional suffering. Through self-reflection, you look into problematic relationships and behavior patterns in your life. This helps you better understand yourself. It can help you change how you relate to other people and your environment.
Cognitive behavioral therapy (CBT):
This is a structured, goal-oriented type of therapy. A therapist or psychologist helps you take a close look at your thoughts and emotions. You’ll come to understand how your thoughts affect your actions. Through CBT, you can unlearn negative thoughts and behaviors. You’ll learn to adopt healthier thinking patterns and habits. It may especially focus on developing social skills.
Medication for AVPD:
There’s currently no medication that can treat personality disorders. But there’s medication for depression and anxiety, which people with avoidant personality disorder may also have. Treating these conditions can make it easier to treat AVPD.
For the best results, however, you should take medication in combination with psychotherapy, but always talk to your doctor about any concerns you may have.