What Is Avoidant Personality Disorder? Exploring Symptoms And Treatments

Many people are shy and struggle to open up in social situations. However, for some people, that fear of ridicule and rejection can escalate to a debilitating mental health condition called avoidant personality disorder (AVPD). Read on to learn more about AVPD, its symptoms, and how therapy can be a valuable part of a comprehensive treatment plan.

What Are Personality Disorders?

According to the American Psychiatric Association, personality disorders are mental health conditions that affect how you think, act, and feel. To qualify as a disorder: symptoms must deviate from the expected cultural norm, cause distress or impair functioning, and persist over time with little or no relief without treatment. 

Personality Disorders

• Cluster A

Characterized by odd thought patterns and eccentric behaviors. Includes schizoid personality disorder and schizotypal personality disorder

• Cluster B

Characterized by dramatic, unpredictable, overly emotional behaviors and thought patterns. Includes antisocial personality disorder, borderline personality disorder, histrionic personality disorder, and narcissistic personality disorder

• Cluster C

Characterized by anxious, fearful thinking and behavior habits. Includes avoidant personality disorder, dependent personality disorder, and obsessive-compulsive personality disorder

— The Mayo Clinic

What is Avoidant Personality Disorder?

The American Psychological Association Dictionary of Psychology defines avoidant personality disorder as a mental health condition characterized by a hypersensitivity to rejection and ridicule, a strong desire for uncritical acceptance by peers, social withdrawal despite a desire for acceptance and affection, and low self-esteem. First defined by Theodore Millon in 1969, AVPD causes long-standing patterns with results severe enough to impair your functional ability to work and maintain personal relationships. 

Beyond Bashful: Exploring AVPD Symptoms

• You are overly sensitive to rejection and criticism. 

• You intensely fear disapproval, ridicule, or embarrassment, especially in public. 

• You often feel inadequate or inferior in many ways.

• You frequently avoid work, school, or social activities that require interpersonal contact. 

• You consider yourself unattractive to potential romantic partners and have low self-esteem.

• You may exaggerate potential problems.  

• You are timid and socially inhibited, preferring social isolation over the risk of meeting new people and trying new activities. 

• You demonstrate extreme shyness and an inability to communicate effectively in personal relationships and social situations. 

• You have few close friends and are hesitant to get involved with people if you don't know how they feel. 

Diagnosing Avoidant Personality Disorder

Similar to the methods used to identify many mental health conditions, the diagnosis process for AVPD generally starts with a physical examination and complete medical history taken by your physician or another healthcare provider. This part of the process rules out other possible causes of your symptoms, such as underlying physical health problems. If no physical issues are found, you may be referred to a mental health professional to complete various diagnostic personality assessment tools and interviews to evaluate whether your symptoms meet the criteria for AVPD.

How Common Is AVPD, And What Causes It?

According to researchers at the Cleveland Clinic, approximately 2.4% of the United States population has an avoidant personality disorder, occurring across all genders equally. Symptoms generally begin appearing during childhood and often escalate to causing discomfort or distress by the time you are an adolescent or young adult. However, the condition usually isn't diagnosed until someone is at least 18—as with many personality disorders—because your mental healthcare provider needs established, persistent behavior patterns to identify the condition.

Like many mental illnesses, the exact cause of AVPD isn’t known. However, the medical community generally believes avoidant personality disorder develops due to a combination of biological factors like genetics and various environmental factors, especially during childhood. Many people with AVPD reported memories of parental or peer rejection that significantly impacted their personality and willingness to make themselves socially vulnerable. 

Avoidant Personality Disorder Treatments

Treating AVPD can be challenging because patients try to reshape behavior and thought patterns established over years of repetition. However, people with AVPD are generally excellent candidates for treatment because their symptoms cause significant distress, and they are committed to making meaningful life changes. Many AVPD patients find that the desire to develop relationships is a strong motivator to endure the short-term discomfort of treatment for the long-term benefits. Therapy is often most effective when patients have support from friends and famillies.

As with most mental health conditions, psychotherapy or talk therapy is the primary treatment. Many patients supplement their therapy with medications designed to help balance their neurochemicals or make it easier to control emotions. Antidepressants and anti-anxiety medications are commonly used to treat patients with AVPD. 

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy is a therapeutic approach focused on identifying and understanding harmful or maladaptive behaviors and thought patterns. Once you can identify why you are thinking and feeling a certain way, you work to reshape your outlook and shift toward healthier habits with the support and guidance of a mental health professional. CBT can help you examine and understand how your past experiences may influence your present behavior. 

Schema Therapy 

Schema therapy combines elements from various therapeutic approaches and is frequently used for patients with personality disorders that don’t respond well to other treatments. This method requires a trusting relationship between the patient and therapist. Much of the work involves examining childhood experiences and how they influence your schema, or unhealthy thought and behavior patterns. 

Additional Therapy Options

• Exposure therapy

• Psychodynamic therapy

• Supportive therapy

• Acceptance and commitment therapy

• Emotion-focused therapy

• Metacognitive interpersonal therapy

AVPD Vs. Social Anxiety Disorder: How To Tell The Difference

Avoidant personality disorder and social anxiety disorder gives so many similarities that it’s easy to understand why many people confuse the two conditions. Some mental health professionals describe AVPD as a severe form of social anxiety, though they are two separate diagnosable mental health disorders. A notable difference is that people with AVPD find their symptoms are not limited to social interactions, and they may allow the fear of failure or judgment to impact their productivity or long-term success. 

What Is The Outlook For People With AVPD?

If left untreated, the outlook for people living with avoidant personality disorder can look pretty grim. The effects of social isolation tend to grow stronger with time, and the longer you maintain habits influenced by AVPD symptoms, the more ingrained those patterns become. People who don’t treat their AVPD are at risk of developing depression or other mood disorders, agoraphobia, and substance or alcohol use disorders. While treatment won't completely change your personality, and you may always be shy, it can help you find ways to cope with your symptoms and manage their effects to communicate and relate to others.

Tips For Coping With Avoidant Personality Disorder

• Practice proper self-care and reaffirm your value daily with positive affirmations. Eat a balanced diet, exercise regularly, and practice healthy sleep hygiene. When your body is healthy, it can be easier to overcome your symptoms. 

• Develop your social skills and continue to practice and evolve them. Try starting with a structured environment like a class.

• Don't force it or push yourself too hard. While you want to progress and continue to expand your limits, it is essential to examine your emotional reactions and development along the way. You may have days where symptoms are much worse, and you struggle to get by. On those days, do what you can. 

Know When To Reach Out For Help

If your symptoms cause you significant distress and interfere with your ability to function, it may be time to reach out for the support and guidance of a mental health professional. Speak to your doctor about your concerns if you don’t know where to start. 

How Therapy Can Help

If you or your child has an avoidant personality disorder, consider working with a licensed therapist online through a virtual therapy platform like BetterHelp. If you are seeking treatment for a child from age 12 to 19, contact TeenCounseling. Therapy can help you identify and replace harmful behaviors, establish healthy, practical coping skills to manage your stress and AVPD symptoms, and build up your communication skills, making you more confident speaking to new people. 

Online cognitive behavioral therapy and other therapeutic approaches provide similar results to treatments in the face-to-face setting, according to a recent study by the American Psychological Association. Many patients, particularly those with AVPD, found teletherapy's extra physical distance to be a significant draw, making it easier to give personal details with their therapists. The convenience of receiving treatment from the comfort of home also makes it easier to attend more sessions, which can increase the efficiency and duration of your outcomes. 

Takeaway 

Avoidant personality disorder can be challenging to manage independently, but you can find practical ways to cope with its effects with treatment. The information provided in this article may offer insight into the condition and how therapy can help you reduce its impact on your life or the life of a loved one.