The avoidant personality disorder is a general avoidance of social interaction for fear of negative outcomes. It occurs in 0.5% – 1% of the general population. It can co-occur with anxiety disorders. Around 10% – 50% of people with panic disorder accompanied by agoraphobia will have avoidant personality disorder. Also, 20% – 40% of those with social anxiety disorder will also have APD.
In this article we’ll examine what avoidant personality disorder is. We will also see how therapy and medication can be used to help. This isn’t a comprehensive source on the topic. For more information, talk to your primary doctor or healthcare provider.
What is Avoidant Personality Disorder?
Avoidant personality disorder is a mental health condition characterized by sensitivity to rejection. It also includes feelings of inadequacy, avoidance of social interactions, extreme shyness, and feelings of inferiority. A diagnosis is usually made when these behaviors interfere with daily life. Avoidant personality disorder is a Cluster C (anxious and fearful) personality disorder. There are four subtypes of APD.
- Phobic: Irrational fear of certain objects/situations;
- Conflicted: Characteristics include confusion, paroxysmic, and unresolved feelings of worry;
- Hypersensitive: Intense suspicion and distrust; panicky;
- Self-Deserting: Avoidance of self-awareness.
Symptoms of Avoidant Personality Disorder
Someone suffering from avoidant personality disorder will avoid social situations. They will not be meeting new friends or speaking in public, due to shyness, fear of being rejected by others or feeling inadequate compared to others. Some other behaviors to look for include:
- Feelings of inadequacy/inferiority;
- Mistrust for others;
- Extremely self-conscious;
- Difficulty completing job;
- Extreme anxiety/shyness in social situations;
- Avoiding physical contact;
- Self-critical about issues related to others;
- Hypersensitivity to rejection/criticism.
Causes of Avoidant Personality Disorder
It’s not clear what causes one to develop avoidant personality disorder. Scientist speculate that the cause may be a combination of biological, psychological, and social influences. From a biological standpoint, one would say the disorder is hereditary.
From a psychological and social standpoint, it is the environment. Children and adolescents with anxiety disorders that are fearful and shy in new situations have a greater chance to develop APD. So do children and adolescents that suffer emotional neglect or rejection from their peers. It’s likely that APD develops due to multiple factors.
Other Issues that Relate to Avoidant Personality Disorder
Avoidant personality disorder is prevalent in those with anxiety disorders. Moreover, APD is more prevalent in those who have co-morbid social anxiety disorder and generalized anxiety disorder (GAD) than those who have only one. Some studies show prevalence rates at 45% for those with GAD. It is also around 56% for those with obsessive-compulsive disorder (OCD).
Those with APD experience physical and psychological side effects. Firstly, physical ones include lack of intimacy due to avoiding physical contact and issues getting work done. Secondly, psychological ones can include low self-esteem, depression, unregulated emotions, emotional outbursts, and panic attacks.
Avoidant Personality Disorder Treatment Options
Treatment options for avoidant personality disorder include therapy that can be:
- Cognitive behavioral therapy (CBT);
- Exposure therapy;
Medications can also be prescribed to manage APD, like selective serotonin re-uptake inhibitors (SSRIs) or sedatives, but these are used to control other aspects of the illness.
A study shows that CBT is helpful in treating APD. This is because the cognitive behavioral therapy approach assumes that someone’s thinking patterns are inaccurate and distorted. Therefore, this created the foundation for their disorder. A CBT therapist will use techniques to confront thinking patterns and refute the assumptions surrounding these patterns. For example, a client may feel inferior and that their company isn’t appreciated. The therapist would ask the client to name friends that enjoy their company and think back to social interactions that were enjoyable. So the client’s worries are unfounded. This technique is called cognitive restructuring.
Exposure therapy is safe when used by an experienced therapist. Research shows it can help people overcome their anxiety and other mental health issues. This therapy has two approaches: flooding and desensitization. Flooding has the client confront their fears head on. Meanwhile, desensitization has the client gradually face their fears. Let’s say a client is extremely shy and goes to great lengths to avoid social interaction. Flooding would have the client go to a party. Or with desensitization, the client can walk down the block in front of their house. Then, the client visits a friend, goes to the grocery store, etc.
Psychotherapy is the main form of treatment for avoidant personality disorder. This type of therapy focuses on changing a person’s thinking and behavior. It is a combination of cognitive therapy and behavioral therapy. Medication is also involved in this route. SSRIs and sedatives quell anxiety, and when used in conjunction with psychotherapy work wonders.
Avoidant Personality Disorder Treatment in Real Life
In a case study conducted by Dr. Sam Vaknin, he takes notes during a therapy session with Gladys. She is a 26 year old female suffering from avoidant personality disorder. Vaknin lets Gladys start the session, with her saying she wants to be normal. She’s having issues at work. Her boss ridicules her publicly. This, in turn, makes her avoid socializing with peers and clients.
When asked to describe herself, she says she’s an ugly duckling that no man would want. She shuns the thought of group therapy. She continues to describe herself as a social cripple that turned down a promotion due to social interaction. Her boss thought less of her. According to her, it’s all her fault and the boss overestimated her abilities in the first place.
When asked to describe how people saw her, she said: shy, timid, lonely, isolated, unfriendly, tense, etc. She described herself in the same way. Then, she said that she accepts others’ flaws and that other people should accept hers.
Wrapping It Up
Even when someone with APD goes to therapy, it can be quite a challenge to break them of their habits. This happens because the habits have usually been ingrained into their brain over years.
Avoidant personality disorder can be difficult to treat. Consequently, they want what they’re afraid of: social interaction. But with even just a little bit of determination and a good therapist, they can overcome their disorder.
Leave a comment if you or someone you know has APD, or has tried any of the above treatments, along with others. Take care.
Images from pixabay.com.