An avoidant personality disorder is characterised by feelings of extreme social inhibition, inadequacy, and sensitivity to negative criticism and rejection. 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. About 1% of the general population has an avoidant personality disorder.
Avoidant Personality Disorder Symptoms
Avoidant personality disorder symptoms include a variety of behaviours, such as:
- Avoiding work, social, or school activities for fear of criticism or rejection. It may feel as if you are frequently unwelcome in social situations, even when that is not the case. This is because people with avoidant personality disorder have a low threshold for criticism and often imagine themselves to be inferior to others.
- Low self-esteem
When in social situations, a person with an avoidant personality disorder may be afraid to speak up for fear of saying the wrong thing, blushing, stammering, or otherwise getting embarrassed. You may also spend a great deal of time anxiously studying those around you for signs of approval or rejection. A person who has an avoidant personality disorder is aware of being uncomfortable in social situations and often feels socially inept. Despite this self-awareness, comments by others about your shyness or nervousness in social settings may feel like criticism or rejection. This is especially true if you are teased, even in a good-natured way, about your avoidance of social situations.
Social Impact of Avoidant Personality Disorder
Avoidant personality disorder causes a fear of rejection that often makes it difficult to connect with other people. You may be hesitant to seek out friendships unless you are certain that the other person will like you. When you are involved in a relationship, you may be afraid to share personal information or talk about your feelings. This can make it difficult to maintain intimate relationships or close friendships. According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a person diagnosed with avoidant personality disorder needs to show at least four of the following criteria:
- Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection.
- Is unwilling to get involved with people unless they are certain of being liked.
- Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.
- Is preoccupied with being criticised or rejected in social situations.
- Is inhibited in new interpersonal situations because of feelings of inadequacy.
- Views self as socially inept, personally unappealing, or inferior to others.
- Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.
Avoidant behaviour may commonly be seen in children or adolescents, but a diagnosis of a personality disorder cannot be made in childhood because shyness, fear of strangers, social awkwardness, or being sensitive to criticism are often a normal part of the child and adolescent development. A mental health professional can assess your symptoms, make an accurate diagnosis, and suggest the appropriate treatment options.
Avoidant Personality Disorder Treatments
As with other personality disorders, a mental health professional will design a treatment plan that is appropriate for you. Avoidant personality disorder treatments vary, but they will likely include talk therapy. If a co-existing condition, such as depression or anxiety disorder, is also diagnosed, appropriate medications may also be used.
Avoidant Personality Disorder and Other Conditions
Other mental health disorders can occur along with avoidant personality disorder. Treatments in these cases will be designed to help with the symptoms of each disorder. A few of the conditions that most frequently occur with avoidant personality disorder include:
- Social phobia, in which a person experiences overwhelming anxiety and self-consciousness in common social situations.
- Dependent personality disorder, in which people rely excessively on others for advice or to make decisions for them.
- Borderline personality disorder, in which people have difficulties in many areas including social relationships, behaviour, mood, and self-image.
Many avoidant personality disorder symptoms are commonly shared among these other conditions, particularly in the case of generalised social phobia. Because of this, the disorders can be easily confused. It may take some time for a mental health professional to make a clear diagnosis and choose the appropriate treatments for you.
Credit: Reviewed by Joseph Goldberg, MD., for WebMD, 13 October 2017.