Avoidant personality disorder (AVPD) is a personality disorder characterized by a high sensitivity to perceived judgment from others and extreme discomfort with social contact and relationships. This distress is so great that a person will likely avoid any situation that may require a lot of socializing or closeness to others for many years, even most of their life, if left untreated.
Having AVPD is more than being introverted in situations with other people; those with this disorder have serious difficulty communicating with others and fostering healthy relationships in their everyday life. They feel inadequate and are extremely sensitive to criticism, disapproval, or rejection.
What Is an Example of Avoidant Personality Disorder?
Someone with avoidant personality disorder will often appear as a “loner;” you might find yourself wondering why this person seemingly doesn’t have any friends. Another example is someone who avoids any sort of extra socialization within their role at their job or school. This can also look like someone who is “unmotivated,” though, in reality, they deal with intense fear and worry about rejection and judgment, which might cause them to be afraid to try new things, be around new people, or learn a new skill.
These individuals have a fear of rejection and a fear of criticism; they worry that they’ll blush, stutter, or be embarrassed in some other way. They spend a lot of time anxiously studying others to understand if they are accepted or rejected.
What Are Avoidant Behaviors?
Individuals with AVPD engage in avoidant behaviors, or behaviors used to escape situations that trigger difficult thoughts and feelings. Avoidant behaviors include:
- Avoiding social situations
- Foregoing new opportunities
- Deflecting praise
- Refusing a promotion
- Abstaining from making new friends
- Refusing to attend family gatherings
What Are the Symptoms of Avoidant Personality Disorder?
Avoidant personality disorder symptoms are centered around fear of judgment, extreme shyness, feeling inadequate, and avoiding social contact. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), reports that an individual who is diagnosed with AVPD will experience at least four of the following:
- They avoid work activities that include significant contact with others because of their fear of being criticized or rejected
- The individual doesn’t associate much with others unless they’re sure they’ll be accepted and/or liked
- They hold back in intimate relationships for fear of being embarrassed or made fun of
- The individual is preoccupied with being criticized, rejected, or disliked in social settings
- They view themselves as socially inept or less than
- They are abnormally reluctant to try new things because they fear embarrassment
How Is Avoidant Personality Disorder Diagnosed?
Avoidant personality disorder must be diagnosed by a licensed mental health professional. They talk to clients about their symptoms and use the diagnostic criteria put forth by the DSM-5 to determine whether they have APVD. From there, they can create a personalized treatment plan for the individual with APVD or refer them to another mental health professional who can.
It’s worth noting that, though traits of avoidant personality disorder might be observed in kids and adolescents, the diagnosis cannot be made in young kids or adolescents. This is due to the fact that being shy, feeling afraid of strangers, and being especially vulnerable to negative comments are all normal behaviors at this age.
Is There an Avoidant Personality Disorder Test?
There is not a formalized test to diagnose avoidant personality disorder, but seeking help from a qualified mental health professional is the best course of action. In their diagnostic interview, clinicians will assess patients for:
- Level/depth of intimacy in interpersonal relationships
- View of self
- Socialization habits and preferences
- History of interpersonal relationships and patterns and trends within those relationships
These symptoms and traits will have been with the patient throughout their lives, impairing their ability to function effectively in society. They are not passing parts of their evolution, but rather persistent qualities and characteristics that they must manage on a daily basis.
Those with avoidant personality disorder will also often have poor insight into their own personal strengths and capacities and demonstrate poor insight due to their low opinion of themselves.
What Causes Avoidant Personality Disorder?
Like most mental health disorders, there isn’t one clear cause of AVPD. However, most experts think avoidant personality disorder is caused by a combination of:
- Genetic factors, in which the individual’s parents or other close relatives have avoidant personality disorder.
- Environmental factors, or how the individual interacts in early development with family members, friends, and other children.
- Psychological factors, or one’s personality and temperament, and the coping skills they’ve learned to deal with stress.
What Are the Risk Factors for Developing Avoidant Personality Disorder?
In addition to the above, risk factors for developing avoidant personality disorder include:
- Personal history of another mental health condition, such as anxiety, depression, or another personality disorder
- Family history of another mental health condition, like those listed above
- Childhood abuse or neglect
- Another form of trauma as a child, related to social rejection/ridicule
- Altered appearance (that might be received poorly by others), due to a physical injury, illness, trauma, or genetics
How Serious Is Avoidant Personality?
Avoidant personality disorder can cause difficulties in one’s personal and professional life. Without treatment, they’re likely to isolate themselves from others and are at a greater risk of developing other mental health problems, like depression, anxiety, and substance abuse.
AVPD can persist throughout someone’s lifetime, but it is rare. With treatment, the individual can learn to better manage their symptoms and correct the negative thoughts or beliefs that contribute.
What Does High-Functioning Avoidant Personality Disorder Look Like?
Those with high functioning avoidant personality disorder can be married, have close friends, and be in a romantic relationship while still having this disorder.
Someone might be able to have the role of partner/family member/friend/coworker but lack any sort of emotional, physical, or other levels of intimacy within those relationships. Those relationships are often perceived as “surface level” relationships, as the person might have a large quantity of friends but is not intimately connected to them.
How to Love Someone With Avoidant Personality Disorder: How Can You Help Them?
It is not rare for people to love someone with avoidant personality disorder—they can and often do have romantic and/or interpersonal friendships.
One of the best things to do is be supportive. Don’t try to fix their problems, but encourage them to seek professional help. You can be supportive by encouraging your partner to engage more frequently within their social support group or offering to join them to help ease the anxiety.
Adding fun to intimacy can also help deepen the relationship. Maybe you get a flashcard game that asks a wide variety of questions: funny, personal, etc. Perhaps you find ways to build shared memories and moments together. Lastly, make sure you communicate your wants and needs to this person directly so they know exactly how to meet your needs. Each of these allow you to demonstrate consistency in your support of them.
Avoidant Personality Disorder Treatment
Therapy, medication, or a combination of the two can prove effective in treating AVPD. Unfortunately, many people with AVPD don’t seek help because they fear the mental health professional will judge or reject them. However, when an individual does seek help, the journey is often successful.
Cognitive behavioral therapy (CBT), a form of talk therapy, is a common approach used for those with AVPD. As mentioned earlier, the therapist works with the individual to explore, reevaluate, and change their negative beliefs. In addition, they help the individual to evaluate the risks of engaging with others, and the two work together to modify them.
Therapy also helps the person to learn proper social skills — first with the therapist, where they can practice how to interact with others. When the individual has the skills to function well with others, they can gradually enter social situations, gain confidence, and find that the reality of the situation is much less terrifying than they imagined.
Medication cannot treat the causes of avoidant personality disorder; however, there are certain medications that can offer relief from one’s symptoms. For example, it’s normal to experience feelings of both anxiety and depression with avoidant personality disorder. Antidepressants and anti-anxiety medication can ease these symptoms.
Because medication can’t directly treat the underlying feelings and contributors to avoidant personality disorder, it’s important that these individuals don’t just take medication for their AVPD, but also work with a therapist.
If you are experiencing symptoms of avoidant personality disorder, don’t be afraid to reach out for help. Better yet, push through your fear and schedule an appointment with a mental health professional. You can learn to address the anxiety that surrounds social rejection and live a better life.