• Avoidant personality disorder (AVPD) is signified by a persistent feeling of distress when the individual is in social gatherings that require them to interact with others.
  • Avoidant behaviors include avoiding social situations, deflecting praise, and abstaining from making new friends.
  • Those with AVPD have difficulty communicating with others, are preoccupied with being or feeling criticized, and view themselves as less than others.
  • While there isn’t one clear cause of APD, the majority of experts agree that genetic, environmental, and psychological factors all play a role.
  • Therapy can prove effective for those with APD, so long as they take that leap of faith and place trust in their therapist who will teach them to reevaluate negative beliefs.

Avoidant personality disorder (AVPD) is a personality disorder signified by a persistent feeling of distress when the individual is in social gatherings that require them to interact with others. This distress is “so great that a person can and will steer clear of any situation that may require such socialization for many years and even most of their life if left untreated,” explains Elizabeth Fiser, Psychiatrist Mental Health Nurse Practitioner (PMHNP) at Thriveworks. 

Having AVPD is more than being introverted or inept in situations with other people; those with this disorder have serious difficulty communicating with others and fostering healthy relationships in their everyday. They feel inadequate and are extremely sensitive to criticism, disapproval, or rejection.

What Is an Example of Avoidant Personality Disorder?

A person with avoidant personality disorder is likely to skip out on social interactions. And when they do attend, they may not speak up because they’re afraid to say something wrong. 

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

Symptoms of Avoidant Personality Disorder

Avoidant personality disorder symptoms are centered around 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

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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. 

Special note: Avoidant personality disorder symptoms might be observed in youngsters and adolescents, but the diagnosis cannot be made in young kids. 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. 

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. 

“This disorder can persist throughout someone’s lifetime, but it is extremely rare,” explains Fiser.  With treatment, the individual can learn to better manage their symptoms and correct the negative thoughts/beliefs that contribute. 

Avoidant Personality Disorder Treatment

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. Therapy, medication, or a combination of the two, can prove effective. 

Therapy: 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: 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 often recommended 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 this 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.