All of us experience periods of shyness, social awkwardness, and fear of rejection among our peers. This is especially true when we encounter new social situations or are going through a difficult time in life. These experiences are normal, though usually fleeting. Most of us, especially if we tend to be introverted, just need to ease into social situations slowly and will begin to feel at ease.
But what if you feel uncomfortable in social situations pretty much all the time? What if you experience feelings of extreme anxiety anytime the idea of interacting with others is even mentioned? What if the idea of being rejected or disliked fills you with unshakable dread, no matter how you try to reason your way out of it? What if you avoid social situations at all costs and this avoidance affects your ability to maintain relationships, work, or function normally?
If this is the case, you may struggle with avoidant personality disorder, a disorder marked by severe anxiety and chronic avoidance of social situations.
Avoidant Personality Disorder Defined
Avoidant personality disorder is one of ten personality disorders recognized by the American Psychiatric Association (APA) and is listed in the DSM-5 manual. The APA defines avoidant personality disorder as “a pattern of extreme shyness, feelings of inadequacy and extreme sensitivity to criticism,” and notes that people with the disorder often avoid relationships with anyone they fear will not like or accept them. Those with avoidant personality disorder usually also have poor self-image and are constantly preoccupied with fears of social rejection or humiliation.
According to the journal Psychology Research and Behavior Management, about 1.5-2.5% of the population has avoidant personality disorder. In most cases, the disorder is not diagnosed until adulthood because extreme shyness is common in childhood, and most children outgrow it. If you haven’t outgrown it, and your “people avoidance” becomes extreme, chronic, fills you with dread, and causes you to actively avoid social situations, you might be diagnosed with the disorder by a medical professional.
Psychologists have not reached a consensus as to what causes avoidant personality disorder, but agree that in most cases, it’s a combination of factors. The disorder tends to run in families, so there may well be a genetic aspect at play here. But usually there are circumstantial triggers as well, including adverse early childhood experiences such as parental detachment, abuse, neglect, and even overprotective parenting.
How To Know If You Have Avoidant Personality Disorder
A psychiatrist, psychologist, or MD is the only person who can diagnose you with avoidant personality disorder, but there are some common symptoms of the disorder that can clue you in as to whether you, or someone you know, suffer from it.
Here are some typical symptoms of avoidant personality disorder:
- Trouble making and maintaining friendships
- Very few close friends
- Extreme shyness in social situations
- Avoiding social situations whenever possible
- Always worrying about social approval
- Feeling like everyone hates you
- Constantly fearing rejection by others
- Persistent fear of social humiliation or embarrassment
- Very low self-esteem
- Unwillingness to try new things or enter new situations
In its most severe form, avoidant personality disorder may extend beyond simple social situations and make it difficult for you to work or even leave your home. This is one of the dangers of not seeking treatment for the disorder, as it tends to get more unmanageable as time goes on. In addition, people whose avoidant personality disorder is not treated may develop comorbid disorders such as depression or substance abuse disorders.
Treatment and Hope for Avoidant Personality Disorder
As someone who has difficulty with social situations, you might find the idea of seeking out a diagnosis absolutely unfathomable — and that is understandable. But it’s the only way to know for sure if what you are experiencing is, in fact, avoidant personality disorder, and getting properly diagnosed is the first step toward feeling better and living the life you want for yourself.
After a diagnosis of avoidant personality disorder, the first line of treatment is usually psychotherapy. Successful therapy modalities have included exposure therapy, cognitive behavioral therapy (CBT), and psychodynamic psychotherapy. Although there isn’t any medication specifically geared toward treating the disorder itself, psychotropic medications may help lessen anxiety and depressive symptoms. An in-person or online psychiatrist can prescribe these medications to help treat avoidant personality disorder.
It’s important to understand that there is hope for avoidant personality disorder. As the Cleveland Clinic notes, personality disorders are typically difficult to treat, but avoidant personality disorder might be one of the easier personality disorders to treat. People who have avoidant personality disorder actually often crave healthy relationships and are able to maintain them — the problem is that they don’t believe they are worthy of such relationships.
Feeling driven to find healthy relationships and companionship may be one of the motivating factors for people with avoidant personality disorder to get treatment. The rewards of treating this disorder are plentiful; after all, experiencing loving and satisfying connections with others is something we all deserve.