Avoidant Personality Disorder: Symptoms, Causes, & Treatment

Avoidant personality disorder is one of the ten personality disorders recognized in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). These are categorized into clusters, with avoidant personality disorder falling under Cluster C—conditions characterized by fear and anxiety. Like other personality disorders, avoidant personality disorder can significantly impair quality of life if left untreated. Read on to learn more about avoidant personality disorder and how to get help for yourself or a loved one. [acf field=cta1]

What Is Avoidant Personality Disorder?

Avoidant personality disorder (AVPD) is a mental health condition in which people feel extreme inadequacy, inferiority, and social inhibition [1]. Individuals with avoidant personality disorder often believe that other people also perceive them as inadequate or inferior, and often are very sensitive to rejection or criticism. Combined, these traits can make a person seem painfully shy or distant; people with avoidant personality disorder also tend to avoid any situation which can expose them to this criticism or rejection. Avoidant personality disorder can severely impact a person’s quality of life. Because people are extremely sensitive to rejection, they may have a difficult time connecting with others or seeking out friendships. Intimate relationships and close friendships are also hard to come by if you have an avoidant personality disorder.

Is Having an Avoidant Personality Type the Same as Having AVPD?

Although some symptoms may overlap if you are avoidant or have an avoidant dismissive attachment style, it is not the same thing as avoidant personality disorder. In order to distinguish the two, one must look at the severity and impact on daily function and life. Only a mental health professional can give a clinical diagnosis and determine whether someone simply has an avoidant personality type or if they have avoidant personality disorder.

What’s the Difference Between Social Anxiety and AVPD?

Avoidant personality disorder and social anxiety disorder share overlapping symptoms, but they are distinct conditions [2]. Social anxiety typically stems from a fear of being judged or watched, while avoidant personality disorder is rooted in feelings of low self-esteem and perceived inferiority. Although they are categorized as two separate mental disorders [3], some mental health professionals believe that AVPD may represent a more severe and pervasive form of social anxiety disorder.

Is Having an Anxious Avoidant Attachment Style Similar to Having AVPD?

Similarly to the links between SAD and AVPD, having an anxious avoidant attachment style might present symptoms like those of AVPD. However, they are not the same thing. An anxious avoidant attachment style shows up as a pattern of relating in relationships that is characterized by a fear of abandonment, and although it can complicate intimacy sometimes, it does not interfere severely with daily life. AVPD is its own disorder that causes extreme behaviors, such as refusing to show up in social settings. 

What Are the Causes of Avoidant Personality Disorder?

Personality disorders are one of the least understood mental health conditions in psychology and psychiatry. Although there is no exact known cause of avoidant personality disorder, researchers believe that AVPD might develop due to the following risk factors.

Risk Factors for Avoidant Personality Traits

• Genetics. A handful of studies propose that there is a hereditary component to personality disorders, including avoidant personality disorder. 
• Temperament during infancy. Researchers discovered connections between temperament traits during infancy and avoidant personality disorder. These traits include rigidity, heightened sensitivity, excessive harm avoidance, and intense fearfulness.
• Attachment style. Individuals with a fearful attachment style are believed to be more likely to develop AVPD. Fearful attachment style means you want to be close to others but inherently distrust them and have a fear of rejection.
• Early childhood development. Children who experienced rejection and were treated differently than others may be more likely to develop AVPD.

Complications Caused by AVPD

Having avoidant personality disorder can interfere with areas of life that involve significant interpersonal contact, including romantic, familial, and social relationships. In short, it makes it difficult to sustain intimate connections and may lead to a diminished quality of life or co-occurring disorders, such as depression or suicidal ideation. [acf field=cta2]

Avoidant Personality Symptoms

Symptoms of avoidant personality disorder include the following: 

• Struggling with a negative self-image, viewing themselves as inadequate or inferior.
• Worrying excessively about criticism or disapproval.
• Hesitancy to engage with others unless confident of being liked.
• Experiencing intense anxiety and fear in social settings and relationships, often avoiding activities or jobs that involve interaction.
• Shyness and self-consciousness due to fear of making mistakes or feeling embarrassed.
• Tending to overstate potential issues or misinterpret feedback as negative.
• Rarely trying new things or taking risks.
• A staunch belief that you are inferior, and believing that others think the same.
• Being hypervigilant to threats
• Experiencing hypersensitivity to other people’s emotions
• Having people-pleasing tendencies

Examples of Avoidant Behavior

The following are examples of avoidant behavior, but do not encompass all the scenarios that might indicate someone has avoidant personality disorder:

• Declining an invitation to a birthday party for fear of being exposed to judgment or criticism, although there is no threat of that
• Extreme exaggeration of hypothetical problems
• Lacking assertiveness and not making any decisions

These behaviors often mirror those seen in social phobia, but in avoidant personality disorder, the avoidance is driven by a deeper sense of inadequacy and chronic fear of rejection that affects multiple areas of life.

How Is Avoidant Personality Disorder Diagnosed?

Diagnosing avoidant personality disorder can be quite challenging, as individuals with this condition often do not recognize their behavior as problematic. This lack of self-awareness can result in them avoiding treatment altogether, even when assistance is readily available or suggested by others. To accurately diagnose AVPD, mental health professionals typically conduct a comprehensive evaluation that involves checking the DSM-5 AVPD criteria [4] and exploring various facets of an individual’s life. This includes a detailed personal history, an assessment of personality traits, and an examination of coping strategies and interpersonal relationships. The clinician may also look for patterns of avoidance, social anxiety, and feelings of inadequacy that characterize the disorder.  Additionally, it is essential to assess any co-occurring mental health conditions, such as depression or anxiety, as these can significantly impact the individual's overall well-being and treatment options. Understanding these interconnected factors is crucial for developing an effective treatment plan that addresses the unique challenges faced by those with AVPD.

Treatment for Avoidant Personality Disorder

While there's no cure, there are proven methods for treating avoidant personality disorder that can lead to major improvements in emotional well-being and social functioning. Common methods of treatment are psychotherapy and medication.

Common Avoidant Personality Disorder Therapies

Psychotherapy, commonly known as talk therapy, consists of regular sessions with a therapist to explore thoughts, feelings, and behaviors. Psychotherapy has proven beneficial to patients who struggle with avoidant personality disorder.  There are different kinds of therapies that a mental health professional might try out with a patient who has AVPD, including: 

• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavior Therapy (DBT)
• Psychoanalytic Therapy
• Psychoeducation

The main goal of talk therapy is to provide individuals with avoidant personality disorder the tools they need to improve their quality of life. This involves recognizing personal challenges, learning from past experiences, and developing a deeper awareness of emotional distress. In some cases, therapists may also evaluate for overlapping traits with dependent personality disorder, particularly in individuals who exhibit intense fear of rejection and a strong need for reassurance. Identifying these traits can help tailor the therapeutic approach and ensure more effective outcomes.

Medication

While no specific medications are approved for treating AVPD, some mental health professionals may prescribe medications to help manage associated symptoms like anxiety and depression. These medications can include antidepressants, anti-anxiety medications, mood stabilizers, or antipsychotics.

Prognosis & Management

The prognosis for AVPD depends on if it is treated or not. If untreated, avoidant personality disorder can lead to depression, substance use disorder, eating disorders, dissatisfaction with life, impaired social functioning, or strained work productivity. Studies show that those with AVPD also may have a higher rate of suicidal thoughts and attempts.  However, if someone is getting treated for AVPD, it can help improve quality of life. Treatment for AVPD is a long process, but sticking to it and continuing it can help an individual relate to others in a better manner and manage the negative symptoms of AVPD. [acf field=cta3]

Get Insurance-Covered Treatment for Avoidant Personality Disorder at Connections 

Living with avoidant personality disorder can be incredibly challenging. If you or someone you care about is navigating this difficulty, Connections is here to help. Our team is committed to providing compassionate care that addresses the whole person, not just their symptoms. We offer a range of services designed to promote well-being and support recovery, including:

• 24/7 supervision
• Customized care plans
• Medication management
• Safe and nurturing living environments
• Cognitive Behavioral Therapy (CBT)
• Schema Therapy
• Motivational interviewing

Our evidence-based approaches are specifically tailored to assist individuals with avoidant personality disorder while also addressing co-occurring issues such as:

• Depression
• Anxiety
• Mood disorders
• Eating disorders
• Suicidal thoughts

At Connections, compassion is at the heart of our mission. Experience the transformative impact that a leading mental health facility can have on your journey to recovery. Contact us at 844-759-0999 to learn more about the resources and support we provide for those dealing with personality disorders. Sources [1] https://my.clevelandclinic.org/health/diseases/9761-avoidant-personality-disorder [2] https://my.clevelandclinic.org/health/diseases/22709-social-anxiety [3] https://pubmed.ncbi.nlm.nih.gov/26332087/ [4] https://www.ncbi.nlm.nih.gov/books/NBK559325/