Avoidant Personality Disorder – Causes, Symptoms and Treatment

We all have moments when we do not want to interact with other people. Whether it is due to social fatigue, brief periods of insecurity or low self-esteem, or because some of us are introverts, sometimes we want to be alone.

But because humans are social creatures who need each other to survive, we put up our big boy pants and let ourselves be known, and our voices heard. But for some people, this is not the case; these people suffer from an enduring and debilitating social anxiety and a fear of rejection.

This may be due to a condition known as avoidant personality disorder. An avoidant personality disorder is characterized by feelings of extreme shyness and social inhibition.

People who suffer from this disorder often feel inadequate and sensitive to negative criticism. They have a severe fear of rejection and are usually socially awkward. This can cause significant problems in their life as it affects their ability to interact with others and maintain a stable relationship.

People with avoidant personality disorder usually consider themselves unworthy and socially unappealing. They fear being rejected, ridiculed, humiliated, or disliked. They may go great lengths to avoid this or becoming involved with others unless they are sure that they would be liked.

An avoidant personality disorder may be attributed to childhood emotional neglect. It is, however, possible for the condition to occur without any history of neglect or abuse.

About 2.5 percent of the general population has this condition, and it is said to occur equally in both men and women. Avoidant personality disorder typically begins in childhood and continues into adulthood.

Causes Avoidant Personality Disorder

There is no known cause for avoidant personality disorder. However, genetic and environmental factors may play a significant role in the development of the condition.

There is a tendency for it to appear in certain families, and this may suggest that it can be inherited through genes. The disorder may also be triggered by environmental factors like parental abuse or neglect and peer rejection, which can have a significant impact on one’s self-esteem and self-worth.

Furthermore, there is no way of knowing who would develop the disorder. People who have avoidant personality disorder are typically shy as children—however, not everyone who is timid as a child goes on to develop the condition.

In the same vein, not every adult who is shy has an avoidant personality disorder. An avoidant personality disorder may begin to manifest at the point when you start avoiding other people or certain situations.

Symptoms of Avoidant Personality Disorder

Below are common signs associated with avoidant personality disorder:

  • Feelings of inadequacy
  • Social inhibition
  • Hypersensitive towards negative criticism or feedback
  • The overwhelming need to be liked
  • Anxiety over saying or doing the wrong thing
  • Lack of assertiveness
  • Low self-esteem
  • Being a people-pleaser
  • Lack of trust in others
  • Avoiding interaction in work environments
  • Avoiding social situations or events
  • Avoiding situations due to the fear of rejection
  • Negative self-image or self-worth
  • Self-isolation
  • Always on the lookout for signs of disapproval or rejection
  • No social network or close friends
  • Anxiety in social situations
  • Fearful and tense demeanor
  • Lack of pleasure in activities (Anhedonia)
  • Unwilling to try new things or take risks

Avoidant personality disorder has been associated with an anxiety disorder. Studies have shown that approximately nearly 40% of people with panic disorder and agoraphobia also have an avoidant personality disorder.

Another condition commonly found with this disorder is Post-traumatic stress disorder (PTSD).

People who are avoidant are often prone to self-loathing, and in some cases, self-harm. Substance abuse, particularly those dealing with alcohol, heroin, and benzodiazepines, are common with avoidant personality types.

Diagnosis

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) of the American Psychiatric Association, a person is said to have avoidant personality disorder if they show four of the following symptoms.

  • Avoids occupational activities that involve significant contact with others, due to fears of criticism, disapproval, humiliation or rejection
  • Displays inhibition in new interpersonal situations because of feelings of inadequacy
  • Unwillingness to get involved with people unless certain of being liked
  • Restraint within intimate relationships because of fear of being ridiculed or shamed
  • Views self as socially awkward, unappealing, or inferior to others
  • Preoccupied with the fear of being criticized or rejected in social situations
  • Unusual reluctance to take engage in new activities or take personal risks that may have embarrassing consequences

Also, the International Classification of Diseases and Related Health Problems (ICD-10) by the World Health Organization (WHO) lists avoidant personality disorder as anxious personality disorder.

The condition is characterized by the presence of at least four of the following:

  • Avoidance of social activities that involve a high level of interpersonal contact because of fear of criticism, disapproval, or rejection
  • The belief that one is socially inept, personally unappealing, or inferior to others
  • Persistent and pervasive feelings of anxiety, tension, and apprehension
  • Overwhelming preoccupation with being criticized or rejected in social situations
  • Restrictions in lifestyle due to the need to have physical security
  • Unwillingness to become involved with people unless there is the certainty of being liked

Treatment

Psychotherapy, also known as talk therapy, is the most effective method of treating avoidant personality disorder. The primary goal of therapy is to help identify the unconscious beliefs about yourself and how others perceive you.

It could also help identify triggers and help you function better socially and at work.

Psychodynamic therapy is a form of psychotherapy that helps you become aware of your unconscious thoughts and understand how past experiences influence your current behavior.

This therapy enables you to examine and resolve past emotional pains, stress, and conflicts. Then you can move on in life with healthier self-worth and how others see you.

Cognitive-behavioral therapy, on the other hand, helps you recognize and replace unhealthy beliefs and thought processes. The therapist will encourage you to examine your thoughts and beliefs and test them to see if they have a factual basis or merit.

They will also help you regulate your behavior and develop alternative, healthier thoughts.  There is no known medication that has been approved to treat this condition. Your doctor may, however, prescribe antidepressant medications if you have co-occurring depression or anxiety.

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Victor Anunobi
Victor Anunobi is an environmentalist, writer and movie enthusiast living in the city of Lagos, Nigeria. He enjoys long walks, food and alternative music.

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