Avoidant Personality Disorder - An Overview

What Is Avoidant Personality Disorder?

Avoidant personality disorder (AVPD) is defined as a constant feeling of being inadequate and highly perceptive of others’ judgment of themselves and a sense of escape when forced into social interaction. In other words, individuals suffering will feel a heightened sense of discomfort and would want to avoid interpersonal contact with anyone at all costs. An avoidant personality disorder is closely related to social inhibition. Social inhibition is defined as the conscious or subconscious effort an individual puts in order to avoid social interaction.

The clinical sign of the disorder is an extremely shy personality, easily offended by criticism, fear of being intimate, inferiority complex, and social isolation. An avoidant personality disorder is also known as cluster C personality disorder. Psychologists have long claimed the presence of other mental illnesses along with avoidant personality disorders, such as anxiety disorders and social anxiety disorder, to be exact. The rate of occurrence of avoidant personality disorder is low, but cases have been reported of individuals suffering from AVPD. The prevalence of avoidant personality disorder is equal in both men and women.

The most common factor that triggers this type of personality disorder is childhood neglect (specifically emotional). A child neglected in their life (childhood in particular) by their parents and peers might develop avoidant personality disorders later on in their life.

Individual suffering is often recognized as being socially awkward individuals.

Everyone is critical of being judged, criticized, rejected, and embarrassed. Still, when individuals are already shy and have difficulty interacting with people, they tend to be extremely cautious and sensitive while receiving criticism. These individuals focus on their shortcomings excessively and extensively. As a result, they have difficulty managing a relationship, as their fear of rejection and intimacy overpowers their need to be in a relationship. This results in being socially outcasted or rejected, making the situation worse.

What Causes Avoidant Personality Disorder?

• Similar to personality disorder, the exact cause of avoidant personality disorder is yet to be known. But it has been theorized that genetics and environmental factors can cause the development and evolution of avoidant personality disorder.

• One of the leading causes of avoidant personality disorder is said to be childhood emotional neglect. Children who have been exposed to emotional neglect tend to be overbearing and socially outcasted. These children have trouble accepting and receiving criticism and have a tendency to be socially awkward.

• Childhood exposure to trauma, neglect, and abuse has low social interaction and may develop personality disorders later on.

• Often the development of the disorder begins in their early childhood, but the development of symptoms begins later in their life. Almost every child has a shy personality, but when the child develops, they outgrow their shy personality; however, an individual with some genetic or environmental traits may not outgrow their shy personality but instead develop an extremely shy nature.

• As a result, the child loses their sense of worth, has low self-esteem, and can harm their potential relationships (including both present and future relationships).

What Are the Types of Avoidant Personality Disorder?

An avoidant personality disorder is majorly categorized into the following types:

• Phobic Avoidant Personality Disorder: Individual suffering portrays apprehensive behavior towards others. Individuals experiencing are often seen dreading any sort of social interactions or circumstances. It majorly involves dependent personality disorder features. Dependent features include needy, passive, and clingy behavior to an excessive degree.

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• Conflicted Avoidant Personality Disorder: Individuals suffering have constant conflict inside their heads; they have internal discord and conflict amongst themselves. They fear dependency and intimacy. The internal struggle ranges from initial fights to irreconcilable issues amongst themselves. They are often confused, tormented, and show negative features. Negativist features include being skeptical, critical, and pessimistic behavior toward themselves and others.

• Hypersensitive Avoidant Personality Disorder: Individuals suffering are intensely cautious, suspicious, terrified, and edgy about the people around them (including known and unknown). Individuals portray paranoid personality disorder features. Paranoid features include a sense of distrust and suspicion of others.

• Self-Deserting Avoidant Personality Disorder: Individuals suffering have self-awareness; they understand their condition. This group of individuals learns to compartmentalize their issues of social interaction. They avoid feeling low or anxious by casting away painful memories or choosing not to talk about them. Individuals experiencing self-deserting avoidant personality disorder show depressive features. Depressive features include hypersomnia, fatigue, low self-esteem, and inability to make decisions.

What Is the Difference Between Avoidant Personality Disorder and Social Anxiety Disorder?

• The golden difference between social anxiety disorder and avoidant personality disorder is the presence of the disorder. An individual suffering from avoidant personality disorder has continuous and compelling fear of all social interaction. In contrast, a person suffering from social anxiety disorder has social anxiety in restricted or selected situations such as public meetings or speaking.

• There are high chances of other mental illnesses accompanying both the avoidant personality disorder and social anxiety disorder. Individuals with an avoidant personality disorder may also have substance abuse disorder, dual-diagnosis or co-occurring disorder, or suicidal behavior and tendencies. Also, in the majority of the cases, social anxiety disorder is observed.

• Individuals with a social anxiety disorder may suffer from depression and obsessive-compulsive disorder (OCD) and may develop personality disorders.

• A clinical sign of both includes misdiagnosis with a schizoid personality disorder. A schizoid personality disorder is characterized by shying away from social gatherings and activities with limited or no emotional expense. The distinct feature between avoidant personality disorder, social personality disorder, and schizoid personality disorder is that individuals with schizoid have little to no empathy for others.

• Some psychologists claim that social anxiety disorder and avoidant personality disorder are almost the same disorder, except that avoidant personality disorder is the extreme version of social anxiety disorder. This means all the symptoms of social anxiety are at their excessive levels, such as more depressed behavior, more phobia for social gatherings, and hypersensitivity towards criticism and judgment from others. However, this hypothesis has not been conceptualized yet.

The most significant difference is that social personality disorder is the fear of specific social circumstances. In contrast, an avoidant personality disorder is the fear of intimacy and social gathering in general.

What Are the Symptoms of Avoidant Personality Disorder?

Avoidant personality disorder comprises other symptoms and fear of social interaction and intimacy. Some of the common symptoms observed in an individual suffering from avoidant personality disorder are:

1. Constant feeling of inadequacy.

2. Fear of rejection.

3. Sensitivity to criticism.

4. Avoids meeting people or establishing interpersonal contact.

5. Poor relationships, both romantic and platonic.

6. Low self-esteem.

7. Poor hygiene.

8. Depressive behavior and mood.

9. Feeling blue often.

10. Avoids or fears getting into social engagements.

11. Oversensitivity or hypersensitivity to judgments and comments of others.

12. Seclusion or social isolation.

13. Inability to make decisions.

14. People pleaser.

15. Lacks assertive behavior and nature.

16. Often experiences miscommunication.

17. Have difficulty trusting others.

18. Inferiority complex.

19. Obsessive-compulsive disorder (OCD).

20. Substance abuse disorder.

21. Anxiety disorder.

22. Suicidal tendencies.

23. May suffer from post-traumatic stress disorder (PTSD).

24. Panic attacks.

25. Anxiety attacks.

What Is the Treatment of Avoidant Personality Disorder?

Treatment for avoidant personality disorder ranges from medicinal therapy to psychotherapy. Many kinds of research and studies have proven that medicinal therapy, when used in conjunction with psychotherapy, yields a better result with low recurrence rates. The treatment plan for avoidant-personality disorder includes:

1. Medicinal Therapy: Medicinal therapy for avoidant personality disorder includes antidepressants, and selective serotonin reuptake inhibitors ( SSRIs), which in particular have proven to be extremely helpful in patients who have an avoidant personality disorder. As the severe case involved signs of depression, antidepressants have proven to lower these symptoms and reduce the severity of the disorder. The most commonly prescribed SSRIs are Citalopram, Fluoxetine, and Sertraline. Other medicines prescribed in the case of avoidant personality disorder are anxiolytics (anti-anxiety medicines).

Individuals suffering from social inhibition due to avoidant personality disorder may suffer from crippling anxiety on the prospect of being social or receiving comments and criticism about themselves. They may, on occasion, experience a panic attack and, in severe cases, an anxiety attack. Anti-anxiety medications help calm an individual during these scenarios and help them move past successfully. Some of the commonly prescribed anxiolytics are Alprazolam, Clonazepam, and Diazepam.

2. Psychotherapy: Psychotherapy or talk therapy is an excellent subpart of the treatment plan. As discussed above, when used in conjunction with medicinal therapy, psychotherapy is the most effective treatment option. Different types of psychotherapy involved in treating avoidant personality disorder are-

• Cognitive-Behavioral Therapy (CBT): Wherein, an individual, is taught to develop their cognitive and behavioral skills. Individuals suffering from fear of social interactions are motivated and encouraged to talk about their anxiety, issues, emotions, feelings, and thoughts. Cognitive-behavioral therapy can only be successful when individuals trust and open up to their therapist or counselor. This helps them heal and move from their distrusting personality to trusting nature.

• Other Therapies: Along with CBT being the main psychotherapy, other therapies suggested in order to help individuals who have avoidant personality disorders are social skills training (individuals are taught to be social and of acceptable nature when indulging in a social setting), group therapy, as the name suggests, individuals are grouped for them to adjust with other individuals and not feel socially outcasted, this helps them understand their condition, be more self-aware and trust more people, and schema therapy (with its namesake, schema therapy is based on CBT, and helps individual to heal their broken or distrusted relationships. It also helps them build a healthy and therapeutic relationship between the therapist and them and also their potential future relationships).

Conclusion:

If an individual suffers daily with the thought or idea of a social engagement and is sensitive and tender towards judgment and criticism by others, then they must visit a healthcare professional. With individuals already having distrusted relationships, it is hard for those suffering to accept and be self-aware of their situation, ask for help, and trust the healthcare professional to help them through this. Therapy is a safe and effective treatment option only when the individual chooses to open up and trust their counselor.

An avoidant personality disorder is a treatable condition when detected early and given symptom-specific treatment. Continuing therapy is another way to ensure a low chance of recurrence.