Avoidant personality disorder (AVPD) is a diagnosable condition marked by a pattern of social inhibition, feelings of inadequacy, and extreme sensitivity to negative evaluation that impacts approximately 1.5-2.5% of adults.1,2 Common symptoms include self-isolation, poor self-image/esteem, extreme anxiety in social settings, and avoidance of situations in which one may be subject to criticism or disapproval.3
What Is Avoidant Personality Disorder?
AVPD is a Cluster C personality disorder marked by severe anxiety and fear. The condition is most often diagnosed in adults aged 18 and over and is considered treatable but incurable. The more symptoms present at greater severity, the more severe the condition.
The diagnostic criteria for AVPD are as follows:1
- A pervasive pattern of social inhibition
- Feelings of inadequacy
- Hypersensitivity to negative evaluation beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:
- Avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection
- Is unwilling to get involved with people unless certain of being liked
- Shows restraint within intimate relationships because of the fear of being shamed or ridiculed
- Is preoccupied with being criticized or rejected in social situations
- Is inhibited in new interpersonal situations because of feelings of inadequacy
- Views self as socially inept, personally unappealing, or inferior to others
- Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing
Symptoms of Avoidant Personality Disorder
If untreated, symptoms of AVPD can become excessively debilitating. Given that symptoms of the condition involve social inhibition, feelings of inadequacy, and extreme sensitivity to rejection/criticism, an otherwise competent person with AVPD may compromise or completely miss out on important social experiences associated with friendships, romantic relationships, work, and otherwise. The experience may prove lonely, which may also contribute to clinical depression.
Symptoms of AVPD include:
- Overly sensitive to criticism or rejection
- Feeling inadequate, inferior, or unattractive
- Avoidance of work activities that require interpersonal contact
- Socially inhibited, timid, and isolated, avoiding new activities or meeting strangers
- Extreme shyness in social situations and personal relationships
- Fear of disapproval, embarrassment, or ridicule4
Symptoms of AVPD are invasive enough that negative feelings become internalized—significantly impairing one’s overall self-concept. When a person struggles to see themself in a positive light, it becomes difficult or impossible to accept and embrace the positivity of others.
Is Avoidant Personality Disorder the Same as Social Anxiety?
Despite similarities between AVPD vs. social anxiety disorder, AVPD is usually more debilitating. Individuals with AVPD internalize social anxiety to an extent that it defines who they are, whereas those struggling with social anxiety can externalize the experience. Accordingly, anxiety for those with social anxiety is more situational; whereas for those with AVPD, it’s constant.5
How to Cope With Avoidant Personality Disorder Symptoms
Although AVPD, like other personality disorders, is incurable, it is treatable. Therapy is highly recommended; however, there are various strategies one may enact personally to cope in everyday situations. The key is to be aware of the condition. When one is aware of having AVPD, they can respond accordingly. Without this awareness, it’s difficult to decipher reality from personal subjectivity.
If you suffer from avoidant personality disorder, try coping by:
- Utilizing mantras: mantras can help reinforce positive thoughts and emotions by continually engaging in positive self-talk such as, “I am worthy,” “I am loveable,” and “I can do this.”
- Using logic to trump subjective thoughts: here, an individual may objectively explore the way one feels by weighing concrete evidence against untrue, maladaptive thoughts and emotions.
- Seeking affirmations: when feeling insecure, seek affirmations from trusted others who will assure you that everything is “OK” while providing an outsider perspective as to the reality of what is happening in any given situation
- Practicing social engagement in safe settings: in safe settings, the risk is low, providing an opportunity to practice interpersonal skills—ultimately increasing confidence over time with successful interactions
- Observing others in social situations: use others to model appropriate behavior in any given situation so long as the behavior is prosocial and not detrimental to the well-being of self or others
- Intentionally putting yourself out there: although stepping outside one’s comfort zone is uncomfortable for most, with practice, this can become the new norm, providing more positive experiences to balance out the negative
Although these recommendations are by no means all-inclusive, they serve as a helpful starting place. Building a set of coping mechanisms takes time and does require some trial and error. Continue with what works while moving past what doesn’t. The more effective coping skills present, the better able one is to move beyond the debilitating anxiety caused by AVPD.
How Therapy Can Help People Manage Their AVPD Symptoms
The best way to manage AVPD symptoms is by fully engaging in therapy. In a therapeutic setting, one may work with a trained professional who is familiar with the signs, symptoms, and effective coping skills associated with AVPD. Cognitive behavioral therapy (CBT) is highly recommended. There is no guarantee that symptoms will fully disappear; however, with management, they will improve over time.
With ongoing support, one may become familiar with living with the diagnosis; continually challenge maladaptive beliefs, thoughts, emotions, and behaviors; work on positive self-talk; experiment with interpersonal skills in varied social situations; and more.
Though there is no medication currently available to treat AVPD, there are ones that may assist with specific symptoms. Antidepressant medications such as selective serotonin and norepinephrine reuptake inhibitors (SSNRIs) and selective serotonin reuptake inhibitors (SSRIs) have demonstrated some efficacy.6 Evidence supporting other mood stabilizer and antipsychotic medication is less clear but may work in some cases.6
With the core of the problem being more so related to deep-rooted anxieties and fears, talking it out is the best course of action whether medication is recommended by a prescribing mental health professional. If you don’t know where to start to find and choose a therapist, explore a free online therapist directory.
Final Thoughts
Avoidant personality disorder symptoms are hard to cope with, but there are ways to move forward. Remember, you’re not alone. Roughly 1.5-2.5% of adults struggle with this condition, which is a significant percentage of the population.2 It helps to acknowledge the condition for what it is, seek professional help, and intentionally and consistently engage in effective coping skills. Progress may feel slow, but the effort is worthwhile.
For Further Reading
Here are additional resources:
Symptoms of AVPD Infographics
