Avoidant Personality Disorder Vs. Social Anxiety: Key Differences

What Is Social Anxiety Disorder?

Social anxiety disorder (sometimes called social phobia) is a type of anxiety disorder that leads people to become extremely nervous, worried, and self-conscious about interacting with others. Fears of being judged, rejected, or embarrassed drive the symptoms of social anxiety, which may be limited to certain types of social interactions (like dating or groups), or may show up in almost any social setting.¹

Common signs and symptoms of social anxiety disorder include:¹

• Excessive and irrational fears of being criticized or rejected by others
• Avoidance of social situations that may lead to rejection or embarrassment
• Feeling uncomfortable, awkward, self-conscious, and distressed in certain social situations (and in some cases, experiencing panic attacks)
• Adopting personas or “safety behaviors” to avoid rejection in social situations (like pretending to be outgoing or trying too hard to be funny)
• Concern that others will notice signs of their anxiety (blushing, shaking, etc.)
• Being hypersensitive to rejection cues
• Expecting or believing that others dislike them
• Ruminating social interactions before, during, or afterward

What Is Avoidant Personality Disorder?

Avoidant personality disorder is a type of personality disorder that is considered one of the most debilitating.⁶ People with AVPD struggle with deep feelings of shame that cause them to avoid interacting with other people, limiting their ability to form healthy relationships and live normal lives. Those with AVPD are often socially isolated, which increases their risk of developing other conditions such as addiction, mood disorders, or psychotic disorders.^1,3,6

While social avoidance is typically a key feature of AVPD, some theorists suggest that AVPD is marked by a broader pattern of this behavior that goes beyond social circumstances and extends to most—if not all—aspects of one’s life. People with AVPD have a long-standing history of social avoidance compounded with a fundamentally distorted sense of self. Essentially, AVPD has more to do with a pervasive negative self-concept rather than the social situation itself.³

Signs and symptoms of avoidant personality disorder include:^1,3,6

• Feelings of being inadequate, inferior, or socially inept
• Needing clear signs that others will accept them before interacting
• Avoiding social interactions, activities, or jobs that require them to interact with others
• Being shy, inhibited, and restrained in social situations
• Being unwilling to try new things
• Excessive worry about criticism, rejection, or embarrassment
• Becoming socially isolated and having few close relationships
• Loss of interest or enjoyment in social interactions, activities, or relationships
• Self-loathing or being overly negative of themselves

Social Anxiety Vs. Avoidant Personality Disorder: Key Differences

More research is required to fully understand the differences between avoidant personality disorder and social anxiety disorder. However, most experts believe that AVPD is just a more severe and debilitating form of social anxiety, rather than a completely separate condition.^2,3,4,5 Still, there are slight differences between the two, especially in how the symptoms show up and interfere with a person’s ability to function.^3,4,5

Avoidant Personality Disorder Vs. Social Anxiety Disorder: Classification

One of the most obvious and important differences between avoidant personality disorder and social anxiety disorder is classification. Personality disorders like AVPD are characterized by abnormal traits and tendencies that inhibit a person from functioning and interacting normally.^1,7 AVPD is difficult to treat because personality characteristics tend to remain the same across one’s life, and are believed to be the result of genetics.⁷

Anxiety disorders are a group of disorders that lead people to feel anxious, nervous, or worried in certain situations. While genes and personality traits can predispose a person to social anxiety, their environment and life experiences also play a major role. Anxiety disorders are highly treatable, often with therapies like cognitive behavioral therapy (CBT) or exposure therapy.

Social Anxiety Disorder Vs. Avoidant Personality Disorder: Severity of Symptoms

Many of the differences between social anxiety disorder and avoidant personality disorder show up in how severe and debilitating the person’s symptoms are.^2,5,8 People with avoidant personality disorder have more severe anxiety and lower self-esteem, making them more likely to completely avoid others and self-isolate than those with social anxiety.^2,3

Compared to people with social anxiety disorder, those with avoidant personality disorder are:^1,2,3,4,5

• More likely to report feeling socially inept
• More likely to suffer from shame or feelings of inferiority
• More preoccupied and afraid of rejection or criticism
• In need of more reassurance that others like them
• Less willing to take risks or leave their comfort zones
• More likely to avoid social interactions and activities
• Less likely to pursue jobs that require them to interact with people
• Likely to experience more distress during social interactions
• Less likely to form or maintain close relationships with people
• More likely to show signs of social inhibition (shyness, social avoidance, even fear of people)

Avoidant Personality Disorder Vs. Social Anxiety Disorder: Social Habits

Social habits in avoidant personality disorder and social anxiety vary. People with both conditions usually want to interact and connect, but individuals with AVPD are less likely to make an effort.^{3, 5} While those with social anxiety might only avoid certain types of social situations, people with AVPD are more likely to avoid all social settings, making them more likely to become isolated and have fewer close relationships.^2,3,4,5

AVPD Vs. Social Anxiety: Self-Esteem

People with avoidant personality disorder and social anxiety disorder both struggle with low self-esteem and personal insecurities, but these issues are more severe in individuals with AVPD. Someone with AVPD is more likely to believe that they are completely socially inept, unworthy, or unable to have normal interactions.^3,4

While a person with social anxiety may struggle with these same insecurities, it will be to a lesser extent. They are more likely to feel slightly insecure or self-conscious rather than entirely inadequate or inferior.^2,3

Social Anxiety Disorder Vs. Avoidant Personality Disorder: Comorbidities

Lower self-esteem in people with AVPD may help explain why they’re at higher risk for depression, eating disorders, and addiction. They’re also more likely to have suicidal thoughts or make suicide attempts than those with social anxiety.³ Additionally, it’s important to note that social anxiety disorder is the most common comorbid condition in people with AVPD.⁶

One out of every two or three people with AVPD is also diagnosed with social anxiety disorder.³ Individuals with social anxiety disorder (without AVPD) are more likely to struggle with other types of anxiety disorders, including panic disorder or phobias (like a fear of being stared at or a fear of public spaces). Their anxiety may even cross over into non-social situations, which is not common for those diagnosed with only AVPD.^4,8

AVPD Vs. Social Anxiety Disorder: Causes & Risk Factors

Many of the possible risk factors of avoidant personality disorder overlap with those of social anxiety disorder, including genetics, having a family history of the disorder, introversion, and neuroticism.^2,3,9 While many risk factors overlap, research suggests that AVPD is more often the result of poor or neglectful parenting, trust issues, and insecure attachment styles.⁹

According to this theory, AVPD symptoms, like avoidance and social inhibition, could develop due to a lack of a consistent and supportive caregiver in childhood. This could also explain why people with AVPD struggle with more shame and lower self-esteem than those with social anxiety disorder.^3,9 Still, it’s possible to never develop this condition even when the familial risk factor is present.

Examples of AVPD Vs. Social Anxiety

Even if AVPD is just a more severe form of social anxiety, there may still be differences in someone’s personal experiences with each.

Here are examples of AVPD vs. social anxiety:

Example of Avoidant Personality Disorder

After finding a therapist to help him overcome job anxiety, Jacob is diagnosed with avoidant personality disorder. He describes himself as an asocial person who spends almost all of his time alone. He does admit to having always wanted at least one friend.

Jacob dropped out of school and completed his GED online because he felt like he didn’t fit in and wasn’t smart enough to get his degree. Additionally, he ensured that the school he chose didn’t require him to take the SAT. Now, he is getting ready to begin his first job. Jacob specifically found a remote position, but it will require him to participate in occasional phone and video meetings. He feels like he doesn’t know how to talk to people and expects to be fired within the first week because of his inability to be “normal.”

Example of Social Anxiety Disorder

Juliette started college and wants to make friends. While she has been invited out several times, she usually ends up canceling plans and making an excuse for baking out at the last minute. She dreads and worries about all the embarrassing things she might do if she goes.

Recently, she had a panic attack before a football game and now she’s afraid it will happen again when she’s around others. She says that while she always worried about what people thought of her, she was popular in school, played sports, and spent a lot of time with close friends. Now that she’s older, Juliette’s main goal in therapy is to overcome her fears so she can have a “normal” social life again.

Can You Have Avoidant Personality Disorder & Social Anxiety Disorder?

Yes, someone can have both avoidant personality disorder and social anxiety disorder.  In fact, AVPD is more likely to co-occur with social anxiety disorder than any other anxiety disorder, and social anxiety disorder most frequently co-occurs with AVPD than other personality disorders. It appears that a shared genetic predisposition between the two disorders may explain this comorbidity.³

How Are AVPD & Social Anxiety Disorder Diagnosed?

A diagnosis for AVPD and/or social anxiety disorder generally starts with a visit to your primary health care provider where you can discuss your concerns. Once your PCP rules out any medical conditions, you’ll be referred to a qualified mental health professional for a thorough psychiatric evaluation. During this assessment, the clinician will interview you and gather information regarding your symptoms and history. Based on this, if you meet the full DSM-5 criteria for the disorder, then a formal diagnosis can be established.

Treatment Options for AVPD & Social Anxiety

There isn’t a lot of research on effective treatments for avoidant personality disorder. However, some studies suggest it can be treated using the same therapies used for social anxiety disorder.^2,6

Therapies

CBT for social anxiety and exposure therapy are some of the most effective therapies for social anxiety disorder (and possibly AVPD).^2,6,8 There is also some research that schema therapy could help some individuals with AVPD by addressing negative beliefs that drive their low self-esteem.⁶ Social skills training and group therapy can also be helpful, especially for those with severe social anxiety or AVPD who would benefit from more social interactions.

Medications

While many people with social anxiety disorder respond well to therapy alone, medications for social anxiety can also help. These same medications can sometimes be used to treat people with avoidant personality disorders, too.^6,8

When to Seek Professional Help

If you or a loved one is struggling with symptoms of social anxiety disorder or avoidant personality disorder, the best first step is to set up an appointment with a trained therapist. A therapist can help confirm your diagnosis and go over treatment options to manage your symptoms. Begin your search on an online therapist directory to find the right therapist with specific training, credentials, or experience.

Final Thoughts

The main differences between avoidant personality disorder and social anxiety are clearer when you look at an individual’s social life, self-esteem, and ability to form relationships. Both conditions can often be treated with therapies like CBT, exposure therapy, or group/individual therapy.^2,6 Finding a therapist who specializes in one of these treatments is an important first step toward recovery.