The symptoms of avoidant personality disorder (AVPD) overlap significantly with those of social anxiety disorder, including strong fears of rejection that lead to social avoidance.1 People with AVPD are more socially isolated and less able to function and form relationships than people with social anxiety, but most researchers believe that AVPD is just a more severe form of social anxiety.2,3,4,5
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. A fear of being judged, rejected, or embarrassed drives 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 all social situations.1
Common signs and symptoms of social anxiety disorder include:1
- Excessive and irrational fears of being judged, criticized, or rejected by others
- Avoidance of social situations that may lead to rejection or embarrassment
- Feeling very 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 and expecting or believing that others dislike them
- Ruminating and overthinking social interactions before, during, or afterwards in ways that feed into anxiety and avoidance
Why Do People Develop Social Anxiety Disorder?
While there isn’t one singular cause for social anxiety, it’s believed that the interaction between biological, environmental, and psychological factors can make someone more vulnerable for developing the disorder. Having a family history of anxiety and/or other mental health conditions is a strong predictor for the emergence of SAD, especially when combined with unhealthy backgrounds and/or negative life experiences. Researchers have also discovered that certain areas of the brain may be implicated in anxiety and that genetics play a role in how these parts function.1
What Is Avoidant Personality Disorder?
Avoidant personality disorder is one of ten types of personality disorders, but 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. This limits their ability to form close, healthy relationships and also can keep them from living normal lives.
People with AVPD are often very socially isolated, which increases their risk of developing other conditions like addiction, as well as mood and psychotic disorders.1,3,6
Signs and symptoms of avoidant personality disorder include:1,3,6
- Feelings of being inadequate, inferior, or socially inept
- Needing clear signs that others like and accept them before interacting with them
- Avoiding social interactions, activities, or jobs that require them to interact with others
- Being shy, inhibited, and restrained in social situations and unwilling to try new things
- Excessive worry about criticism, rejection, or embarrassment
- Becoming socially isolated or identifying as a “loner” and having few close relationships
- Loss of interest or enjoyment in social interactions, activities, or relationships
- High self-loathing or being overly critical, negative, or judgmental of themselves
Is Avoidant Personality Disorder More Than Avoidance of Social Situations?
While social avoidance is typically a key feature of avoidant personality disorder (AVPD), some theorists suggest that AVPD is marked by a broader pattern of avoidance because it goes beyond social circumstances and extends to most—if not all—aspects of life starting at an early age. People with AVPD have a long-standing history of social avoidance compounded with a fundamental distorted sense of self and fear of being negatively judged. Basically, AVPD has more to do with a pervasive negative self-concept rather than the social situation itself.3
What Causes Avoidant Personality Disorder?
Avoidant personality disorder doesn’t have a specific cause, but like other mental health conditions, it may have a genetic component, specifically family history of social anxiety, yet genetics alone can’t account for having AVPD. It’s possible to never develop this condition even when the familial risk factor is present. Instead, social researchers posit that a more likely explanation is that a combination of genetic predisposition and innate personality traits along with adverse childhood experiences (like parental neglect/overprotection, childhood abuse, insecure attachments, being ostracized by peers or family etc) may likely contribute most to the emergence of AVPD.3,9
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
Classification: Personality Disorders vs. Anxiety Disorders
One of the most obvious and important differences between avoidant personality disorder and social anxiety disorder is their classification. Personality disorders like AVPD are characterized by abnormal personality traits and tendencies that inhibit a person from functioning and interacting normally.1,7 Personality disorders are difficult to treat because personality traits tend to remain the same across a person’s life, and are believed to be the result of their genes.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.
Because there are such slight differences between the symptoms of social anxiety and avoidant personality disorder, some researchers argue AVPD should be re-classified as an anxiety disorder.2,8
Severity of Symptoms In Social Anxiety Disorder vs. Avoidant Personality Disorder
Most of the differences between social anxiety disorder vs 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, lower self-esteem, and are more likely to completely avoid people and isolate themselves than those with social anxiety.2,3
Compared to people who just have a diagnosis of 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 with shame, or feelings of inferiority or inadequacy
- More preoccupied and afraid of rejection or criticism
- In need of more reassurance/validation 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)
Social Habits In Avoidant Personality Disorder vs. Social Anxiety Disorder
Social habits in avoidant personality disorder and social phobia vary. People with both conditions usually want to interact and connect, but people with AVPD are less likely to make an effort.3, 5 While people with social anxiety might only avoid certain types of social situations, people with AVPD are more likely to avoid all social interaction, making them more likely to become isolated and have fewer close relationships.2,3,4,5
Self-Concept & Self Esteem In AVPD vs. Social Anxiety
People with avoidant personality disorder and social anxiety disorder both struggle with low self-esteem and personal insecurities, but these are more severe in people with AVPD. People with AVPD are more likely to believe that they are completely socially inept, unworthy, or unable to have normal interactions.3,4
People with social anxiety may struggle with these same insecurities but to a lesser extent. They are more likely to feel slightly insecure or self-conscious instead of completely inadequate or inferior.2,3
Comorbidities in People With AVPD & Social Anxiety
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 It’s also 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 are also diagnosed with social anxiety disorder.3 People 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). They’re also more likely to have anxiety in non-social situations, unlike people diagnosed with only AVPD.4,8
Risk Factors for AVPD vs. Social Anxiety Disorder
Many of the risk factors that can cause a person to develop avoidant personality disorder overlap with the risk factors for social anxiety disorder, including genetic risk factors or having a family history of the disorder.2,3,9
Here are risk factors for AVPD and social anxiety disorder:
- Personality traits like introversion, neuroticism, and risk-aversion
- Poor parenting or experiencing neglect or abuse from a caregiver
- Being socially isolated with fewer chances to interact with others
- Being naturally more shy, reserved, or inhibited
- Past negative interactions with others that affect self-esteem
- Having a family history or genetic predisposition of anxiety or personality disorders
While many risk factors overlap, research suggests that AVPD is 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 be the result of not having a consistent and supportive parent or caregiver as a child. This could also explain why people with AVPD struggle with more shame and lower self-esteem.3,9
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; however, he admits to always wanting at least one friend.
He 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. He went on to earn an online degree at a school that didn’t require him to take the SAT and is now getting ready to begin his first job.
Jacob specifically chose a remote position but it will require him to have occasional phone calls and Zoom meetings. He feels like he doesn’t know how to talk to people and expects to be fired from his job within the first week because of his inability to be “normal.”
Example of Social Anxiety Disorder
Juliette started college and wants to make friends. She has been invited out several times, but she usually ends up canceling plans and making an excuse to back out at the last minute because 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 she was invited to, and now she’s afraid it will happen again when she’s around other people. She says that while she always worried about what other people thought of her, she was popular in school, played sports, and spent a lot of time with close friends.
Juliette’s main goal in therapy is to overcome her fears so she can have a “normal” social life again.
Can Someone Have Both Avoidant Personality Disorder & Social Anxiety Disorder?
Yes, someone can have both AVPD and social anxiety disorder. The available data indicates that avoidant personality disorder is usually more likely to co-occur with social anxiety disorder, particularly the generalized type, than with any other anxiety disorder. By the same token, social anxiety disorder is more comorbid with AVPD than with any other personality disorders. It appears that a shared genetic predisposition between the two disorders may explain the co-occurrence.3
How Are AVPD and Social Anxiety Disorder Diagnosed?
A diagnosis for AVPD and/or SAD 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 full criteria for the disorder laid out by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) 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 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 people with AVPD by addressing negative beliefs that drive 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, anti-anxiety medications including selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines can also help. These same medications are sometimes used to treat people with avoidant personality disorder.6,8
How To Get Help For AVPD & Social Anxiety Disorder
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 a therapist with specific training, credentials, or experience.
Final Thoughts On Avoidant Personality Disorder Vs. Social Anxiety
The main differences between avoidant personality disorder and social anxiety are clearer when you look at the 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 towards recovery.
Avoidant Personality Disorder vs. Social Anxiety Infographics
