All About Avoidant Personality Disorder

Avoidant personality disorder is characterized by a long-standing pattern of restraint and avoidance in situations that are social or involving completion and achievement.

Folks with this condition may not feel anxious but rely on angst due to a habitual belief that it helps you avoid catastrophe.

This condition may manifest that way, or fill someone with intense and overwhelming fears around negative feedback and rejection that can lead you to avoid social situations.

Avoidant personality disorder can seem similar to shyness or social anxiety, but there’s more to it than relationships and uneasiness around unfamiliar settings.

Avoidant personality disorder makes relationships of all degrees more difficult than they already are, for all of us.

A few quick facts:

• Most research suggests avoidant personality disorder appears to occur in approximately 1.5-2.5% of the population. For the U.S. population, that’s about 8 million of us.
• Females may have a slightly higher chance of developing the condition.
• Clinicians usually diagnose avoidant personality disorder in adults.

It’s not the same as shyness or social anxiety

If you live with avoidant personality disorder, others might think of you as shy, reserved, or private.

This condition goes beyond being bashful, although early signs often include childhood timidness. Shy people might have trouble connecting with new people at first but gradually feel more comfortable as time goes on.

Social anxiety and avoidant personality disorder share so many similarities that some experts suggest avoidant personality disorder is best understood as a severe form of social anxiety.

Officially, they’re considered separate conditions.

Avoidant personality disorder is also noteworthy because it’s not limited to social interactions. Fear of being judged harshly may also affect someone’s productivity and life success. Think of that saying: “If I don’t try, then I won’t fail.”

One key difference between the two lies in the fact that people living with anxiety often recognize their responses as anxiety.

If you have social anxiety, you might have a lot of fear around going to a party. You may know the things you worry about — spilling your drink down your shirt or saying the wrong thing — are pretty unlikely, but you still can’t help worrying about them.

With avoidant personality disorder, folks often lack that same awareness. Instead, you may feel convinced you’ll say or do something to earn negative judgment from others.

It doesn’t mean antisocial, either

Antisocial, by definition, means unsocial. Antisocial people avoid others because they are content with their own company above anything else anyone could offer.

Fearing rejection from others and not wanting their company at all are two different things.

If you have avoidant personality disorder, your symptoms might include:

• avoiding social situations, or hold back when you can’t steer clear of them
• considering yourself inferior to others
• being very sensitive to judgment or negative feedback

These traits can show up in different ways. You might:

• avoid activities where you have to spend time with people
• keep personal information to yourself
• frequently worry about the impression you have on others
• believe others find you unappealing or awkward
• regularly imagine the relationships you’d like to have
• find it difficult to share feelings, even with loved ones
• avoid trying new things because you don’t want to embarrass yourself
• consider everyday situations difficult or mortifying
• feel as if you have an undefined or incomplete sense of self
• avoid places, people, and situations you aren’t familiar with

Your concern over potential criticism can lead to constantly play back other people’s words and actions in your head. You might take neutral remarks, such as “I just saw your work,” or “Could you please look this over one more time?” as judgmental or critical.

Avoidant personality disorder doesn’t necessarily mean you completely isolate yourself.

You might feel able to form relationships with people who convince you of their affection for you. Still, you might need a lot of reassurance to trust they really do accept you without judgment.

While experts have yet to determine a clear cause of avoidant personality disorder, most believe it develops from a combination of factors:

• early childhood environment and relationships
• life experiences that shape your personality
• genetics or a family history of the condition

Many experts believe personality disorders develop as an adaptive response to challenging or traumatic situations.

In other words, these specific traits and behaviors can serve as defense mechanisms. They help you cope with stress and protect you from emotional pain.

Some research suggests your attachment or abandonment experiences with your first caregivers may have a lot to do with the development of avoidant personality disorder.

Perhaps, instead of providing encouragement and support, your parent:

• neglected or ignored you
• offered harsh criticism
• mocked, demeaned, or devalued you

Bonds with childhood caregivers typically lay the foundation for the relationships you develop later in life. If you absorb their criticism, you might grow up with a negative self-image and have trouble trusting others.

This fearful or avoidant attachment mode can make it difficult to form relationships. Despite your desire for intimacy, you might not be able to shake the underlying conviction that you’ll eventually face the same rejection and disdain.

Only trained mental health professionals can diagnose avoidant personality disorder.

Experts don’t often diagnose the condition in children and teens. A pattern of shyness or reticence often begins in childhood or adolescence, but this can happen as a typical part of development.

Before diagnosing avoidant personality disorder, mental health professionals will ask questions about the signs and symptoms you’ve noticed, including:

• How long have you experienced them?
• In what setting do the recurring feelings arise? For example, at school, work, or home.
• How do they affect your life?

Clinicians also may observe how those being screened for avoidant personality disorder respond to them directly. Sometimes folks will show avoidant or extremely acquiescent reactions in assessment or therapy.

Traits of personality disorders persist over time and appear in most areas of folks’ life.

With that information, an expert likely wouldn’t diagnose avoidant personality disorder.

A diagnosing professional could diagnose avoidant personality disorder if you explain it feels impossible to pursue friendships and relationships or finish projects you start because you fear mockery or rejection.

You might also describe continually taking pains to avoid or escape any possibility for rejection. This symptom could play out in these everyday scenarios below.

Over time, avoidant personality disorder can begin to have a deep impact on your day-to-day experience if not managed.

You might notice some of the following:

Isolation and loneliness

Not everyone desires a large social circle, and it’s perfectly fine to have only one or two close friends — as long as you feel satisfied with those relationships.

With avoidant personality disorder, you might hesitate to make friends or date because you feel strongly that prospects will reject you. This belief can get in the way of forming fulfilling relationships.

A lack of social connection can leave you feeling alone and isolated. It can even contribute to depression.

Challenges at school and work

Fear of negative feedback and trouble connecting with others can eventually affect your performance at work or school.

At school

At work

Co-occurring health concerns

Social support can be a fringe benefit when it comes to ordinary life stress. If you don’t have that support, you might end up struggling to manage any difficulties that come up and end up feeling more overwhelmed.

Research also suggests loneliness can factor into other health issues, including:

• sleep disorders
• diabetes
• cancer
• heart disease
• high blood pressure
• depression
• substance use

Other research notes that avoidant personality disorder often occurs with depression and substance use.

For some, there’s a perception substance use mighthelp your symptoms feel more bearable, but that’s temporary. Science tells us symptoms will return once sober again. In fact, substances are known to intensify feelings of depression, and both mental illness and substance use feed each other’s perpetuating condition.

Sharing your concerns with a therapist might seem like a ghastly prospect if you have avoidant personality disorder. Even when you think therapy could help relieve some of your distress, the fear of criticism and judgment might outweigh your desire for support.

Consider, though, that mental health professionals specialize in compassionate care that meets you where you are. They understand you didn’t choose to have a personality disorder.

A therapist will offer empathy and kindness as they validate your experience, help you identify and address symptoms, and explore helpful coping methods.

It’s always worth reaching out for support when your symptoms lead to thoughts of self-harm or suicide.

Treatment for avoidant personality disorder

Though no medication is specific to avoidant personality disorder itself, treatment generally involves talk therapy, also known as psychotherapy.

Treatment doesn’t mean changing your disposition or personality. Rather, overcoming and addressing your fears of rejection could help you establish stronger connections with yourself as well as others. Therapy, then, can help you establish a complete sense of self.

Psychotherapy for avoidant personality disorder

When it comes to therapy for this condition, it’s generally most helpful to connect with a therapist who specializes in treating personality disorders, particularly since avoidant personality disorder symptoms can resemble social anxiety symptoms.

Research suggests several approaches can have benefit for avoidant personality disorder:

• schema therapy
• cognitive behavioral therapy
• exposure therapy
• psychodynamic therapy
• supportive therapy
• acceptance and commitment therapy
• emotion-focused therapy
• metacognitive interpersonal therapy

Your therapist might also recommend group therapy to help you practice interacting in a safe space.

No matter which type of therapy you choose, a mental health professional can offer guidance with:

• identifying and navigating fears of rejection and criticism
• reframing unhelpful beliefs
• practicing social skills
• learning coping strategies to manage distress
• exploring potential factors contributing to avoidant personality disorder
• addressing any other mental health symptoms, including anxiety, stress, or depression

You can dive here into a more in-depth look at treatment for avoidant personality disorder.

Medication for avoidant personality disorder

Although medication can’t treat avoidant personality disorder symptoms specifically, antidepressants and antianxiety medication could help relieve other mental health symptoms you experience.

Overwhelming feelings of anxiety and depression aren’t always manageable alone. They can make day-to-day life more difficult and complicate the therapy process.

Some people report medication offers enough space from distressing thoughts and feelings that daily life becomes more manageable.

Medication can help ease distress, but it won’t treat the underlying causes. Mental health professionals typically recommend a combination of medication and therapy rather than medication alone.

Experts haven’t yet found a cure for avoidant personality disorder or any other personality disorder, but support from a trained therapist can make a difference.

Therapy won’t change your personality completely, so you might still hesitate before interacting with new people or situations.

That said, therapy offers a safe, nonjudgmental space to address and challenge distressing thoughts, which can make it easier to overcome self-doubt and build fulfilling relationships.

Ready to find the right therapist? These resources can help:

• American Psychological Association
• National Alliance on Mental Illness
• Project Air
• National Institute of Mental Health