To a certain extent, everyone has had the experience of feeling shy or socially awkward at some point in their lives. People may, in fact, describe themselves as being shy or unassertive in situations involving groups of people. However, someone who suffers from Avoidant Personality Disorder (APD) takes this to a far higher degree, feeling crippling levels of anxiety and extreme shyness which have a hugely significant impact on all areas of their life.
Typically sufferers will experience debilitating social anxiety and social inhibition. They may also have a tremendous fear of being rejected by others – hence they may seem to others to be something of a ‘loner’ while they themselves would like nothing more than to engage with others but experience feelings of extreme inferiority and an innate fear of being rejected. This makes sufferers of Avoidant Personality Disorder highly reticent to interact with others both in a work or social setting. Caught in this web of anxiety and lack of self-esteem they may berate themselves for being ‘stupid’ or in some way a ‘failure’. It is vital for people with APD to realise that they are suffering from a recognised medical disorder and that in no way are they to blame or responsible for developing this condition. With the appropriate help and therapy, it is entirely possible that significant improvement in the sufferer’s symptoms will be seen.
In this article we will not only be looking at the specific symptoms of Avoidant Personality Disorder but also the suspected causes and the range of treatment options which are available.
Recognising symptoms of Avoidant Personality Disorder
Determining that someone is suffering from Avoidant Personality Disorder is a matter of examining both the symptoms they display and the severity by which they negatively impact
a person’s life. Experiencing normal levels of shyness, social awkwardness or the normal human desire to be accepted is not what APD is about. Suffering from Avoidant Personality Disorder is a serious and crippling condition with people being forced to endure massive levels of worry regarding inferiority, loneliness, isolation and rejection. Typically people with this condition will go to extreme lengths to avoid any social interaction, both in their work and outside lives. They do this not because they don’t wish to enjoy interaction with others but in the terrible fear that they will be somehow ridiculed, rejected or embarrassed. Sufferers display a marked level of fear about and avoidance of new activities or people and are very sensitive to criticism or disapproval by others. Due to their extreme fear of rejection people with Antisocial Personality Disorder may lack any close friends or people in whom they trust fully – this is not due to their being ‘cold’ or ‘standoffish’ but rather because they have such a terrible fear of being rejected that they dare not take the risk of getting close to others, even though they have a desperate longing for a ‘normal’ relationship. If they do manage to surmount these issues they may well show excessive levels of restraint in relationships with friends or partners, being reluctant to ‘open up’ and trust those close to them.
As a consequence of having APD, sufferers may also take a rather negative view of any circumstances which revolve around their core fears. For example, they may be prone to exaggerating the difficulties around getting to a social function, giving them an ‘excuse’ not to attend, etc.
Symptoms of Avoidant Personality Disorder include:
- Avoids both work and social activities which involve being around others
- Experiences low-self esteem, feelings of inferiority, inadequacy and lack of confidence – especially when dealing with other people
- Fears being rejected by others – even though you may feel desperately lonely, unhappy or isolated
- Worries about being embarrassed, ridiculed or shamed by others
- Constantly fears being ‘found out’ and then rejected by others
- Has a very low tolerance for any criticism or disapproval of self by others – May well display great sensitivity to being ‘judged’.
- Avoids intimate relationships or even friendships due to the innate fear of being rejected, humiliated or ridiculed (even though you wish you could form these attachments)
- If in a relationship they may well have difficulties with opening up or sharing their thoughts/feelings with a partner
- Avoids new experiences due to the fear of embarrassment &/or rejection
- Needs to be well-liked
- Experiences anxiety around saying or doing the wrong thing
- May lack assertiveness or avoids any decision making
- Is hyper-vigilant about signs of disapproval or rejection by others
- May misinterpret a neutral response or situation as negative
In terms of those affected by Avoidant Personality Disorder this condition there is no preference for either sex with both males and females equally exhibiting symptoms. Within the general population it is believed that around 2% of all people suffer from APD. As in other types of personality disorder symptoms tend to lessen as the sufferer ages, with the strongest symptoms appearing in adolescents and young adults. Typically, it is unusual for a child or teenager to be diagnosed as having Avoidant Personality Disorder. This is due to the fact that adolescence typically means changes in personality and emotional stability are common as the individual matures – Some shy personality traits in early childhood will disappear naturally as the child grows. A diagnosis of a personality disorder must relate to long-standing and enduring forms of behaviour – hence most people are diagnosed with APD during adulthood.
As with other types of personality disorder, people with APD do not often seek treatment without the condition either having a significant detrimental effect on their lives or after a major life crisis. Typically a formal diagnosis must be made by a mental health professional rather than a GP.
The causes of Avoidant Personality Disorder
It is believed that the cause of Avoidant Personality Disorder can be traced back to childhood. Generally, this can come from an ‘unsafe’ or even abusive childhood family environment where the child was ignored or didn’t feel safe to participate or voice one’s own needs and demands. In such circumstances, the child feels it is easier to withdraw and keep themselves safe by not trying to engage. Some sufferers may develop this condition because they have been subject to excessive criticism, ridicule, lack of affection and/or nurturing by a caregiver while still a child – such emotional abuse can have a highly significant and lasting effect on a person’s ability to be reasonably assertive and experiment in differing communication methods whilst growing up. Sometimes harsh and continued rejection of the child by their peers can have a similarly negative effect, leading to the onset of Avoidant Personality Disorder in adulthood.
As above the causes of APD are largely believed to be down to environmental and developmental reasons, however, there is some belief that genetic and biological factors could play a part in why someone develops Avoidant Personality Disorder.
Treatment of Avoidant Personality Disorder
People suffering from APD may fear that their shyness and timidity is simply too great and that full recovery is beyond them. However, this is far from the truth: the good news for anyone diagnosed with this disorder is that with successful treatment and alleviation of the most troubling symptoms is entirely possible.
Therapy for Avoidant Personality Disorder is strongly led by the ‘talking’ treatments, such as psychoanalytic psychotherapy and, in some cases, Cognitive Behavioural Therapy (or CBT to use the common abbreviation). In regular sessions with a therapist, sufferers can learn how to be more assertive and practice different communication styles in a safe and nurturing controlled environment. By exploring the reasons behind their condition, how their own negative thinking styles may be contributing to the problem and finally experimentally learning to feel safe whilst asserting themselves the sufferer can achieve real success and relief for this debilitating condition. With the help and support of a therapist the individual
can learn new coping strategies and tools with which to begin dismantling the hold that Avoidant Personality Disorder has taken over their lives.
Tell us your experiences with Avoidant Personality Disorder
Are you, or do you know someone who suffers from APD? We would love to hear about your own personal experiences as a sufferer or those of your family and friends. Sharing your unique story, APD experiences and how you have may have learned to cope can be very helpful in inspiring others to find the strength and courage to finally address the crippling lack of self-confidence and anxiety which is central to this serious and much misunderstood mental illness. Please feel free to leave your comments, tips and observations below.
Finally, if you believe that yourself or someone you love may have Avoidant Personality Disorder why not get in touch with us now? We can promise a friendly, understanding and no obligation chat about how talking treatments can help take the fear out of your life.