Understanding Avoidant Personality Disorder
Fri, December 3, 2021

Understanding Avoidant Personality Disorder

More and more people nowadays are getting informed about the seriousness of mental health illnesses, the importance of seeking professional help, and supporting people who struggle with them the most. However, there are still a lot of misunderstandings and misconceptions about mental health disorders such as personality disorders that leave sufferers in the dark. 

Just like other mental health illnesses, personality disorders can affect an individual’s way of thinking, feeling, and behaving, making that person different from other people. Their behavior may deviate from the expectations of their culture, causing them distress or problems in functioning. Personality disorders, which are a group of mental illnesses, are characterized by distorted thinking patterns, inappropriate emotional responses, lack of impulse control, and social impairment.

According to The Recovery Village, a drug rehab center in Florida offering treatment for alcohol and drug addiction, co-occurring mental health and eating disorders, the Diagnostic and Statistical Manual of Mental Disorders, DSM-5, categorized personality disorders into three clusters: cluster A, described as “odd and eccentric”; cluster B as “dramatic and erratic,” and cluster C as “anxious and fearful.” Researchers have conducted several studies to determine the prevalence of this mental illness across the world.

A 2007 study revealed that 9.1% of the US population meet the criteria for a personality disorder. Out of the Fog, an online site that aims to provide information and support to the family members and loved ones of individuals who suffer from a personality disorder, reported that 5.2% of Americans have been diagnosed with avoidant personality disorder (AVPD). This is followed by schizoid (4.9%), schizotypal (3.3%), obsessive-compulsive (2.4%), paranoid (2.3%), borderline (1.6%), and more. 

The American Psychiatric Association’s “Understanding Mental Disorders: Your Guide to DSM-5,” narrated a story of a young woman suffering from a personality disorder. While each individual who suffers from a personality disorder has their own stories and challenges, Maria’s story shows us a glimpse of what kind of life they face every day. Maria, who was diagnosed with borderline personality disorder and major depressive disorder, had been in psychiatric treatment since age 17. She experienced spending months just lying in her bed, eating junk food, and not functioning at all.

At the same time, Maria would self-harm whenever she felt empty and depressed which would lead her to act on impulse with great risk to her safety. She’d resort to destructive coping mechanisms like drug abuse and reckless driving just to make her feel better. However, Maria refused prescribed medications, stating, “When I take those drugs, I have no feelings. I can’t even cry at a sad movie.” Thus, she was referred to a form of psychotherapy called dialectical behavior therapy or DBT, which helped Maria learn how to feel more in control of her extreme feelings. 

However, there are other types of personality disorders that are rarely discussed today, particularly AVPD.

What is Avoidant Personality Disorder?

It’s natural for most of us to not enjoy rejection, criticism, or embarrassment. However, some people spend most of their life avoiding them. These socially challenged people with hypersensitivity to rejection and constant feelings of inadequacy spend a lot of time focusing on their shortcomings. They are extremely hesitant to form relationships where they feel they could be rejected, resulting in feelings of loneliness and becoming disengaged from relationships. People who feel this way may be suffering from AVPD.

According to the Cleveland Clinic, a non-profit academic medical center that provides clinical and hospital care and is a leader in research, education and health information, it is estimated that about 2.5% of the population has AVPD, equally affecting men and women. Usually, this disorder starts in infancy and childhood, and continues into adulthood. However, AVPD mostly isn’t diagnosed in people younger than 18 years of age. 

People suffering from AVPD usually feel extreme social inhibition, inadequacy, and sensitivity to negative criticism and rejection. This causes significant problems that affect their ability to interact with others and maintain relationships on a daily basis. Since they generally avoid work, social, or other activities due to fear of criticism or rejection, they feel as if they are unwelcome in social situations, even if that’s not the case. The reason behind this is because they don’t have a low threshold for criticism and often imagine themselves to be inferior to others.

Causes and Symptoms

For years, researchers have identified how AVPD socially affects people. For instance, they are unwilling to get involved with people unless they are certain of being liked; show restraint within intimate relationships; are preoccupied with being criticized or rejected in social situations; and are unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing. However, researchers don’t completely understand what causes this mental illness.

According to Psych Central, the internet’s largest and oldest independent mental health online source, AVPD is likely caused by biological and genetic, social, and psychological factors. This suggests that no single factor is responsible. Instead, it is the complex and likely intertwined nature of all three important factors. There are several common symptoms associated with this mental disorder. This includes social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation, low self-esteem, lack of assertiveness, extreme self-consciousness, and self-isolation. 

Treating AVPD

AVPD is usually diagnosed in adults because children's personalities are still developing. Thus, feelings and behaviors that kids feel that can be associated with this disorder can be normal experiences in childhood that are later outgrown. According to VeryWell Mind, a trusted and compassionate online resource for mental health, AVPD can only be diagnosed by a trained mental health professional based on criteria outlined in the DSM-5. 

A diagnosis will require a psychological evaluation by a mental health professional, which aims to rule out other potential diagnoses or determine whether a person has more than one diagnosis. When diagnosed with AVPD, a mental health professional will design a treatment plan that is appropriate for the patient. Since there are currently no medications specifically approved for this mental health illness, doctors usually recommend undergoing therapy. Several therapies are available to address AVDP such as CBT, psychodynamic therapy, schema therapy, and more. 

Most importantly, people suffering from AVPD need a strong support system that would help and understand them. This mental health illness is extremely hard to face every day but with supportive and understanding people around them, patients can get by.