People with avoidant personality disorder avoid social situations due to fear of rejection and being judged by others. However, because most people with this condition want to develop relations, they may be more likely to respond to the work of psychotherapy.
Avoidant personality disorder is one of a group of conditions known as personality disorders. These disorders, in general, are enduring patterns of behavior out of keeping with cultural norms that cause emotional pain for an individual or those around them. Avoidant personality disorder is grouped with other personality disorders marked by feelings of nervousness and fear. People with avoidant personality disorder have chronic feelings of inadequacy and are highly sensitive to being negatively judged by others. Though they would like to interact with others, they tend to avoid social interaction due to the intense fear of being rejected by others.
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It is estimated that about 2.4% of the U.S. population has avoidant personality disorder. It appears to affect men and people assigned male at birth (AMAB) and women and people assigned female at birth (AFAB) equally. Like other personality disorders, avoidant personality disorder symptoms may be noticed in childhood and often begin to create discomfort in adolescence or early adulthood. Avoidant personality disorder usually isn’t diagnosed in people younger than 18 years of age like many other personality disorders, as there should be evidence that these patterns of behavior are enduring and inflexible and don’t readily fade with time.
The exact cause of avoidant personality disorder isn’t known. However, it’s believed that both genetics and environment play a role. It’s also believed that avoidant personality disorder may be passed down in families through genes, but this hasn’t yet been proven. Environmental factors, particularly in childhood, do play an important role. Shyness, often normal in young children, lasts into adolescents and adulthood in those with avoidant personality disorder. Those with the disorder often report past experiences of parental or peer rejection, which can impact a person’s self-esteem and sense of worth.
For people with this disorder, the fear of rejection is so strong, they choose isolation rather than risk being rejected in a relationship. The pattern of behavior in people with this disorder can vary from mild to extreme. In addition to their fear of humiliation and rejection, other common traits of people with this disorder include:
If symptoms are present, a healthcare provider will begin an evaluation by performing a complete medical history and physical examination. Although there aren’t any laboratory tests to specifically diagnose personality disorders, a provider might use various diagnostic tests to rule out physical illness as the cause of the symptoms.
If the provider finds no physical reason for the symptoms, they might refer you to a psychiatrist or psychologist, healthcare professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder like avoidant personality disorder.
Treating personality disorders is difficult because people with these disorders have deep-rooted patterns of thinking and behavior that have existed for many years. However, people with avoidant personality disorder tend to be good candidates for treatment because their disorder causes them significant distress, and most want to develop relationships. This desire can be a motivating factor for people with avoidant personality disorder to follow their treatment plans.
As with other personality disorders, psychotherapy is the main treatment for avoidant personality disorder. Psychotherapy is a type of individual counseling that focuses on changing a person’s thinking (cognitive therapy) and behavior (behavioral therapy). Therapy is likely to focus on overcoming fears, changing thought processes and behaviors, and helping the person better cope with social situations. Medication — such as an antidepressant or anti-anxiety drug — might be used to help manage the anxiety felt by people with this disorder. For the best results, however, medication therapy should be done in combination with psychotherapy. Treatment for people with this disorder is most effective when family members are involved and supportive.
Without treatment, a person with this disorder can become isolated from society, causing long-term difficulties with work and social functioning. They’re also at greater risk for depression and substance abuse.
Although it might not be possible to prevent this disorder, it might be helpful to begin treatment in people as soon as they begin to have symptoms.
As with other personality disorders, treatment for avoidant personality disorder is a long process. The willingness of the individual to seek and stay with treatment can have a significant effect on treatment success and, therefore, the outlook. With treatment, some people with avoidant personality disorder can learn to relate to others more appropriately.
Last reviewed by a Cleveland Clinic medical professional on 10/06/2020.
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