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Deciphering Avoidant Personality Disorder: Inner Demons Unleashed

Submitted by on August 31, 2015 – 10:47 PM

social_phobia“There’s only two ways to be completely alone in this world: lost in a crowd or in total isolation.”
-Jeff Lemire


A number of people out there suffering from said isolation—or in medical terms, from Avoidant Personality Disorder—often need help in the form of someone trying to understand the reason behind their isolated personality.


Being a medical student, I thought the reason behind my isolated behavior was lack of social interaction and a busy schedule. Whenever my mom would ask me to meet family members (of whom I was fond, once) or even have fun with siblings, I would feel disturbed and refuse to join them.

The thing is, this severely isolated behavior—or you can say anxious personality disorder—is a Cluster C disorder in which people avoid social interaction in fear of being humiliated, rejected, disliked or ridiculed for any of their personal reasons. However, none of this is likely to happen in reality.

Before moving on to symptoms and further details, let’s have a look at the diagnosis and its differentiation with agoraphobia. Agoraphobia is described as severe and unrelenting fear of a situation, activity, or thing that compels one to avoid it. It is a fear of being outside or otherwise being in a situation from which one either cannot escape or from which escaping would be difficult or humiliating. The patient can often suffer from panic attacks as a result of this condition.

On the other hand, Avoidant Personality Disorder has characteristics that resemble those of social phobia, including hypersensitivity to possible rejection and the resulting social withdrawal in spite of a strong need for love and acceptance. Individuals with this disorder are inhibited and feel inadequate in social situations.

According to WHO’s ICD 10, Avoidant Personality Disorder is indicated by having at least four of the following characterisics:

  1. Persistent and pervasive feelings of tension and apprehension;
  2. Belief that one is socially inept, personally unappealing, or inferior to others;
  3. Excessive preoccupation with being criticized or rejected in social situations;
  4. Unwillingness to become involved with people unless certain of being liked;
  5. Restrictions in lifestyle because of need to have physical security;
  6. Avoidance of social or occupational activities that involve significant interpersonal    contact because of fear of criticism, disapproval, or rejection.

The DSM-5  also has an Avoidant Personality Disorder diagnosis. It refers to a widespread pattern of inhibition around people, feeling inadequate and being very sensitive to negative evaluation. Symptoms begin by early adulthood and occur in a range of situations. Four of seven specific symptoms should be present, which are the following:

  1. Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection.
  2. Is unwilling to get involved with people unless certain of being liked.
  3. Shows restraint within intimate relationships due to the fear of being shamed or ridiculed.
  4. Is preoccupied with being criticized or rejected in social situations.
  5. Is inhibited in new interpersonal situations because of feelings of inadequacy.
  6. Views self as socially inept, personally unappealing, or inferior to others.
  7. Is unusually reluctant to take personal risk or to engage in any new activities because they may prove embarrassing.

Heading towards symptoms and causes, let me first direct your attention towards a particular theory, stating that people with depression or any kind of excessive brain use demonstrate higher IQ levels; the brain is a muscle—the more you use it, the stronger it gets. Albert Camus once said, “Nobody realizes that some people expend tremendous energy merely to be normal.”

The causes of Avoidant Personality Disorder are biological and genetic factors, social factors and psychological factors. AVDP is a complex disorder which can be transferred via genes if the parents were once the sufferers. Possible symptoms an individual may experience include self-isolation, sensitive behavior, low self-esteem, and reluctance to make personal decisions.

Treatment of Avoidant Personality Disorder typically involves psychotherapy with a professional who has experience in treating this type of personality disorder. While some people with a personality disorder may be able to tolerate long-term therapy, most people with such concerns typically go into therapy only when they feel overwhelmed by stress, which usually exacerbates the symptoms of the personality disorder. Such shorter-term therapy will typically focus on the immediate problems in the person’s life, giving them some additional coping skills and tools to help.

Certain medications such as anti-anxiety agents and antidepressants may also be prescribed, but only when another psychiatric problem co-occurs (e.g. anxiety or depression). Since support groups are not preferred for such people (keeping in mind their tendency to get anxious and panic), people around them should not force them to attend parties or any kinds of activities. In fact, if they share anything with their friends or family, consider this a sign of well-being; if they can shut their social interaction down completely, they might end whatever relationship you have with them.



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