Avoidant Personality Disorder

Many of us struggle with shyness, but approximately two percent of the population suffer from avoidant personality disorder. Extreme shyness and fear of rejection make it difficult for some people to interact socially and professionally.

Definition

Personality disorders are long-lived patterns of behavior that cause problems with work and relationships. Avoidant personality disorder is a psychiatric condition characterized by a lifelong pattern of extreme social inhibition, feelings of inadequacy, and sensitivity to rejection. People with avoidant personality disorder may avoid work activities or decline job offers because of fears of criticism or disappointment from others. They may be inhibited in social situations as a result of low self-esteem and feelings of inadequacy. Additionally, they may be preoccupied with their own shortcomings and form relationships with others only if they think they will not be rejected. Loss and rejection are so painful to these individuals that they will choose loneliness rather than risk trying to connect with others. About two percent of the population, equally divided between the sexes, have this disorder.

Symptoms

Some common signs of avoidant personality disorder include:

  • Easily hurt by criticism or disapproval
  • No close friends
  • Reluctance to become involved with people
  • Avoidance of activities or occupations that involve contact with others
  • Shyness in social situations out of fear of doing something wrong
  • Exaggeration of potential difficulties
  • Showing excessive restraint in intimate relationships
  • Feeling socially inept, inferior, or unappealing to other people
  • Unwilling to take risks or try new things because they may prove embarrassing

Causes

The cause of avoidant personality disorder is unknown. Genetics or environmental factors, such as rejection by a parent or peers, may play a role in the development of the condition.

The avoidant behavior typically starts in infancy or early childhood with shyness, isolation, and avoidance of strangers or new places. Most people who are shy in their early years tend to grow out of this behavior, but those who develop avoidant personality disorder become increasingly timid as they enter adolescence and adulthood. 

Treatments

Antidepressant medications can often reduce sensitivity to rejection. Psychotherapy, particularly cognitive/behavioral approaches, may be helpful. A combination of medication and talk therapy may be more effective than either treatment alone.

People with this disorder may have some ability to relate to others, and this can be improved with treatment. Without treatment,  those with avoidant personality disorder may become resigned to a life of near or total isolation. They may go on to develop a second psychiatric disorder such as substance abuse or a mood disorder such as depression. It is important to get help from a health-care provider or a psychiatrist if shyness or fear of rejection overwhelm one's ability to function in life and form relationships.

References

  • American Psychiatric Association, Diagnostic and Statistical Manual, Fifth Edition 
  • National Institutes of Health
  • National Institute on Alcohol Abuse and Alcoholism
  • National Library of Medicine

Last reviewed 04/19/2017