Many people struggle with shyness, but a small segment of the population suffers from shyness so severe that it brings about extreme social inhibition. In avoidant personality disorder, extreme shyness and fear of rejection make it difficult for people to interact socially and professionally. People with avoidant personality disorder may avoid work activities or decline job offers because of fears of criticism 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 2 percent of the population, equally divided between the sexes, has this disorder.
- 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
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 the behavior, but those who develop avoidant personality disorder become increasingly timid as they enter adolescence and adulthood.
Psychotherapy, particularly cognitive/behavioral approaches, may be helpful. Antidepressant medication can often reduce sensitivity to rejection. A combination of medication and talk therapy may be more effective than either treatment alone.
People with avoidant personality disorder may have some ability to relate to others, and the ability can be reinforced and 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. While shyness is not a disorder, help from a health-care provider or a psychiatrist is important if shyness or fear of rejection overwhelms a person's ability to function in life and form relationships.