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Is avoidant personality disorder the fullblown version of social anxiety disorder?

20K views 47 replies 28 participants last post by  hotrod280 
#1 ·
Just from the names (an anxiety disorder versus a personality disorder) the latter seems worse. Is the difference that former is curable while the latter is more permanent?
 
#2 ·
People argue about this a lot. I think AvPD is just more severe SA, but others disagree. I doubt experts will say AvPD is incurable but I don't know anyone who cured it.

For definitions of psychological problems its best to refer to a book called The Diagnostic and Statistical Manual of Mental Disorders. Its the official book in the US which gives the definition of each diagnosis. This way every mental health professional in the US means the same thing when use a term. Its also used widely in foreign countries.
 
#4 ·
I don't believe that there's a distinct line between shyness and SAD and between SAD and avoidant personality disorder. I think it's a continuum. It's kinda like hypertension/heart disease. We set it at a certain level to make it easier to diagnose/treat and while useful, it's a bit arbitrary and set by social/cultural conventions. Shyness/SAD is looked down/frowned upon a lot more in a an aggressive/competitive/narcissistic society like today.

Having said that, I think it's generally easier to live with shyness versus SAD and with SAD versus Avoidant Personality Disorder. I think all 3 are somewhat permanent but the latter is much less changeable with any type of therapy (whether psychological or pharmaceutical).
 
#5 ·
From what I know and remember, avoidant personality disorder has to do with a person feeling inferior and therefore they stay away from getting a job and things. They fear they will get embarrassed or feel shame. Social anxiety or social phobia I think is just a fear and anxiousness of being around others and communicating.
 
#6 ·
there were some good threads on this. the two theories are basically that:

A) avpd is just the full blown version of social anxiety disorder as you said.

B) social anxiety disorder is more about experiencing physical symptoms of anxiety and feeling anxious whereas avpd is more about deepset beliefs that you if you let people truly get to know you, they would not like you and a history of avoiding social interaction.

personally, i don't think they are different enough to be considered too separate entities. there is too much overlap and i think most of the time they have the same root cause.

i can see how one might argue they are different, especially because some people with social anxiety do not avoid social interaction so they are obviously not avpd but i still prefer to think of avpd as the same thing further along the continuum than as a separate thing.
 
#8 ·
Symptoms/signs of Avoidant Personality:
-feelings of inadequacy
-mistrust of others
-feeling inferior to others
-severe low self-esteem
-self imposed isolation
...etc.

Doesn't most everyone with social anxiety experience the above signs/symptoms of Avoidant Personality? Am I in the minority with my feeling of being inferior to others and feeling like I don't measure up? It seems to me that if you've had social anxiety for awhile, your self-esteem would take a real nose-dive, and you'd progress to isolating yourself more and more. I don't really see the difference between the two disorders. Where does severe social anxiety end and avoidant personality disorder begin? I'm confused.
 
#9 ·
I sometimes wonder whether my issue actually is social anxiety because I rarely feel anxious in social situations. I feel nervous and uncomfortable, but I don't panic.

The other thing that I just CANNOT wrap my head around is that most SA'ers are functional: most are in school, have jobs (careers!), have had relationships, and yes, many have friends/acquaintances. I don't relate to that at all.

I've read that SA'ers don't truly believe they're defective, inferior people; that many still see themselves as likeable, intelligent, etc. AvPD, otoh, is characterized by a persistent inferiority complex and extremely low self-esteem. Basically, they feel wholly inadequate, so they avoid everything and just isolate themselves. that describes me to a T (but I still dont' know whether it's avpd - kinda don't care either at this point; i don't think i'm going to change).

Makes ya wonder.
 
#10 ·
I sometimes wonder whether my issue actually is social anxiety because I rarely feel anxious in social situations. I feel nervous and uncomfortable, but I don't panic.

The other thing that I just CANNOT wrap my head around is that most SA'ers are functional: most are in school, have jobs (careers!), have had relationships, and yes, many have friends/acquaintances. I don't relate to that at all.

I've read that SA'ers don't truly believe they're defective, inferior people; that many still see themselves as likeable, intelligent, etc. AvPD, otoh, is characterized by a persistent inferiority complex and extremely low self-esteem. Basically, they feel wholly inadequate, so they avoid everything and just isolate themselves. that describes me to a T (but I still dont' know whether it's avpd - kinda don't care either at this point; i don't think i'm going to change).

Makes ya wonder.
Yeah, I mean when I first began found out about SA (stumbled upon it at 15) I remember reading that like a worst case scenario of social phobia would be someone who stays in their house all day because the fear has literally become so bad they either have decided a life isolated is better or they literally would have a panic attack at the first instance of interaction.

And I know what you mean alot of people who post on these forums seem like they atleast try even if they fail miserably as where I have been much more accepting of my situation and really don't put myself in fear-inducing situations on a daily basis. This isn't just for social phobia this is just how I choose to respond to fear (i haven't been on a rollercoster in ten years) so when I recently heard of avpd I was like oh great this is like a specialized version of SA that is more specific to me, but then when I read it was like the worst case scenario of not leaving the house I had read about and was like oh ****.
 
#11 ·
With APD, SA is so intense, that you avoid any situation that leads to anxiety symptoms. You no longer (or very rarely) suffer SA anymore, because you avoid anything that makes SA happen. This constant avoidance is APD, as I understand it.

So, APD isn't an anxiety disorder, it's a behavioural disorder. It is the direct result of wanting to avoid the sypmtoms of the anxiety disorder.

It should NOT be called a personality disorder. That's just about the stupidest name for it that it could have. Why? because that name implies that there's something wrong in your DNA that makes you that way. It's misleading, because APD is learnt behaviour. It's extreme extreme social avoidance tactics, and nobody is born with those as a part of their personality - they learn avoidance habits. If you cognitively learn something, then it can be unlearnt. If you can unlearn APD, then it's stupid to call it a personality disorder, since it isn't a part of your personality - it's just behaviour that helps you cover up your personality.
 
#46 ·
With APD, SA is so intense, that you avoid any situation that leads to anxiety symptoms. You no longer (or very rarely) suffer SA anymore, because you avoid anything that makes SA happen. This constant avoidance is APD, as I understand it.

So, APD isn't an anxiety disorder, it's a behavioural disorder. It is the direct result of wanting to avoid the sypmtoms of the anxiety disorder.

It should NOT be called a personality disorder. That's just about the stupidest name for it that it could have. Why? because that name implies that there's something wrong in your DNA that makes you that way. It's misleading, because APD is learnt behaviour. It's extreme extreme social avoidance tactics, and nobody is born with those as a part of their personality - they learn avoidance habits. If you cognitively learn something, then it can be unlearnt. If you can unlearn APD, then it's stupid to call it a personality disorder, since it isn't a part of your personality - it's just behaviour that helps you cover up your personality.
this
 
#12 ·
interesting, i avoid people on purpose. is not that they don't want to talk to me, on the contrary, i don't want to talk to them. they ask me for my cell phone number i don't give it. they want to joke around with me and get to know me, i avoid it. hmmm...

google, here i come.
 
#13 ·
I'm most likely in the minority that don't believe that AvPD is simply an extreme version of SA.

Socially Anxiety is caused by an inability to effectively cope with anxiety in social situations. Most of the symptoms of SA are byproducts of this.

AvPD is caused by unhealthy internalized beliefs (usually beginning from childhood).

While it's true that SA and AvPD share very similar symptoms, they originate from different things. The low self-esteem from SA is caused by repeated perceived social falures, while the low self-esteem from AvPD is from an unhealthy belief. The thing is that with AvPD that belief doesn't necessarily have to come from the same origin as SA (the perceived social failures). For me, personally, that unhealthy belief came from how I was mostly responded to as a child by my parents. Like everything I did or said, every emotion I expressed didn't matter or was inappropriate. Social anxiety came later when I had to make new friends because I moved to a different area.

Now, as far as this notion that people with AvPD just avoid everything that makes us anxious, that's true but only for severe cases. In milder cases the avoidant behavior is more toward becoming close or familiar with others. Needless to say it hampers our ability to make friends and especially form romantic relationship or get intimate if we were able to get into a romantic relationship.



But all of this is just my personal experience with AvPD and SA. Talk to someone else and they may have a totally different story.
 
#14 ·
The more I read about this, the more I'm convinced I have AvPD. I've had unhealthy internalized beliefs ever since I was a little kid. I feared rejection before people even rejected me. I don't really have any "bad experiences" in terms of socializing; my social anxiety is, in my opinion, a natural reaction to my perceived shortcomings and general inferiority to most people around me. I hope to have friends one day. I'll probably never have a boyfriend/significant other because I feel like that's really audacious of me, to want or even think I could have love in my life. I know that that is not true, that I am lovable and I'm not inferior, yet I've internalized it to such a point that logical reasoning does not do any good--my beliefs about myself are way too deep within myself.
 
#15 ·
AvPD from wikipedia:

I have SA and I can relate with pretty much everything in that list, except that I don't have agoraphobia and I don't feel inferior to others except in social skills. So what makes the difference in SA vs AvPD?
 
#17 ·
AvPD from wikipedia:

I have SA and I can relate with pretty much everything in that list, except that I don't have agoraphobia and I don't feel inferior to others except in social skills. So what makes the difference in SA vs AvPD?
Easiest way to think of SA vs AvPD:

SA = Fear of social situations
AvPD = Fear of close/intimate relationships

Like all mental disorders, there are severe and mild cases of AvPD. SA and AvPD symptoms are so similar because they have a similar effect, which is social inhibition. It's also why most suffers of AvPD also suffer from SA.
 
#16 ·
Yes, AVPD is worse;

Read this, it looks like a lot of text but once you read it, it's really clear, it gives the best definition of AVPD, this is from the "finally revealed: the difference between SA and AVPD" thread

there are a lot of similarities between SA and AVPD but there is also a significant difference

similarities

social phobics and avoidants both fear social situations
social phobics and avoidants both feel self concious in social situations
social phobics and avoidants both use safety behaviours in social situations
social phobics and avoidants both avoid social situations

differences

*social phobics may only fear one or a few social situations were as avoidants fear every situation to some degree. even situations that they can torelate they are never truly comfortable in them
*even if the social phobia is the generalized type its still not as generalized as avpd because avpd covers everything from situation to self
*social phobics fear social situations for different reason than the avoidant fears them
*social phobics fear social situations becasue they fear being judged or evaluated negatively by others and they also worry that they will have a panic attack or that they will show physical symptoms such as blushing, shaking etc... wich will prove to be embarrassing
*avoidants fear social situations because they are worried that their real self will be exposed and they they will be rejected as a result of it
*social phobia is to do with fears about performing socially were as avoidant personality disorder is to do with fears about the self and about who you are as a person
*social phobics feel self concious in social situations becasue they are trying to prevent people noticing their symptoms such as blushing, shaking etc...
*avoidants are self concious in social situations cos they are preocupied with trying to hide their real selves, and doing their best not to lose themselves in the moment incase a part of their real self is reveal and that they will be rejected cos their real self is not acceptable
*social phobics safety behaviours are designed to hide physical symptoms of anxiety
*avoidant's saftey behaviours are designed to hide the real self
*avoidants also scan their environment in social situations looking for signs of rejection, ridicule and disaproval from others
*social phobics avoid social situations becasue of fears of having a panic attack or showing signs of anxiety or being embarrased
*avoidants also avoid social situations because of fears of being embarrassed but also becasue of fears of revelaing their selves and being rejected
*low self esteem goes hand in hand with avpd. avoidants have a low sense of self worth and beleive they are inferior and worthless
*social phobics dont nessecarily have low self worth. some might , some might not. social phobia is an anxiety disorder that is seperate to self worth. self worth may become an issue later on due to years of isolation but its a seperate issue to the actaull anxiety. the anxiety may be the casue of it but that doesnt make the slef worth a part of the anxiety
*avoidants not only avoid feared social situations but they also avoid negative feelings and even negative thoughts. they have a low threshold for discomfort/dysphoria. avoidants frequently procrastinate with even trivial everyday tasks such as getting out of bed, starting an exercise regime, brushing their teeth etc... this is not a feature of social anxiety
*social phobia is a fear of situations
*avpd is also a fear of situation but more so a fear of revealing the self
 
#18 ·
SAD "mainly fear social circumstances, while people with AVPD tend to fear close social relationships."
AVPD have a harder time trusting people & feeling unsure about others. SAD have very strong fears & may lack social skills.
 
#19 ·
I can't imagine having one without the other. With SAD, experience social rejection enough times, this can lead to a distorted self-image (especially if the rejection is perceived, a misperception bound to happen given the heightened sensitivity to rejection) and aversive behavior. With AvPD, having thoughts that you're inadequate or sub-par relative to the world, I'd bet any person would feel some degree of discomfort/anxiety when he/she must confront the world, which leads to anxious behavior. The two are too interrelated to exist on their own. They should be lumped together as one disorder. Or is there anyone here who can identify with one disorder and not at all the other?
 
#23 ·
@ Kon. Thx for sharing. Interesting... So you fear revealing your true self because you anticipate others won't receive it well (understandably, based on prior experience). I do wonder though. Does not all this negative reception affect how you view yourself? I know for me, there are some traits that I have that I have valued but I've come to question (pretty violently) because society or people don't take to them well. It can be hard sometimes to stand up for yourself when you're alone. Not that I encourage conformity or mindless assimilation to what's mainstream ('normalcy' and the often psychotic attempts to achieve this state are overrated, among other things if you ask me). I advocate respecting the individual all the way (so long as it doesn't offend the ultimate functioning of society). But it can be hard to stand alone without being somewhat affected.

Though, one thing I've learned. People tend to be receptive to differences if they feel they've some sort of understanding of them. Explaining your circumstance in terms that people can understand helps (perhaps overly diplomatic but is the truth). Then again, not all people are ready/able to listen...
 
#24 ·
Woah,I havent looked into this avpd much but its given me a totally different outlook because it seems like I've always had SA but at the same time I always avoided social situations to prevent the anxiety.I could have that but not to the degree that I'm too shy all the time.Sort of in between.IDK it doesnt seem like theres much of a fine line between the two anyway.
 
#25 ·
I'm in the group that kinda sees them as related to eachother, at least for me personally. But its still possible to have one without the other...

I dont get panic attacks in social situations, i'm just really high strung, quiet, etc etc because of the reasons listed in what people feel with AvPD. It's almost like I get SA because of the characteristics of AvPD
 
#28 ·
In my opinion, the differences only matter to professionals who are needing to give a diagnosis. In reality, they are treated the same. Sure, if you open up a DSM, you can see that Avoidant Personality Disorder sounds like a much more extreme version of SAD, but the underlying behaviors are similar. In a therapeutic session, there really isn't any need to distinguish between the two because they are so similar and are thus treated the same.
 
#33 ·
I don't know that there necessarily is a difference. If you look at the history of the DSM it doesn't seem entirely trustworthy. Many health professionals don't even seem aware of AvPD, which is one reason I think no one ever thought of diagnosing me with it. From what I read it pretty much fits, same way SAD fits.

And I'm a lot happier identifying myself with an anxiety disorder than a personality disorder. So it's all good.
 
#32 ·
I think the hypertesion (high blood pressure) is a good analogy.

Essential or Primary Hypertension=AvPD that leads to high measured blood pressure (SAD). There's no real known cause for it. Some people just seem more susceptible to it. So, if you have this greater susceptibility to AvPD then depending on the seriousness, you will develop different levels of SAD (increased blood pressure).

However, high blood pressure can also be caused my many other factors like kidney problems, hormonal imbalance, congenital abnormalities (narrowing) of certain arteries, environmntal factors (diet). This is called secondary hypertension.

Same with SAD. Some of these other factors that may lead to SAD even if one doesn't have AvPD are things like other mental illnesses, environmental factors, developmental disorders like Asperger's, etc.

I'm not sure if this makes sense?
 
#36 ·
Here is what the DSM-IV says with AvPD and Differential Diagnosis:

"There appears to be a great deal of overlap between Avoidant Personality Disorder and Social Phobia, Generalized Type, so much so that they may be alternative conceptualizations of the same or similar conditions."

That's all they mention about the similarities. Basically saying they are the same thing, the same concept.
 
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