Mental health diagnoses are a joke. It's really just a label that describes your behavior. And you can go to 5 different shrinks and get 5 different diagnoses. I see a lot of people saying they have 5 different disorders because they have gotten 5 different diagnoses from 5 different shrinks. I got a bunch of possibilities when I was in the loony bin; Schizophrenia, GAD, SAD, avoidant PD, delusional disorder.
There's almost no difference between SAD and AvPD. AvPD just seems like SAD that is impossible to treat because it has become a part of your personality. Think how hard it is for someone to change personailities - just about impossible In fact until a few years ago personality disorders were considered completely untreatable.
I think this is a key way of distinguishing the two besides severity:
In particular, those with AvPD experience not only more severe social phobia symptoms, but are also more depressed and more functionally impaired than patients with generalized social phobia alone. But they show no differences in social skills or performance on an impromptu speech. Another difference is that social phobia is the fear of social circumstances whereas AvPD is better described as an aversion to intimacy in relationships.
That and the avoidance is a coping mechanism that expands to things not SA related as well.
AvPD is more prevalent in families of people with schizophrenia, and it's debated as to whether it's a schizophrenia spectrum disorder:
The detection of relatives of schizophrenia (Sz) probands who are affected by a schizophrenia-spectrum diagnosis allows delineation of an extended phenotype that may be helpful for establishing patterns of familial transmission. Accepted schizophrenia-spectrum disorders include: Sz, schizoaffective disorder, atypical psychosis, schizotypal personality disorder and paranoid personality disorder. Some family studies have also found a familial relationship of Sz with avoidant personality disorder which suggests that avoidant personality disorder is a schizophrenia-spectrum disorder. (Asarnow et al., 2001; Baron et al., 1985; Kendler et al., 1993)
Meehl (Meehl, 1962) hypothesized that social anxiety is part of the schizotypy core, predisposing to Sz. We review below several other lines of research which support the association between symptoms of social anxiety and a liability to Sz: social anxiety symptoms in the relatives of schizophrenics, social anxiety in patients with Sz, examination of “high-risk” children for early predictors of psychosis, and factor analyses demonstrating that social anxiety is separable from other types of schizophrenia-spectrum related psychopathology. These studies offer mixed support for the hypothesis that symptoms of social anxiety may represent an extended phenotype that may be helpful in the delineation of the familial transmission of Sz.
Even when controlling for the presence of paranoid and schizotypal personality disorders, the analysis demonstrated that avoidant personality disorder is more prominent in first-degree relatives of Sz probands compared to CC relatives. This pattern suggests that avoidant personality disorder should be included as a Sz spectrum disorder. Our findings replicate and extend the findings of other family studies (Asarnow et al., 2001; Baron et al., 1985; Kendler et al., 1993).
Two individual symptoms of avoidant personality disorder had the highest odds ratios in the Sz relatives when compared to the CC relatives: avoids social or occupational activities…” (OR 4.6) and “exaggerates the potential difficulties…” (OR 4.5). These are the symptoms most characteristic of avoidant personality disorder when it lies on a Sz spectrum. These symptoms are similar to the symptoms found in children at high risk for developing Sz (Auerbach et al., 1993).
Since 71% (24 of 34) of the time, avoidant personality disorder appears outside the presence of other Sz spectrum disorders in first degree relatives of Sz probands, it may detect additional relatives with liability to schizophrenia. These are not simply cases that are a “near miss” for either schizotypal or paranoid personality disorder, since more than 92% (22/24) of these cases were 2 or more criteria below the threshold for a diagnosis of either schizotypal or paranoid personality disorder, further supporting avoidant personality disorder’s putative role as a separable Sz spectrum disorder.
Our findings are a continuation of Bleuler’s observations of the prominence of social dysfunction in Sz, referred to as autism in his writings (Bleuler, 1950). Our findings are also supportive of Gottesman’s hypothesis of the epigenetic transmission of Sz wherein the diathesis of Sz is dependent upon subtle disruptions in processes critical to forming and maintaining social relationships (Gottesman & Shields, 1982). Studies of normal social development find that these processes include being able to adroitly monitor and adjust to the demands of social relationships, which requires monitoring one’s own affective state while recognizing how this is impacting other persons. Deficiencies in these processes early in development lead to a vicious cycle, whereby children are less likely to have successful peer relations, and as a consequence have less opportunity to acquire social skills through peer interactions (Garmezy, 1987). When deficiencies in social development derive from a vulnerability to Sz, they may be represented by avoidant personality disorder
Social functioning has typically been treated as if it were a dimension independent of core Sz pathology. Level of social functioning in adults prior to onset of psychosis is one of the best predictors of level of functional adaptation after the onset of psychosis, a better predictor than type and severity of acute symptoms, and may represent a core aspect of Sz pathology (Liddle, 1987; Strauss & Carpenter, 1977). An emotional atmosphere of criticism is a risk factor for subsequent relapse of psychotic symptoms in Sz, and may be dependent upon avoidant personality disorder symptomatology (Nuechterlein et al., 1992b; Subotnik et al., 2002). The results of the present study suggest that sensitivity to criticism is associated with the liability to Sz, not just secondary to the development of a psychotic disorder. Avoidant personality symptoms may represent a core expression of vulnerability to Sz.
My cousin got unlucky I guess and developed full blown schizophrenia.
It was also at one point considered part of the same diagnoses as schizoid personality disorder until they were separated, and superficially I can see myself a lot in that disorder too especially as I've gotten older. Though AvPD does still fit fairly well. I feel like there's probably a line there in symptoms that some people straddle.