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I also suffer from both. :afr
DSM-IV always has the answers
The DSM-IV-TR, a widely used manual for diagnosing mental disorders, defines avoidant personality disorder as a "pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection
is unwilling to get involved with people unless certain of being liked
shows restraint within intimate relationships because of the fear of being shamed or ridiculed
is preoccupied with being criticized or rejected in social situations
is inhibited in new interpersonal situations because of feelings of inadequacy
views self as socially inept, personally unappealing, or inferior to others
is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing
Very similar to SA
 

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To me, they are the same thing. At the very least, SA leads to avoidant personality disorder, which makes them very closely connected, and feels like the same thing.
 

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avpd (which I have) is a more extreme version of SA, but very interrelated. SA is more like a subset of AVPD. weatherman pretty much covered the symptons very well.
 

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I really don't know which one I have anymore.
 

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Discussion Starter · #7 ·
Whenever I read about APD it sounds a lot like me. But how could 4 psychiatrists, a nurse practitioner, a therapist, and two autistic specialists miss it?

I've been diagnosed with asperger's syndrome, (high function autism) but I know it's not the right diagnosis for me. I know they have it confused, because it doesn't make sense to me. My therapist started the whole thing about me having asperger's because I hardly showed facial expressions when I was there. But when I'm at home I'm nothing like that. The reason I don't show emotions around people or facial expressions is because I am afraid to, I am so afraid that it'll give them a reason to hate me.

She also said that I didn't catch a lot of social cues, but how would I if I don't have experience talking to people much at all? I have the ability to learn them.

One thing that confuses me about APD is that it sounds like people with it are so depressed all of the time, although I get depressed I usually ignore it, and don't think about it. Because if I think about it then I'll be depressed all of the time. I used to be depressed all of the time, but that was because I felt so excluded and unloved, my expectations were that I felt so inhuman and I wanted to be included, but wanting to be normal was too hard. And always feeling like everyone hates me and leaves me out on purpose felt too painful. I'm never going to have friends if it happens it happens, but I'm not expecting that it ever will, it's too painful to be disappointed like that. I didn't give up I'm still fighting the social anxiety, I still want to be able to drive to the store myself, or at least be able to go in by myself. But for socializing with people and enjoying it will never happen, I wanted it my whole life, I don't fight myself by wanting it anymore, I'll always want it, but I can't go there, while it is so hopeless. I'm not hopeless on life. But wanting to socialize with people for so long and not being able to throughout when I was a kid has taught me that I can live without normal social interaction, it might not be plesant but it's the best I can do right now. Or I could just be depressed all of the time, so wheres the point in that?
 

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I don't think that social anxiety leads to avoidant personality disorder. Like most disorders, anxiety is a likely byproduct.

Causes of AvPD:

1 of many explanations:
Being born with a difficult temperament or personality characteristics which makes their parents reject them or at least not provide them with enough early, uncritical love. This rejection may result in low self-esteem, social alienation.. conditions that persist into adulthood. People with AvPD are more likely to recall their parents as being more rejecting, more guilt engendering, and less affectionate than the control group. They are more likely to report childhood experiences of isolation, rejection, and conflict with others . . . . because the problems experienced by people with AvPD resemble those of social phobia, many of the same treatments are used.

This was from one of my psychology text books.

Another difference between the two is that AvPD is that it begins in early childhood and is lifelong. Social anxiety has a mean age of onset in mid-adolescence, I believe (I don't feel like checking.) People suffering from any personality disorder are less likely to benefit from treatment. Basically, AvPD is severe social anxiety; It begins earlier and lasts indefinitely. Anxiety has a high success rate of being lessened; that's not the case with a personality disorder.
 

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I started out shy, then developed SA rather young, then started to severely avoid situations. So pretty much the same to me.
 

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Discussion Starter · #11 ·
Drella's_Rock_Follies said:
I don't think that social anxiety leads to avoidant personality disorder. Like most disorders, anxiety is a likely byproduct.

Causes of AvPD:

1 of many explanations:
Being born with a difficult temperament or personality characteristics which makes their parents reject them or at least not provide them with enough early, uncritical love. This rejection may result in low self-esteem, social alienation.. conditions that persist into adulthood. People with AvPD are more likely to recall their parents as being more rejecting, more guilt engendering, and less affectionate than the control group. They are more likely to report childhood experiences of isolation, rejection, and conflict with others . . . . because the problems experienced by people with AvPD resemble those of social phobia, many of the same treatments are used.

This was from one of my psychology text books.

Another difference between the two is that AvPD is that it begins in early childhood and is lifelong. Social anxiety has a mean age of onset in mid-adolescence, I believe (I don't feel like checking.) People suffering from any personality disorder are less likely to benefit from treatment. Basically, AvPD is severe social anxiety; It begins earlier and lasts indefinitely. Anxiety has a high success rate of being lessened; that's not the case with a personality disorder.
My parents always cared about me, but I didn't feel like they really cared if I did anything with my life, I always felt like they didn't like me socializing or talking with anyone. I remember having severe social anxiety when I was 3. I was terrified of people, afraid they'd hurt me. I was terrified of communication and I never felt capable or worthy of talking to people. I deeply doubted myself and deeply doubted my abilities to socialize.

I remember feeling like my parents ignored me, especially around 8, I always was testing them to see if they cared or loved me and usually everyone failed my tests. I remember around age 5 my mom treated me different, that was when I felt like she no longer paid the same kind of attention to me, maybe she treated me different cause I acted different. when I was a little older I felt like she cared about strangers more than me a lot of the time. I know I exaggerated it all in my mind, but if my parents did anything small that could be misunderstood I saw it as that they hated me or didn't care about me, even if they didn't even act that way. When my social anxiety got really bad, I started skipping school in the second grade, everyday we'd argue about school and in the mornings it was really tough to get me to go, I put up really difficult fights until my parents gave in. My parents were loving to me, I don't think it's their fault.
 

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I have social anxiety as well as avoidance. The only time I have contact with people is when I go to work or to the supermarket. I dont know any people on a personal level, never get visitors or the phone never rings. I live by myself and if it wasnt for my job I wouldnt talk to anyone at all.

I started avoiding people when I was at school and being bullied which is where it all started. I have always been shy and sensitive and very self conscious. The way I coped with the bullying at the time was the worst thing I could do. I withdrew into myself, put the walls up and turned into a loner overnight, if anyone tried to be friendly I used to be rude to them so that they would keep their distance, I was sick of being hurt by people and that was over 20 years ago. I'm alot worse now.
 

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Alot of these anxiety based/anti-social disorders are kind of the same thing. Who's to say someone with GAD doesnt have SAD or vice versa...it seems all the same to me. But then again maybe there are people who have really specific symptoms and i've just never met them.

Infact when i was first diagnosed i was told that depression is my problem and once the depression goes away so does the anxiety hohoho.

ps. GPs are horribly bad at assessing the anxiety disorders
 

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It's not clear to me that there is a difference. Perhaps the biggest obvious difference is that SAD is an Axis I disorder, and AvPD is an Axis II disorder. Axis I disorders are your standard mental disorder categories, whereas Axis II disorders are considered developmental or more global, affecting all aspects of the individual's life, and are typically chronic.

http://allpsych.com/disorders/dsm.html

Some relevant reviews:

Avoidant personality disorder, generalized social phobia, and shyness: putting the personality back into personality disorders.

Avoidant personality disorder and social phobia: distinct enough to be separate disorders?

They can probably be thought of as different in a way similar to how autism is different from Pervasive Developmental Disoders. Autism is a subtype of PDD, and PDD is a "spectrum" disorder that encompases many different manifestations. This is certainly probably true of social anxiety as well.
 

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K, only two people in this post say they have it and were diagnosed. (I think I counted right, sorry if I didn't.)

But AvPD sounds like what I have. SA was really life-long for me. I always extremely anxious around people as a young child. I rarely voluntarily talked to people. I still don't know what it's like to raise my hand in a classroom and give an opinion. Or have a job. I get really sensitive around people, so if I've known them for a little while and I'm still not positive they like me, I tend to avoid them big time. When I had a roomate these past two semesters, for months and months we only said "goodnight" to each other pretty much. Maybe that doesn't seem so extreme, but I'm a pretty dull person--I don't like to take risks and make mistakes, and if you got to know me, you'd definately see how hypersensitive I am.

My last therapist whom I quit once said to me "well, i see you aren't avoidant!" after I told him I went to a meeting for some club on campus. So maybe he considered that diagnosis. But really, that's not typical of me to take such a big risk.

After I saw this post, I started reading some stuff on the internet about it. It's all quite depressing. Could it be that maybe therapists and doctors don't diagnose it right because it's deathsentence-y? I mean, they couldnt' justify that no way, but maybe they are doing it nonetheless. Gosh, the things I read! There are all sorts of warnings about treating AvPD people. Progress is slow. They quit their therapists. They become dependent on their therapists. You should be careful giving em benzos because they abuse them. They're unpleasant to be around. They're needy and whatnot. They need comprehensive treatment that involves meds and group therapy and regular therapy and cognitive therapy to have any sort of chance really. They'll never be outgoing really, just homebodys who are less freakish.

It's like that with the other personality disorders too. Geez, no one wants to be thought of as a hassle! but you read that stuff and you feel hopeless and yr self-esteem goes to sh.it.

If AvPD is underdiagnosed, I think that's bad. And I think they way people look at personality disorders is bad too. I mean, how can you find a balance between being realistic, and trying to help people? With personality disorders, you get a lot of books about people with degrees in psychology or counseling, or who've had personality disorders themselves writing books about what to do to make a big change in yr life and gradually rise above the disorder and life life to the fullest--which seems like too much of an exception to the rule. And then you have people actually practicing counselling and psychology and stuff who maybe see AvPD as so hopeless, that the diagnosis should only be reserved to people who are so disfunctional that they act out in society? Like the squeaky wheel getting the grease?

You know what? I think my post is going to sound crazy and conspiracy theoryish tomorrow hehe. I wrote this in the middle of the night. Sorry it's all emotionally charged and I didn't quote any sources.

Also, I think I'm going to call my last couple of therapists and get what I can from them, I dunno, notes and write-ups and thingys. Those would be interesting to read.
 

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perfectlycalm said:
Whenever I read about APD it sounds a lot like me. But how could 4 psychiatrists, a nurse practitioner, a therapist, and two autistic specialists miss it?
Because insurance companies don't reimburse for treatment of personality disorders. So the diagnoses always magically cluster around Axis I conditions like social anxiety, depression, etc., and "somehow" ignore Axis II (personality) conditions. I think it's a joke. It's rooted in the idea (false) that people with personality disorders can't change.
 

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I have been diagnosed with AvPD but not SA. I think there were a lot of good posts on here and I'm not sure there's much more I can add. I do have a lot of thoughts on the topic but I don't feel that I can put it into words right now. I'm going to try to come back and do so.
 

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:haha I just came back to point out the irony of my post ^
 

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I mean, how can you find a balance between being realistic, and trying to help people?
That is always a difficult balance to find, for anyone working in healthcare or similar fields.
 

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Discussion Starter · #20 ·
breydonlee said:
I have social anxiety as well as avoidance. The only time I have contact with people is when I go to work or to the supermarket. I dont know any people on a personal level, never get visitors or the phone never rings. I live by myself and if it wasnt for my job I wouldnt talk to anyone at all.

I started avoiding people when I was at school and being bullied which is where it all started. I have always been shy and sensitive and very self conscious. The way I coped with the bullying at the time was the worst thing I could do. I withdrew into myself, put the walls up and turned into a loner overnight, if anyone tried to be friendly I used to be rude to them so that they would keep their distance, I was sick of being hurt by people and that was over 20 years ago. I'm alot worse now.
Kids bullied me in school, but I withdrew before I even got teased, I withdrew when I stepped on the bus the first day of school before I got to school. When I did get teased it just made me worse.

In the 3rd grade there was a girl who was trying to be friends with me, she talked to me for a couple of months I really didn't talk to her but I listened, I started to talk every once and a while, but she got me in trouble. The teacher was too hard on me, it seemed like whenever I got up the nerve to feel normal and have a little fun the teacher was there to embarrass me and chew me out, make a big scene.
 
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