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We all get shy from time to time - often, these feelings can lead us to act or behave in a particular way. Perhaps you find yourself blushing around someone you’ve had a secret crush on for a while, or maybe you have an essential work presentation and dread having to talk in front of a large crowd. Shyness Many of us struggle with shyness occasionally. And this is normal, not pathological. However, a portion of the population suffers the kind of debilitating shyness that is so severe it leads to social isolation and inhibition. In many cases, those presenting with crippling timidity and social shyness are often diagnosed with an avoidant personality disorder. This mental health condition is marked by a pervasive pattern of behaviour that involves feelings of inadequacy, inferiority, and extreme social inhibition. Avoidant personality disorder Individuals with avoidant personality disorder tend to suffer from extreme fear of social rejection and shyness, making it challenging to interact with others professionally and socially (Psychology Today, Avoidant Personality Disorder). What causes avoidant personality disorder? Mental health experts suggest various factors that could lead someone to develop an avoidant personality disorder. They include: Having authoritarian parents or caregivers A family history of avoidant personality characteristics or disorder Neurotransmitter impairment or dysfunction Individuals who were extremely shy in childhood are at higher risk of developing avoidant personality disorder in later life. However, experts say that not every person who develops the condition experienced shyness as a child. Signs and symptoms Broadly, avoidant personality disorder is marked by several key symptoms, including fear of rejection, extreme shyness, and fear of being ridiculed by others. A person with an avoidant personality disorder may experience various feelings and emotions, such as: Significant feelings of inferiority Feelings of inadequacy Profound low self-esteem and lack of confidence Fear of rejection Fear of being negatively judged or ridiculed by others Hypersensitivity to negative criticism or evaluation Fear of criticism One of the most pervasive symptoms of avoidant personality disorder is fear of criticism; those with the condition tend to suffer extreme hypersensitivity from even the slightest remark or criticism. Avoidance behaviours Because of this, individuals with an avoidant personality disorder may decline (or avoid) job opportunities due to fear of being criticised or judged by others. Moreover, people with this disorder may only feel comfortable around those who they think will not reject them. Due to their low self-worth and lack of confidence, those with avoidant personality disorder are often inhibited in social situations and are usually preoccupied with their flaws and shortcomings. Fear of rejection The thought of being rejected is such a painful concept to those with an avoidant personality disorder that many prefer to be alone and opt for solitude rather than risking rejection or putting themselves in a position to be hurt by someone else. All this may result in a lack of connection and authenticity in the person’s relationships, making it challenging for them to form or sustain lasting bonds with friends, family, and partners. Significant signs of avoidant personality disorder Studies show several critical signs that may signify avoidant personality disorder. For instance, someone who constantly finds reasons to avoid social interactions and lacks meaningful relationships with others may show signs of the condition. We are all guilty of canceling plans at the last minute or avoiding social interaction from time to time. Since, after all, lazing on the sofa in our comfiest pyjamas and watching our favourite Netflix series is often too hard to resist. However, when social avoidance is persistent, this may denote avoidant personality disorder. Prevalence rates The diagnostic and statistical manual states that around 2.4 percent of Americans have an avoidant personality disorder (Psychology Today, Avoidant Personality Disorder). Such rates are similar for women and men. Avoidant personality disorder vs social anxiety disorder According to the research literature, an avoidant personality disorder is often confused with other anxiety disorders, mainly social anxiety. All this is because the symptoms of these conditions can sometimes overlap; for instance, both avoidant personality disorder and social anxiety disorder include social avoidance. However, avoidant personality disorder and social anxiety disorder have entirely different origins, i.e., an avoidant personality disorder is fueled by negative feelings directed toward oneself; this may involve negative self-evaluation compared to others (Psychology Today, Avoidant Personality Disorder). On the other hand, social anxiety disorder is fueled by a fear of doing or saying something shameful or embarrassing in a social situation that a person may later regret. Projection People with an avoidant personality disorder often dislike who they are and project this self-loathing onto others, believing that others will reject or disapprove of them. Paranoia and low self-esteem are core features of this mental health disorder (Psychology Today, Avoidant Personality Disorder). Diagnosis Various factors are involved in a person getting diagnosed with an avoidant personality disorder. The condition is typically diagnosed in adults, not children since young people’s personalities are still developing. Thus specific traits like shyness can be ordinary experiences in childhood that are outgrown once a person reaches adulthood (What Is Avoidant Personality Disorder (AVPD)? Verywell mind, Arlin Cuncic, August 8, 2020). Criteria To be diagnosed with avoidant personality disorder, a person must exhibit a pervasive pattern of extreme sensitivity to criticism, social avoidance, and significant shyness and inadequacy. Additional criteria include: Avoiding intimate relationships for fear of being rejected or ridiculed Avoidance of social activities that involve being near others due to fear of disapproval, rejection, or criticism An unwillingness to get involved with others unless you are confident they will like you Feelings of social ineptness, inferior to others, or believing you are unappealing Resistance to trying new things out of fear or embarrassment Preoccupation with rejection or criticism in social situations Co-occurring conditions Studies show that avoidant personality disorder may co-occur with other mental health conditions, including: Substance use disorder Depression Borderline personality disorder Dependent personality disorder Treatment options Like many personality disorders, an avoidant personality disorder can be a complex condition to treat. Studies show that many people with avoidant personality disorder do not seek support and treatment for their symptoms. Since personality disorders are enduring patterns of behaviour, it can be challenging for a person to recognise that they have a problem. As a result, people with avoidant personality disorder usually only seek help for symptoms of other mental health conditions such as depression and anxiety. The good news is that those who do seek treatment experience favourable outcomes, such as a reduction in their symptoms and positive coping mechanisms. Talk therapy Those with avoidant personality disorder benefit from talk therapy such as cognitive behavioural therapy (CBT). Other treatments like schema therapy and psychodynamic therapy are also proven effective. CBT allows a person to reframe and change unhelpful thoughts and beliefs that may lead to destructive behaviour and thinking patterns. On the other hand, psychodynamic therapy helps people explore their thoughts, behaviour and ideas and bring any unconscious conflict that might be causing a person’s unpleasant symptoms into conscious awareness. Schema therapy involves ‘’limited reparenting’’ in which a person learns to express any unmet childhood needs and desires, thus internalising a healthy, loving parent voice (What Is Avoidant Personality Disorder (AVPD)? Verywell mind, Arlin Cuncic, August 8, 2020). Contact White River Manor If you want more information about this article or are concerned about your mental health, please get in touch with one of our specialists who can help. We specialise in treating various mental health disorders and addictions and are always here to lend a compassionate, supportive ear. Speak to a specialist today. Additional resources Avoidant Personality Disorder: Psychology Today What Is Avoidant Personality Disorder (AVPD)?: Verywell mind, Arlin Cuncic, August 8, 2020