Avoidant personality disorder and social anxiety are characterized by a crushing sense of fear and uneasy feelings about social situations and interpersonal relationships. This means that often both concepts are used interchangeably. The similarity might be alarming but the significant difference can’t be ignored as well. You are about to learn and understand avoidant personality disorder vs social anxiety: similarities and differences to avoid misdiagnosing.
Key Takeaways
- An avoidant personality disorder is a personality disorder characterized by an overwhelming fear of criticism, embarrassment, and inadequacy in a social gathering or situation.
- Social anxiety or social phobia is one of the most known types of anxiety disorders which heightens people’s sense of nervousness and worry about interpersonal interactions making them anxious, scared, and extremely self-conscious.
- People with social anxiety disorder tend to understand the irrationality of their thoughts and fears. They understand that the rest of the world is not judging and criticising them but they can’t help but feel like they are.
- On the other hand, people with avoidant personality disorder are so deep in their minds that they believe that their perception of themselves and their negative self-evaluation is factual. They have a very poor self-image and a strong conviction that they are judged and criticized.
What Is Avoidant Personality Disorder?
An avoidant personality disorder is a type of personality disorder. This disorder is characterized by an overwhelming fear of criticism, embarrassment, and inadequacy in a social gathering or situation. This condition is so debilitating that an individual who suffers from an avoidant personality disorder may find himself unable to interact normally with people and feel out of place in a social gathering or event. In addition, they are unable to maintain interpersonal relationships with their families, relatives, and colleagues. They are categorized under cluster C personality disorder. They are a hermit, very often isolated and avoidant of situations that will lead to interaction with other people.
According to reports by DSM-5, about 2.4% of the world’s population has an avoidant personality disorder.
Symptoms of Avoidant Personality Disorder
- Inferiority complex
- An overwhelming fear of criticism and rejection when they have to interact with other people
- Avoidance of social gatherings such as school, churches, parties, etc.
- Feeling of inadequacy
- Often isolated
- Intense level of shyness that limits interaction
- Hesitant to try out new things
- Afraid of intimate relationship
- Irrational fear of doing something wrong
Example of Avoidant Personality Disorder
Ben is in his sophomore year in college, and his parents complain that he gets angry easily, refuses to mingle, spends his day in his room, and often sleeps. This has apparently affected Ben’s academic performance drastically. They confess that it’s even a surprise that he got to this point academically because he doesn’t seem to be interested in school. He won’t attend classes or tuition lessons.
He’d decline to talk to his relatives and neighbors. His parent has tried everything to make him socialise but it seems Ben has a phobia of the outside world. What’s worse is the gut-wrenching anger that envelops him when they bring up his predicament. Ben has no girlfriend and treats girls like they are plagues. He would become extremely shy and uncomfortable when he was in the presence of girls, and he wouldn’t attend school parties or get-togethers.
Ben finally got to see a psychologist who diagnosed him with a severe case of avoidant personality disorder. He was treated with so many medications and therapy before making some improvements.
What Is Social Anxiety?
Social anxiety or social phobia as some people call it is one of the most known types of anxiety disorders. It heightens people’s sense of nervousness, and worry about interpersonal interactions making them anxious, scared, and extremely self-conscious. They fear that people are judging and criticising them and this often limits social anxiety victims from relating and interacting with other people.
People with social anxiety disorder would most likely decline an invitation to a social gathering, get nervous when they are compelled to speak to people and show physical signs of anxiety like sweating, nervousness, shaking, and increased heartbeat during an interaction. It could be so bad that they may find themselves declining job offers, and staying away from school just to avoid being in the presence of people.
Symptoms of Social Anxiety Disorder
- Excessive worry about humiliating yourself
- Not wanting to be the center of attention
- Anxious about people taking notice of your anxiety
- Fear of being judged
- Trying so hard to adopt mechanisms to hide your anxiety and fear
- Hypersensitivity to negative evaluation by others
- difficulty holding eye contacts
- trembling or shaking when they find themselves in an unavoidable social situation
- panic attack when compelled to socialize
Social anxiety disorder at an early stage may just come off as shyness. However, shyness doesn’t disrupt interpersonal relationships and people’s lives, unlike social anxiety. Social anxiety disorder is more chronic and wrecks more havoc on people’s lives.
Example of Social Anxiety Disorder
Brenda is in high school. She remembers her ‘shy’ nature starting from when she was a little kid. She couldn’t socialize with other kids and would often go numb and quiet when she was in the midst of people. ”I thought it would all stop by the time I am grown, but it seems to get worse as the day goes by,” she says. Brenda complains that she’d go white and scared when the teacher asked her a question in class even when she knew the answer.
She had severe self-doubts. It’s like people are always watching her and talking. “I’d rather just be in my room” she confesses. Brenda’s nervousness about social gatherings and interactions has affected her academic life. She says that most time she tunes off in class, wondering what people may be saying about her. Brenda has never been in a relationship and can’t imagine herself in one.
She tells her psychologist “I just want to be normal”. Apparently, Brenda feels she’s abnormal.
Avoidant Personality Disorder vs Social Anxiety: Differences
There is a major difference between avoidance personality disorder and social anxiety. People with social anxiety disorder tend to understand the irrationality of their thoughts and fears. They understand that the rest of the world is not judging and criticising them but they can’t help but feel like they are. They often want to make friends and associate with people irrespective of the hindrance their feelings pose. People with social anxiety oftentimes don’t feel inferior, they’re just very uncomfortable with social events.
On the other hand, people with avoidant personality disorder are so deep in their minds that they believe that their perception of themselves and their negative self-evaluation is factual. They have a very poor self-image and a strong conviction that they are judged and criticized. This has a serious impact on their interaction with people and makes them not lead a normal life. However, an avoidant personality disorder is more genetically predisposed because it is a personality disorder. Meanwhile, social anxiety disorder is greatly influenced by the environment.
Let’s continue with our case studies, Ben and Brenda. It’s obvious that from the physical and behavioral symptoms, the complications of these two conditions overlap which means that it is hard to tell them apart. They both revolve around intense fear of criticism, judgment, and embarrassment and could disrupt people’s lives and relationships with others.
Can a Person Have Both Avoidant Personality Disorder and Social Anxiety?
The symptoms of Avoidance personality disorder and social anxiety disorder overlap and it’s often very difficult not to confuse one for another. Noting that the major difference in these two conditions is not physical but psychological makes it even harder for scientists to tell if the two can coexist in one person.
There is a hypothesis that has been put forward that rests on the notion that avoidant personality disorder and social anxiety disorder are one construct. And what distinguishes them is the severity of one over the other. Thus, this hypothesis says that AVPD and social anxiety disorder are one and that AVPD is merely a more severe case of social anxiety disorder.
If this hypothesis is true, then the two (or maybe one) conditions can affect one person albeit not at the same time. However, if the hypothesis is false, then it will be difficult, if not impossible to tell if a victim has both disorders.
How to Diagnose AVPD and Social Anxiety Disorder
If you suspect you are suffering from any of these conditions, it’s important to see a therapist to help you determine which one. As already stated, the symptoms of AVPD and anxiety disorder overlap a lot. Self-diagnosis can be dangerous because you could think you have one when you actually have the other, and hence, this may hinder effective treatment.
Though there is no significant laboratory test to check for anxiety and personality disorders, there are five criteria according to DSM-5 reports for social anxiety disorder. They are;
- persistent and extreme fear and anxiety about specific social situations because you feel judged and criticized
- total avoidance and endurance of these social situations
- disproportional anxiety toward a situation
- anxiety that interferes with your day-to-day activities
- Excessive fear that has no medical explanation.
When symptoms of either of these two conditions are present, psychologists and psychiatrists may use the DSM-5 criteria to ascertain if a patient has a social anxiety disorder or AVPD.
How Do You Treat Social Anxiety Disorder?
Thankfully, social anxiety disorder is not a permanent condition and can be treated.
Psychotherapy
This form of therapy will help victims of social anxiety develop good coping mechanisms for the disorder. There are various types of psychotherapy and Cognitive Behavioural Therapy is the most efficacious method for treating social anxiety disorder. During Cognitive Behavioural Therapy(CBT), patients are exposed to the source of their fears and anxiety and duly work through overcoming them. This type of therapy enables people to understand that the fears and anxiety they experience in certain situations are all in their heads and subsequently, develop confidence and the esteem to face them.
Medications
There are equally medications that could be effective in the treatment of social anxiety disorder. There are three major medications that psychiatrists recommend to manage the condition. They are;
- Antidepressants
- Antianxiety medications
- Beta-blockers
Antidepressants
Of the three, Selective Serotonin Reuptake Inhibitors, a type of antidepressant takes the lead in the treatment of Social anxiety disorder. Examples of SSRIs include; Paxil, (Paxil CR), Zoloft, Prozac, and Sarafem. Your doctor may prescribe any of these; you should nevertheless note that these medications take time to take effect.
Antianxiety medications
These types of medication, unlike antidepressants, take effect more quickly. Doctors may prescribe them for short-term use. The classes of drugs under antianxiety medications are benzodiazepines, Xanax, and Klonopin. It is strictly warned that antianxiety medications be used on a doctor’s prescription. Due to their quick action, these drugs can amount to dependence and even, addiction.
Beta-blockers
These classes of drugs are prescribed to be used occasionally. They block anxiety-induced behaviors such as increased heart rate, sweating, shaking, blood pressure, etc.
Often, doctors only prescribe these classes of drugs in specific situations for example, when a patient has to speak to a crowd. This will help them manage their anxiety while on stage.
Note; that medications are often used alongside therapy. Social anxiety is not a condition that goes in a day or even, months. Sometimes it takes years to finally get over social anxiety.
Treatment of Avoidant Personality Disorder?
Treating personality disorders is far more difficult than anxiety disorders. This is because people form their personalities over a period of time. This means that people with personality disorders have deep-seated beliefs, thoughts, and feelings already embedded in their personalities. Treating personality disorders will require a change in thought processes.
Treating avoidant personality disorder is however easier than other personality disorders. This is reliant on the fact that most AVPD victims crave a normal relationship and are, therefore, often willing to receive treatment.
Like social anxiety disorder, psychotherapy is the most effective method of treating AVPD. Of all the types of psychotherapy, CBT and psychodynamic therapy are two methods often used when it comes to AVPD.
Psychodynamic Therapy
Psychodynamic therapy is a type of psychotherapy or talk therapy that helps people better understand their emotions, feelings, thought processes, and unconscious motives for their various behaviors or actions. This type of therapy involves talking to a therapist. The more you talk about your thoughts and emotions, the more you’ll get an understanding of why you do the things you do.
Psychodynamics has proven to be an effective method in the treatment of avoidant personality disorder since it helps people understand their thought processes and brings their unconscious motives, to the conscious.
CBT method of treating an avoidant personality disorder is more or less the same as anxiety disorders. It is a form of therapy where you are exposed to the source of your irrational fears and walk through them.
These two therapies can go together
Medication
Antidepressants are equally used to treat AVPD. People who have AVPD are more often placed on antidepressants than those with social anxiety disorder. However, due to the severity of AVPD, the effectiveness may be less.
Why Do People Develop Avoidant Personality Disorder and Social Anxiety Disorder
There are no known causes of these conditions, perhaps this is a result of the fact that people often do not know the exact moment they develop these conditions. However, it’s believed that avoidant personality disorder and social anxiety could be genetic and passed across generations in a family. The environment could also influence AVPD and social anxiety disorder to an extent.
When people are exposed to esteem-crushing situations as kids, they are most likely to grow up socially awkward and may in turn develop any of these conditions.
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Risk factors of AVPD vs Social Anxiety Disorder
These refer to factors that increase the chances of developing AVPD and social anxiety. They include
- Genetics: If you have a family member who has it, you run the risk of developing it too.
- Brain structure: It is believed that people who have an overactive amygdala have greater chances of having AVPD or social anxiety.
- Childhood experiences: people who were exposed to negative experiences may have low self-esteem and self-image. It could cause AVPD and social anxiety
- Attention-drawing features: Kids who have attention-drawing features may develop social anxiety. Features like disfiguration, stammering, etc. These features may not only affect their self-esteem, it will equally put them in an uncomfortable spotlight which makes them feel watched and criticized.
- Temperament: children who are introverted, withdrawn, and basically shy stand greater chances of suffering from AVPD
Complications of AVDP and Social Anxiety
When AVPD or social anxiety goes untreated, it may give rise to other psychological complications in its victims such as,
- Depression
- Substance abuse
- Postpartum depression
- Suicidal tendency
- Eating disorder
- Poor academic performance
How Can I Help Someone with Avoidant Personality Disorder or Social Anxiety?
If your friend or loved one has any of these conditions, don’t try to ‘talk’ them out of it. Refer them to a professional, a psychologist, or a psychiatrist. Personally, you can share and relate with them in their struggle and encourage them to keep up with treatment.
Is Avoidant Personality Disorder a Mental Illness?
Yes. An avoidant personality disorder is a personality disorder and therefore, recognized as a mental illness.
Can Someone with AVPD or Social Anxiety Enjoy Themselves in a Social Gathering?
People with avoidant personality disorder have a chronic feeling of inadequacy. This may make them avoid social gatherings altogether. but as a matter of fact, they can enjoy themselves in a social gathering. When the gathering consists of people they have grown very comfortable around and they feel loved, they can muster up the energy to enjoy themselves.
Can People with Social Anxiety Disorder Be Extroverts?
Yes, they can. People with social anxiety disorder can equally be extroverts. These groups of people usually have the worst hit of social anxiety disorder because they derive their energy from interaction with people. When social anxiety becomes a hindrance to this trait, their situation may even become more severe than the regular introvert.
Are Introverts More Prone to Social Anxiety Disorder?
Both introverts and extroverts can be victims of social anxiety disorder. Extroversion or introversion has nothing with feelings of anxiety but research shows that introverts are more susceptible to social anxiety disorder. This is because introverted people derive their energy from being alone and tend to be more sensitive.
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