What is avoidant personality disorder?

People who have avoidant personality disorder (APD) avoid people because they fear being embarrassed and rejected.

How does it occur?

APD usually starts in early adulthood. Both women and men may have this disorder. The exact cause of APD is not known. Experts think it may be caused by differences in the brain or nervous system. It might also be related to problems in the family such as abuse, financial stresses, death of loved ones, or mental illness.

Children who are criticized or punished when they express emotion may try to avoid being hurt by keeping their feelings to themselves. They might avoid other people to avoid feeling bad. Children may learn fear from parents who were fearful. The person may often feel overwhelmed and withdraw as a way to protect himself.

What are the symptoms?

People who have APD have at least 4 of the following symptoms. They:

• avoid jobs that have a lot of people contact because they fear criticism, disapproval, or rejection
• do not get involved with people unless they can be certain of being liked
• do not trust others. They find it very hard to share feelings or let themselves be vulnerable.
• fear that people will make fun of them
• worry all the time about being criticized or rejected
• feel so shy and inadequate that they keep other people from getting close
• see themselves as hopeless, unappealing, or not as good as other people
• do not take risks or try new activities because they do not want to be embarrassed
• insult people who attempt to be friendly
• avoid intimacy rather than avoiding people.

How is it diagnosed?

Your healthcare provider or therapist will ask about your symptoms and examine you. He or she may also:

• give you a personality test
• suggest lab tests to rule out medical problems
• make sure medicines are not causing or increasing your symptoms
• rule out other mental health problems.

How is it treated?

Psychotherapy can help you see yourself more clearly. It helps you recognize the effects of your behavior on others. This can help you change behaviors that get in the way of living a satisfying life. Several types of therapy may help.

• Behavior therapy helps you face social interactions for longer periods of time.
• Cognitive behavior therapy is a way to help you identify and change views you have of yourself, the world, and the future that are not realistic. This therapy helps you recognize unhealthy ways of thinking. You will learn new thought and behavior patterns that lead to healthier living.
• Supportive therapy gives encouragement ("you can do it"), positive feedback ("you are good enough to succeed"), and reassurance ("you can handle the anxiety").

Antidepressant medicines may help relieve anxiety.

When should I seek help?

If your symptoms are seriously interfering with your daily life, seek help from your healthcare provider or a mental health professional.

For more information, contact:

The National Alliance for the Mentally Ill (NAMI) 800-950-NAMI Web site: http://www.nami.org

Mental Health America (formerly The National Mental Health Association or NMHA) 800-969-6642 Web site: http://www.NMHA.org

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