What is avoidant personality disorder (AVPD)?

Avoidant personality disorder (AVPD) is a mental health condition involving intense and ongoing discomfort in social situations. People with AVPD fear rejection or humiliation, even in situations where rejection is unlikely. AVPD affects around 2% of the U.S. population, and it may be slightly more common in people assigned male at birth.

Symptoms of avoidant personality disorder

Personalities come in so many different forms. Some people are more outgoing, while other people prefer spending time alone. Being a shy person doesn’t mean you have a mental health condition. It might just mean that your “social battery” needs recharging more often, and this isn’t the same as having AVPD.

AVPD can make social interaction of any kind feel overwhelming. People with this condition fixate on their perceived shortcomings and may not engage with anyone unless they feel sure they won’t be rejected. Some other possible signs of AVPD include:

• Refusing a great job offer because you’ll need to work closely with other people
• Not leaving the house unless absolutely necessary and spending nearly all of your time alone
• Always worrying that other people will think you’re unintelligent or inept
• In social settings, keeping to yourself and staying quiet for fear of embarrassing yourself 
• Avoiding hobbies or activities you might enjoy because you think you’ll humiliate yourself or be a total failure

Having any of these experiences from time to time doesn’t mean you have a mental health condition. Almost everyone knows what it’s like to feel inadequate, ill prepared, or unsure whether you’ll be accepted. Sometimes, it’s tough to enter new social situations with confidence — especially if you don’t know anyone. 

But to be diagnosed with AVPD, a person must demonstrate more than just occasional social avoidance or awkwardness. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), they must show a “persistent pattern of avoiding social contact, feeling inadequate, and being hypersensitive to criticism and rejection,” along with at least four of the following symptoms by early adulthood:

• Avoiding employment or job-related tasks that require engaging with other people due to fears of being criticized or rejected 
• Being totally unwilling to build relationships unless they feel 100% sure of being liked and accepted
• Being unable to be open and vulnerable in relationships due to fears of rejection, disapproval, or embarrassment
• Fixating on fears of being rejected or criticized in social situations
• Feeling reserved or inhibited in social settings due to fears of inadequacy
• Seeing oneself as inherently incompetent, undesirable, and/or inferior to other people
• Being unwilling to take risks or try new things for fear of embarrassment or failure

Like many other mental health conditions, AVPD shares some symptoms with other conditions. For example, social anxiety and schizoid personality disorder also cause intense discomfort in social situations. But with social phobia, the fear is more often focused on a specific scenario, like public speaking, while the social anxiety caused by AVPD is more universal. Similarly, schizoid personality disorder is known to cause a tendency to self-isolate. But this is typically due to a disinterest in other people rather than a fear of being rejected by them.

What causes avoidant personality disorder?

AVPD hasn’t been studied as extensively as other mental health conditions. So we don’t have an abundance of information on its possible causes. However, researchers have identified a few factors that may contribute to AVPD. These factors include:

• Genetics: While the specific genes associated with AVPD haven’t been identified, having a first-degree relative — like a sibling or parent — who also has it may increase your risk.
• Environment: There’s an established link between negative childhood experiences — like trauma, abuse, or neglect — and personality disorders. Also, having a poor attachment with a primary caregiver during childhood may contribute to avoidant behavior as a coping mechanism later in life.
• Temperament: A few personality traits are associated with AVPD. These include novelty seeking, a tendency to shape one’s behavior to please others (also called reward dependence), harm avoidance, and persistence.

Can avoidant personality disorder be cured?

AVPD is a chronic condition that can significantly impact social and occupational functioning. People with AVPD may continue to experience symptoms even if they’re engaged in treatment. However, research shows that a subset of people (about 50%) may eventually experience a remission of AVPD symptoms with the right support. 

While each person’s treatment experience will be based on their unique needs, managing AVPD often involves a combination of:

• Therapy: Approaches like cognitive behavioral therapy (CBT) can be used to interrupt maladaptive thought and behavior patterns, enhance social skills, improve self-esteem, and challenge avoidant tendencies. However, because AVPD symptoms may not go away, even with treatment, the goal of therapy may be to reduce stress and increase socioeconomic stability.
• Self-care: Regardless of your diagnosis, practicing self-care can have a positive impact on both your physical and mental health. So try to get adequate sleep, fuel your body with nutritious food, and make time for activities you enjoy.
• Medication: While there’s no medication approved to treat AVPD, it can be helpful in some cases. For instance, if you have a co-occurring condition — like depression or anxiety — you can talk to your provider about adding medication to your treatment plan.

Find care with Rula

AVPD is a chronic mental health condition that affects how people see themselves and interact with others. It can cause a fixation on one’s perceived shortcomings and ongoing fears of judgment, humiliation, and embarrassment. This can lead a person to self-isolate and avoid activities that require social interaction, even at their own expense. However, with the right support, people with AVPD can improve their social skills and enhance their well-being.

When you need support for AVPD or any other mental health condition, we want to welcome you to Rula. With a network of over 10,000 providers to choose from, we can connect you with a therapist who takes your insurance in just a few clicks. No matter the issue you’re facing, we want you to know that help is available and you don’t have to wait weeks or months to receive the support you deserve. Simply head over to our therapist-matching program, where you can sort through your options, select a provider, and make your first live video appointment for as soon as tomorrow.

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