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Avoidant Personality Disorder: Symptoms, Causes, and Treatments

Katelyn Hagerty

Reviewed by Katelyn Hagerty, FNP

Written by Rachel Sacks

Updated 12/27/2022

Do you want close relationships and productive life experiences but feel like something is holding you back? Or do you feel extremely shy or terrified of the possibility of rejection?

If these apply to you, then you might be dealing with an avoidant personality disorder. But what exactly is this disorder?

In short, avoidant personality disorder is a mental health disorder in which someone feels extremely shy or inadequate, as well as sensitive to rejection, their entire life, which can cause issues in interpersonal relationships. Just over an estimated two percent of the U.S. population have this disorder, with men and women equally affected.

Before you turn to Google, keep reading for more information on this disorder, as well as avoidant personality disorder symptoms, causes and treatments.

Before diving into symptoms and treatment, let’s start with a more in-depth definition of this disorder.

Avoidant personality disorder is one type of personality disorder.Personality disorders are a group of mental disorders that involve long-term, problematic behavior and mood patterns, including issues with how people relate to others. Oftentimes, those with personality disorders don’t realize how disruptive or problematic their thoughts and behavior are, both to themselves and others.

Avoidant personality disorder begins in childhood and may start to cause more problems or become more noticeable in early adulthood.

Those with this condition may want to interact with others but are highly sensitive to being judged negatively, or may have long-term feelings of inadequacy.

Avoidant personality disorder is often associated with other mental health conditions like schizoid personality disorder and dependent personality disorder. For more information on mental illness vs personality disorder, our guide takes an in-depth look at the two.

Borderline personality disorder and avoidant personality disorder also share several symptoms and other similarities.

There’s also a close relationship between avoidant personality disorder and anxiety disorders — in particular, social anxiety disorder.

Researchers once thought that social anxiety disorder and avoidant personality disorder were comorbid mental disorders. Further research has classified avoidant personality disorder as a more severe form of social anxiety disorder, and there are still many overlapping symptoms.

There’s also often comorbidity between an avoidant personality disorder diagnosis and depressive disorders, substance abuse and other personality disorders, such as cluster C personality disorders, which are characterized by anxious, fearful thinking and behavior.

The main avoidant personality disorder symptoms are being shy, feeling like you're not good enough or don't measure up, and hypersensitivity to rejection.

Other symptoms include:

  • Isolation

  • Having few or no friends

  • Avoiding intimate relationships

  • A need to be liked

  • Extreme anxiety in social situations

  • Feeling shy, awkward or self-conscious

  • Fear of criticism

  • Avoiding social activities that involve being with others

  • Rarely trying anything new or taking personal risks

  • Fear of being embarrassed or doing something wrong

  • Poor self-image

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The cause of avoidant personality disorder is unknown, though both genetics and environmental factors are believed to play a role. Childhood shyness, as well as early parental or peer rejection, has been found to last into adulthood and impact self-esteem and self-worth.

Attachment style is also thought to play a role in whether this condition develops.

How we form relationships as adults is thought to be shaped by our childhood experiences or how we bonded (or didn’t) with our caretakers or parents. There are four attachment styles:

Those with anxious or avoidant attachment styles are thought to be more likely to develop avoidant personality disorder.

Because not too much is known about the cause of this personality disorder, treatment can be difficult.

Fortunately, because many people with avoidant personality disorder truly desire relationships and connections, they’re often good candidates for treatment, as they have a motivating reason.

Psychotherapy — or talk therapy — is an effective treatment for this personality disorder. Therapy focuses on changing a person’s thinking and behavior to overcome fears, learn coping mechanisms and help them better handle social situations.

Different types of therapy have been found effective, including:

Antidepressant medication might be used to help manage anxiety symptoms, usually in combination with psychotherapy.

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Feeling better is possible

So what is avoidant personality disorder? Intense fears of rejection or criticism, extreme shyness and feeling like you’re not enough.

This condition doesn’t just come up in social settings though. Those with avoidant personality disorder may also find their productivity impacted, because they believe that if they don’t try, they won’t fail.

Living with this disorder can be difficult and affect your quality of life. But there are ways to get help. If you want to get started with online therapy, you can consult with a licensed mental health professional from the comfort of your couch. Or you can browse our mental health resources for more information.

8 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Avoidant personality disorder. (2020, November 7). MedlinePlus. Retrieved from https://medlineplus.gov/ency/article/000940.htm
  2. Avoidant Personality Disorder: Symptoms, Causes & Treatments. (2020, October 6). Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/diseases/9761-avoidant-personality-disorder
  3. Personality Disorders: Types, Causes, Symptoms & Treatment. (2022, April 16). Cleveland Clinic. Retrieved from https://my.clevelandclinic.org/health/diseases/9636-personality-disorders-overview
  4. Lampe, L., & Malhi, G. S. (2018). Avoidant personality disorder: current insights. Psychology research and behavior management, 11, 55–66. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5848673/
  5. Denny, B. T., Fan, J., Liu, X., Guerreri, S., Mayson, S. J., Rimsky, L., McMaster, A., Alexander, H., New, A. S., Goodman, M., Perez-Rodriguez, M., Siever, L. J., & Koenigsberg, H. W. (2016). Brain structural anomalies in borderline and avoidant personality disorder patients and their associations with disorder-specific symptoms. Journal of affective disorders, 200, 266–274. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5841761/
  6. Fraley, R., (2018). Adult Attachment Theory and Research. University of Illinois. Retrieved from http://labs.psychology.illinois.edu/~rcfraley/attachment.htm
  7. Attachment. (n.d.). Psychology Today. Retrieved from https://www.psychologytoday.com/us/basics/attachment
  8. Dimaggio, G., D'Urzo, M., Pasinetti, M., Salvatore, G., Lysaker, P. H., Catania, D., & Popolo, R. (2015). Metacognitive interpersonal therapy for co-occurrent avoidant personality disorder and substance abuse. Journal of clinical psychology, 71(2), 157–166. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25557644/

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Katelyn Hagerty, FNP

Kate Hagerty is a board-certified Family Nurse Practitioner with over a decade of healthcare experience. She has worked in critical care, community health, and as a retail health provider.

She received her undergraduate degree in nursing from the University of Delaware and her master's degree from Thomas Jefferson University. You can find Katelyn on Doximity for more information.

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