Avoidant personality disorder and social anxiety

The short answer

Social anxiety is a fear of being judged in social situations. Avoidant personality disorder (AvPD) is broader and deeper. It is a long-standing sense that you are not good enough, together with a strong fear of criticism and rejection, and a pattern of avoiding closeness to stay safe.

Put simply: in social anxiety the fear is “they will see me as awkward”. In AvPD it is often closer to “I am inadequate, and they will see it”.

They overlap a lot. Many people have both. And researchers still argue about whether AvPD is a separate condition or the severe end of social anxiety.

What avoidant personality disorder looks like

Personality disorder means a pattern of thinking, feeling and relating that is long-lasting, shows up in many parts of life, and causes distress. It does not mean your character is bad.

People with AvPD often:

• feel inferior, unappealing or socially inept;
• avoid jobs, friendships or relationships unless they are sure they will be liked;
• hold back even in close relationships, for fear of shame or ridicule;
• are very sensitive to any hint of criticism or disapproval;
• avoid new activities because they might be embarrassing.

Many people with AvPD experience it as “who I am”, not “a problem I have”. That sense of it being part of the self is a common difference from social anxiety.

How it differs from social anxiety

The official guides note that the two can look alike, because both often begin in childhood. AvPD tends to involve wider, more pervasive avoidance.

What the research shows

• They share genes. A review of the research found that AvPD and social anxiety share genetic risk. They may differ in which life experiences raise the risk.
• Shame and a negative view of yourself are especially typical of AvPD, the same review found.
• They often occur together. A study that combined 125 studies found AvPD was among the most common personality disorders in people with anxiety disorders. It was especially common in people with social anxiety.
• But not always. The same review of AvPD noted that, in its sources, most people with AvPD did not also meet the criteria for social anxiety disorder. Other studies find much more overlap. The answer depends on who was studied.

What helps

There are far fewer treatment trials for AvPD than for social anxiety. In practice, the same approaches are used:

• Therapy built for social anxiety, such as cognitive therapy for social anxiety. It works on fear, self-image and avoidance.
• Work on shame and self-worth. The review above suggests that treatment may help most when it adds work on shame to the usual social anxiety methods. This has not yet been tested in trials. A therapist who knows this can add it.
• Medication, such as SSRIs, which have good evidence for social anxiety. Talk to a doctor about any medicine.

Treatment may take longer when AvPD is present. That is not a reason to give up. It is a reason to look for a therapist with experience of both. See finding a therapist.

Should you seek a diagnosis?

You do not need the label to get help. Many people find “avoidant personality disorder” a heavy name. Others find it a relief, because it explains why social anxiety advice never quite fit.

What matters more is telling a clinician how deep the sense of inadequacy goes, and how much of your life it shapes. That helps them choose the right focus.

AvPD can come with low mood. If you feel hopeless, or think about harming yourself, please reach out now. See crisis lines and depression and social anxiety.