Avoidant Personality Disorder creates avoidance of others, which in turn makes the problem worse. Avoidant behaviour fuels the problem whereas approach-behaviour, while scary, is the best way forward when dealing with social anxiety. The aim is to enable participants to centre themselves in a crisis through mindfulness techniques, and secondly to survive a crisis by identifying their triggers and impulse actions and then exploring how to respond instead of reacting.
Avoidant Personality Disorder
Social anxiety involves dysfunction in the amygdala and its connections. Dysregulation in the brain’s dopamine system has also been found to be associated with adult social anxiety disorder. Some of the genes related to the personality trait of introversion, such as brain-derived neurotrophic factor (BDNF), are likely related to disorders such as avoidant personality disorder. Evidence shows that some of the risk genes for avoidant personality disorder are shared with schizoid personality disorder and social anxiety disorder.
- Genetic factors have been hypothesized to cause avoidant personality disorder and social phobia. A twin study of Norwegian young adults found a 35% genetic effect for avoidant personality disorder; most (83%) of these genes are also related to other personality disorders.
- Environmental factors also play in role in avoidant personality disorder. Parenting behaviors, such as low parental affection or nurturing, were associated with an elevated risk of avoidant personality disorder when these children reached adulthood.
There are many likely causes, with genetic and environmental factors interacting from infancy in various combinations.
Patients with an avoidant personality disorder are encouraged to participate in as many social activities as can be tolerated. In children, parents are encouraged to help their child confront their fears without setting them up for repeated failure. Some individuals find that social encounters can be better tolerated and even enjoyed if they have a specific job or role to play.
No medications have been specifically tested or approved by the US Food and Drug Administration (FDA) for individuals with avoidant personality disorder. Selective serotonin reuptake inhibiters (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) have been found to be effective for social anxiety disorder. In addition, some studies have reported that benzodiazepines, monamine oxidase inhibitors (MAOIs), and the anticonvulsant gabapentin are effective in the treatment of social anxiety in adults with avoidant personality disorder.
SSRIs paroxetine (Paxil) and sertraline (Zoloft) and the SNRI venlafaxine (Effexor) are FDA-approved to treat social anxiety disorder.
Zoloft (called LUSTRAL in the UK) and other SSRI medications are considered first-line treatment for APD and social phobia. Benefits of SSRIs include relatively high tolerance, ease of administration, and relative safety in overdose.
Parents and patients are encouraged to confront feared situations as tolerated. Supporting additional social interaction in activities in which someone feels competent (eg, sports, art, music) can increase the chance of success.
Avoidant personality disorder is a learned way of thinking, feeling and behaving that doesn’t lead to an effective solution, sometimes based on certain predispositions.
The best news is that anything you’ve learned, you can also unlearn.
Successfully getting rid of AvPD typically involves a three folded process:
1) Challenging and changing dysfunctional thinking. People with avoidant personality disorder tend to have a lot of limiting beliefs, plus an unrealistic view of social standards and of themselves. These need to be corrected by consciously changing the way they think.
2) Gradual exposure. People with avoidant personality disorder need to gradually face those exact situations they’re afraid of and they typically avoid. Systemic exposure, combined with combating unrealistic thinking will set their mind and emotions on the right path.
3) Improving people skills. Since individuals with AvPD avoid social situations as much as they can, their people skills have often atrophied or they’ve never truly developed at all. Thus, training key people skills and learning how to start a conversation, how to keep it going or how to connect with people is crucial.
The methods of intervention that have been proven to work best for overcoming avoidant personality disorder are cognitive-behavioral therapy and coaching. There is a raft of research that confirms the success of these methods. No other methods even come close to the elegance and effectiveness of cognitive-behavioral methods.
If you have Avoidant personality disorder, the first essential step is to recognize it without making a big deal out of it.
The second step is to realize that there is hope for you and to fully commit to overcoming this condition. This can be tricky particularly because people with Avoidant personality disorder will sometimes tend to avoid the very things that will lead to overcoming their condition.
Using cognitive-behavioral principles and techniques on your own, you will see progress. However, given the seriousness of the condition, initially working one-on-one with a competent coach or a therapist is a good idea.
You will make much faster progress, you’ll successfully get past those first hurdles and get the wheels spinning in the right direction.
A rich and fulfilling social life doesn’t have to exist only in your daydreams. Pick the best tools to use, put them into practice and keep moving forward despite the struggles, and you will make it real.
Photo by Vladimir Fedotov on Unsplash