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[Brokenme]

Avoidant personalty disorder: CRINGES (4 criteria).
C: Certainty (of being liked required before willing to get involved with others)
R: Rejection (or criticism) preoccupies one's thoughts in social situations
I: Intimate relationships (restraint in intimate relationships due to fear of being samed)
N: New interpersonal relationships (is inhibited in)
G: Gets around occupational activity (involing significant interpersonal contact)
E Embarrassment (potential) prevents new activity or taking personal risks
S: Self viewed as unappealing, inept, or inferior

this is creepy... i identify with all of them

[AngelOfTheMoor]

I do, too, Cally. Perhaps I should bring it up with my pdoc when I see him on Tuesday. Have you ever talked to a doctor about avoidant anxiety disorder?

[Brokenme]

No i haven't, angel. I'd be interested in what they'd say though - because it just *is* me. Like i don't think of it as a "disorder" as such because as long as i can remember, i've been this way?? Its like my personality -- my closest friends know me enough to 'fend' for me when things get rough ie. new environment and someone talks to me, i freeze up and they answer for me...but i feel like they will start to resent me at any time..:(
and, i don't see my closest friends (aka high school best friends) on a daily basis anymore so its becoming apparent that i *don't* go to said social events. and since i don't know the new friends as well as old ones, i do fear rejection all the time. But that's me. Is there something wrong with this "personality" that makes it a "disorder"? hmmm

[AngelOfTheMoor]

No i haven't, angel. I'd be interested in what they'd say though - because it just *is* me. Like i don't think of it as a "disorder" as such because as long as i can remember, i've been this way?? Its like my personality -- my closest friends know me enough to 'fend' for me when things get rough ie. new environment and someone talks to me, i freeze up and they answer for me...but i feel like they will start to resent me at any time..:(
and, i don't see my closest friends (aka high school best friends) on a daily basis anymore so its becoming apparent that i *don't* go to said social events. and since i don't know the new friends as well as old ones, i do fear rejection all the time. But that's me. Is there something wrong with this "personality" that makes it a "disorder"? hmmm

I don't think that the "personality" is automatically a "disorder," Cally. I think it should only be considered a "disorder" if you perceive it as a "disorder" and it upsets you to be that way. I didn't really have any close friends, ever, except a couple of them in college. I do have a couple of people who are good friends now, though. I'd constantly thought that something was wrong with me because I desperately wanted friends but couldn't ever have one who did more than use me for their own purposes. I had one friend in elementary school, but she'd always make me do what she wanted if I objected to her ideas. She'd come up with an excuse for doing that--if we were at her house, we had to do what she wanted because it was her house. If she was at mine, we had to do what she wanted because she was a guest. If I tried to turn this logic around, she wouldn't go along. I started making excuses not to see her. Then, one day while I was in high school, she contacted me and asked if we could hang out. I thought that was nice. But then, when I went to her house, I only stayed for a few hours rather than spending the night. She got a little peeved and started groaning about how she had nothing to do that night. I think that's why she had contacted me.

I've talked about this many times on DF; I also had a friend in college with whom I'd always do what she wanted. I was afraid that she'd reject me if I didn't. Then one day I got really upset because I took something she did to mean that she didn't truly value our friendship. I insisted that if she weren't a selfish b**** (I really did say that; I'm ashamed) she would have at least honored my wishes a little bit. I'd known that she was selfish, but I'd put up with it because I thought friendship meant accepting someone for their strengths and their flaws. Well. Apparently a mistake. She's completely cut me off now.

A few weeks ago, someone told me that I seemed distant and therefore inaccessible. (I was discussing my depression and social anxiety with her even though we aren't close. She understands a little bit because her husband has social anxiety.) I feel like this is something that could be associated with APD. I try to overcome being standoffish, but I can't. Thus the reason that I perceive it as problematic. Of course, it could very well just be the social anxiety.

I don't like naming things, anyway. I don't think of myself as "having a disease" because I'm depressed. That makes depression sound trivial to me. There are some things that I like about my personality that could be associated with APD. If I were ever diagnosed with APD, I still wouldn't think of myself as having a "disorder." I don't like to definitively label myself because there are reasons that I don't think I fully belong under the label's umbrella. For me, my diagnoses are just tools. Something I can use to understand myself and deal with things. They don't decisively define me.

So, long answer there. Sorry for that.

[Brokenme]

oh (((((angel))))) i'm sorry you feel that way. i've had many many problems with people and friends over the years too.
i totally understand that giving in to your friend thing, i've been guilty of that so many times that i have lost count
it is a problem in my life. i have trouble getting close to people because i don't know what they may think. and i don't feel worthy for people to consider a good friend. so i try hard to please so they won't forget me :(
i always wait for people to invite me before i join in something. a good friend once joked and said she needed to issue an invitation to me to get me to do something. but i just don't want to "intrude" into something and find out i'm not supposed to be there/wasn't really invited!!:(

[AngelOfTheMoor]

Thank you, Cally!

i always wait for people to invite me before i join in something. a good friend once joked and said she needed to issue an invitation to me to get me to do something. but i just don't want to "intrude" into something and find out i'm not supposed to be there/wasn't really invited!!:(

I do that as well. I tend to think that people don't want to spend time with me. Even when I do sometimes get an invitation to something, I occasionally don't even go because I'm afraid that I was invited out of politeness but my presence is not really desired. At parties, I usually wind up awkwardly standing on the sidelines and unable to go to another spot because I've been blocked in by the crowd. Once in a while, someone will converse with me. Sometimes I do go to an event and have fun, though. I also constantly feel that people are irritated when I'm present.

[AngelOfTheMoor]

Interesting post, bravetwilight. I would've publicly supported you. I'm contrarian like that. Even though taking those stands, both online and in real life, petrifies me to know end, my "guilt complex," for lack of a better term, kicks in. It sounds like many of those people at that forum are ignorant, prejudiced, and uninformed. That definition, as I'm sure you know, is so totally the opposite of what it means to have APD. I think my avoidant tendencies have sort of made it to where people don't notice me much, so I've never had a problem with discrimination. However, I too don't disclose these sorts of things except to people whom I know I can trust. Throwing around "mentally ill" as a slur just really grinds my gears. :wink:

"Normal" people are boring anyways.

I can't believe your therapist treated you like that. Obviously, the therapist's job is to listen to the client's feelings and explanations . . . and if she can't do that, then she's not a good therapist. Or else not good when it comes to some issues. Perhaps she felt most comfortable helping people with BPD, so she tried to push you into that corner.

Please don't be afraid to talk here. We all understand.

[AngelOfTheMoor]

Well those forum people . . . I guess they can't go against the owner or they'd be banned. But seriously. Maybe they were close-minded because they didn't feel as if they could handle the "dark" side. They just want to focus on whatever makes them feel good. A limited point of view, one that is one of my pet peeves. People who feel so smug in their own ways that they don't want to listen to anything that contradicts them. Heck, if I were at that forum, I would probably leave it of my own volition.

I agree about the therapist. As I said, I think she was just trying to find a way to label you with something that she knew she could deal with. I could understand her telling you that you need to find another therapist. What I don't like, if I understand this correctly, is that she tried to force you to accept her diagnosis rather than telling you to find someone else in the first place. That idea just disturbs me.

[AngelOfTheMoor]

I fit all of the criteria, too, rw0, and I haven't been diagnosed with any personality disorder, either. I think the overlap between it and other disorders might lead people to treat it differently. For instance, I have been diagnosed with social anxiety disorder. I'm not quite sure that social anxiety disorder and avoidant personality disorder are two distinct entities. Are they just variations of something? Is one a more intense version of another? Do people with social anxiety not have some of the problems that people with avoidant anxiety disorder do? I'm not sure, but I do know that what I experience seems to fit under both categories. I figure that professionals label me as "socially anxious" because it's the more well-known of the two.

In any event, I do think that it's good to know what sounds like you, even if it's not a diagnosis from a professional. I feel that it can help us understand ourselves and know what to do.

[AngelOfTheMoor]

I agree, rw0. As long as you recognize the issues that need to be worked on, it's all good. To me, I really do find "labels" to just be tools that might be able to help me in that regard. Nothing more. They're all a bit subjective, anyway. It's not like there's an "avoidant personality disorder" gene that's labeled exactly as such. As long as you understand what you need to work on, then you're fine.

[bananaramafofama]

OMG OMG OMG OMG. I never knew this existed, but reading this was so creepy. I swear it's like someone who knows me better than I do wrote this about me. I'm printing this and asking my doc about it ASAP. Every single thing applies to me perfectly. not just some. ALL. how weird.

[Trace]

OMG OMG OMG OMG. I never knew this existed, but reading this was so creepy. I swear it's like someone who knows me better than I do wrote this about me. I'm printing this and asking my doc about it ASAP. Every single thing applies to me perfectly. not just some. ALL. how weird.

Hi and Welcome bananaramafofama

I think that printing this out and going to your doc is a great idea. Please let us know what the doc says.

Trace

[Girly]

OMG OMG OMG OMG. I never knew this existed, but reading this was so creepy. I swear it's like someone who knows me better than I do wrote this about me. I'm printing this and asking my doc about it ASAP. Every single thing applies to me perfectly. not just some. ALL. how weird.

Hi there bananaramafofama bananaramafofama to the Personality Disorder room, great to have you here.

As Trace said it is a great idea to take the print out to your doctor. Let us know how you get on.

Girly

[AngelOfTheMoor]

Hi banana! Welcome! I understand your reaction to the description. When I took a psychology class in high school and read a description, I felt chills. It sounded so much like me, and I'd always known that I didn't operate quite like everyone else, and that it seemed more elaborate than social anxiety. I've never brought it up with my pdoc, funnily enough, but I should whenever I finally get around to finding a pdoc around here. Then again, I'm content with my diagnoses because I am (or was, until I just moved, lol) getting the help I need for my mental well-being.

I'd love to know how your appointment goes.

[Kalla]

Avoidant personalty disorder: CRINGES (4 criteria).
C: Certainty (of being liked required before willing to get involved with others)
R: Rejection (or criticism) preoccupies one's thoughts in social situations
I: Intimate relationships (restraint in intimate relationships due to fear of being samed)
N: New interpersonal relationships (is inhibited in)
G: Gets around occupational activity (involing significant interpersonal contact)
E Embarrassment (potential) prevents new activity or taking personal risks
S: Self viewed as unappealing, inept, or inferior

avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection
is unwilling to get involved with people unless certain of being liked
shows restraint within intimate relationships because of the fear of being shamed or ridiculed
is preoccupied with being criticized or rejected in social settings
is inhibited in new interpersonal situations because of feelings of inadequacy
views self as socially inept, personally unappealing, or inferior to others
is unusually reluctant to take personal risks or to engage in any new activities because they might prove embarrassing.
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). American Psychiatric Association

Thanks for posting this. I haven't been formally diagnosed with APD but I think that I do have it. It explains me perfectly. But, the word "disorder" bothers me a lot - it makes me depressed to think that my own personality is a "disease" or "abnormal" but I've been working on my issues for the past few years, and things are getting (slowly) better.

Another symptom of APD is fantasy as escapism too - since those with AVD believe they are socially inept and inferior, they sometimes create their own fantasy relationships in their heads. For example, for me in my fantasy world, I am always talented, perfect, etc with lots of friends and interesting adventures. Things can get so detailed that I have no desire to be around people in real life, because I am living my own "life" in my head. This has been the hardest to fix...it's so easy to go into my fantasy world and stay isolated from others, which is ironic, because I generally like people and I want to be involved with them.

[Girly]

Avoidant personalty disorder: CRINGES (4 criteria).
C: Certainty (of being liked required before willing to get involved with others)
R: Rejection (or criticism) preoccupies one's thoughts in social situations
I: Intimate relationships (restraint in intimate relationships due to fear of being samed)
N: New interpersonal relationships (is inhibited in)
G: Gets around occupational activity (involing significant interpersonal contact)
E Embarrassment (potential) prevents new activity or taking personal risks
S: Self viewed as unappealing, inept, or inferior

avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection
is unwilling to get involved with people unless certain of being liked
shows restraint within intimate relationships because of the fear of being shamed or ridiculed
is preoccupied with being criticized or rejected in social settings
is inhibited in new interpersonal situations because of feelings of inadequacy
views self as socially inept, personally unappealing, or inferior to others
is unusually reluctant to take personal risks or to engage in any new activities because they might prove embarrassing.
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). American Psychiatric Association

Thanks for posting this. I haven't been formally diagnosed with APD but I think that I do have it. It explains me perfectly. But, the word "disorder" bothers me a lot - it makes me depressed to think that my own personality is a "disease" or "abnormal" but I've been working on my issues for the past few years, and things are getting (slowly) better.

Another symptom of APD is fantasy as escapism too - since those with AVD believe they are socially inept and inferior, they sometimes create their own fantasy relationships in their heads. For example, for me in my fantasy world, I am always talented, perfect, etc with lots of friends and interesting adventures. Things can get so detailed that I have no desire to be around people in real life, because I am living my own "life" in my head. This has been the hardest to fix...it's so easy to go into my fantasy world and stay isolated from others, which is ironic, because I generally like people and I want to be involved with them.

Hi there Kalla.

We are not medical professionals and the criteria are just to give you an idea of the tools used to diagnose Avoidant Personality Disorder.

Is it possible for you to speak to a medical professional and request a formal diagnosis? I convinced myself that I had bi-polar before being given a diagnosis of Borderline personality Disorder so I know the dangers of self-diagnosis!

As for the words 'presonality disorder' I agree that the labels are not good ones. The best thing to remember is that this is just a lablel and is not all of someone

I know that you've already posted in the topic Fantasy- As A Form Of Escapism , also in this room, and it is important that you are not the only one who has fantasies such as this. I don't believe that only people with APD have these fantasies.

Girly

[Kalla]

Avoidant personalty disorder: CRINGES (4 criteria).
C: Certainty (of being liked required before willing to get involved with others)
R: Rejection (or criticism) preoccupies one's thoughts in social situations
I: Intimate relationships (restraint in intimate relationships due to fear of being samed)
N: New interpersonal relationships (is inhibited in)
G: Gets around occupational activity (involing significant interpersonal contact)
E Embarrassment (potential) prevents new activity or taking personal risks
S: Self viewed as unappealing, inept, or inferior

avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection
is unwilling to get involved with people unless certain of being liked
shows restraint within intimate relationships because of the fear of being shamed or ridiculed
is preoccupied with being criticized or rejected in social settings
is inhibited in new interpersonal situations because of feelings of inadequacy
views self as socially inept, personally unappealing, or inferior to others
is unusually reluctant to take personal risks or to engage in any new activities because they might prove embarrassing.
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). American Psychiatric Association

Thanks for posting this. I haven't been formally diagnosed with APD but I think that I do have it. It explains me perfectly. But, the word "disorder" bothers me a lot - it makes me depressed to think that my own personality is a "disease" or "abnormal" but I've been working on my issues for the past few years, and things are getting (slowly) better.

Another symptom of APD is fantasy as escapism too - since those with AVD believe they are socially inept and inferior, they sometimes create their own fantasy relationships in their heads. For example, for me in my fantasy world, I am always talented, perfect, etc with lots of friends and interesting adventures. Things can get so detailed that I have no desire to be around people in real life, because I am living my own "life" in my head. This has been the hardest to fix...it's so easy to go into my fantasy world and stay isolated from others, which is ironic, because I generally like people and I want to be involved with them.

Hi there Kalla.

We are not medical professionals and the criteria are just to give you an idea of the tools used to diagnose Avoidant Personality Disorder.

Is it possible for you to speak to a medical professional and request a formal diagnosis? I convinced myself that I had bi-polar before being given a diagnosis of Borderline personality Disorder so I know the dangers of self-diagnosis!

As for the words 'presonality disorder' I agree that the labels are not good ones. The best thing to remember is that this is just a lablel and is not all of someone

I know that you've already posted in the topic Fantasy- As A Form Of Escapism , also in this room, and it is important that you are not the only one who has fantasies such as this. I don't believe that only people with APD have these fantasies.

Girly

Hi Girly! I don't believe in self-diagnosis either so that's why I would never say I have it for sure. I've seen way too many people try the self-diagnosis thing and have it backfire on them terribly. It's just that APD is the only thing other than depression and anxiety that fits me well, after years of research, so for me I mostly use it as a "well at least I'm not completely alone" sort of feeling. I never spoke to a doctor about it because I was always bothered by certain aspects of my symptoms that I was afraid I'd be labeled as "crazy" because of them - especially the fantasy worlds. My psychologist said once that I display avoidant tendancies but never went too much in detail with me about them. Someday I'd like to get it checked out, but as of now, it hasn't been causing me too many problems...at least, nothing more than usual

I did post in the Fantasy thread, but thank you for mentioning it! I also agree that anyone can have fantasies, not just those with AVP. I've always seen fantasy worlds as a coping mechanism.

[Girly]

It sounds like you have the right viewpoint there Kalla, no point adding more things to worry about if isn't causing you too much concern at the moment

Girly

[kms_broken15]

wow. its so nice to finally find people who share this issue.
i haven't been diagnosed with this disorder but i have all the characteristics.
i don't exactly fear talking to people.. i loved talking to people but i am very shy when i first meet people and it takes me a long time to get comfortable around them unless i know for sure that the person likes me. when i got out with friends or even simply going to the store i constantly feel the need to keep checking my hair and make-up and i am always checking my body position and the way i walk and if i feel like i'm not perfect i feel as if everyone around me is watching me and talking about me. it kind of creates a paranoid feeling. i also compare myself to everyone around me and i have have very low self esteem.

[InaBoBina]

Avoidant personalty disorder: CRINGES (4 criteria).
C: Certainty (of being liked required before willing to get involved with others) --yes
R: Rejection (or criticism) preoccupies one's thoughts in social situations --yes
I: Intimate relationships (restraint in intimate relationships due to fear of being shamed)
N: New interpersonal relationships (is inhibited in) --yes
G: Gets around occupational activity (involing significant interpersonal contact) --yes
E Embarrassment (potential) prevents new activity or taking personal risks --yes
S: Self viewed as unappealing, inept, or inferior --some

avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection
is unwilling to get involved with people unless certain of being liked --yes, i want to get involved, but i hate trying to join a group being uncertain they really want me around.
shows restraint within intimate relationships because of the fear of being shamed or ridiculed
is preoccupied with being criticized or rejected in social settings --gosh, yes, i avoid most social situations unless i know for sure who will be there and what will be happening
is inhibited in new interpersonal situations because of feelings of inadequacy --yes, inadequate conversationalist for one. not interesting enough for another.
views self as socially inept, personally unappealing, or inferior to others --so very socially inept!
is unusually reluctant to take personal risks or to engage in any new activities because they might prove embarrassing. --every new activity terrifies me of being embarrassed

Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). American Psychiatric Association

This is me, so completely and totally. The only time I can talk to people is if I'm absolutely forced to. Currently I'm in school again, and I've had to do a few presentations. This I can do. But in my personal life, when I need to make an important phone call, ask my boss for some time off at work, invite a friend to do something, or need a favor from my family I freeeeeeeeeze. I cannot do it. I cannot pick up the phone. I just let it slide and 'forget' and post-pone until usually it's too d*** late. There is one person that I could talk to about all of this, but now he's no longer available either. I could rely on him to make a phone call for me or push me to get things done that I needed to.

Common comments in this thread seem to be be: have you gone to your doctor and been formally diagnosed, can you talk to your doctor about this...
Ah, but that's the tricky bit. I don't have a doctor and I don't have insurance and I'm not too well off. I'm in a sinking boat with three giant leaks.

How do I find a doctor? And I mean, I know how, I just don't know how I'm supposed to do it. I'm terrified.

[birdfeets]

Thank you for this information. I've always considered myself lacking in personality. I've always had the symptoms described in this article. I am also printing this out to take to my psychiatrist next Thursday. Thank you

[jetmccartney]

Hi I'm Megan. I was diagnosed with APD as a young teen, my Pdoc having suspected it for a long time. My symptoms first appeared when I was 7 or 8. I'm now 19 and I still have a long way to go managing my PD's. I'd like to be able to tell everyone with APD that is a light at the end of the tunnel. When I was 14 I could barely look people in the eye. Today, I am working at a chemist and studying nursing where communication with people is a major component of both jobs. There are days when it is difficult, but for the most part I am very well-adjusted, and actually quite charming if I say so myself :). APD is one of the major PD's I suffer, and I have found both pharmacological and therapy to be helpful to me. I can answer phones and the front door, and actually smile at people when they make a joke. APD can be such a lonely PD but with help you find that there is a world out there just waiting for you.

[Grits Girl]

OMG why must I relate to just about every Mental Disorder I read about???? Im Serious there is not one MD that I read about and not say Yes this is me I can say that to all of them WTH I can't possibly be that much of a nut job

[sadmelissa]

Thank you sooo much for this post it really helped me

Avoidant personalty disorder: CRINGES (4 criteria).
C: Certainty (of being liked required before willing to get involved with others)
R: Rejection (or criticism) preoccupies one's thoughts in social situations
I: Intimate relationships (restraint in intimate relationships due to fear of being samed)
N: New interpersonal relationships (is inhibited in)
G: Gets around occupational activity (involing significant interpersonal contact)
E Embarrassment (potential) prevents new activity or taking personal risks
S: Self viewed as unappealing, inept, or inferior





AVOIDANT PERSONALITY DISORDER (APD)

For a number of years there was little distinction between the avoidant personality disorder and the schizoid or dependent personality disorders. However with the modifications included in DSM-IV, the three are now sufficiently differentiated.

Essentially, avoidant patients long for close interpersonal relationships, but fear humiliation, rejection, and embarrassment, and so avoid and distance themselves from others. Schizoid patients have little need or desire for close interpersonal relationships, and so avoid and distance themselves from others. Dependent patients are clinging and submissive because of their excessive need for attachment.

Essentially then, avoidant patients withdraw because of fears of humiliation, embarrassment, and rejection.

This disorder has a relatively low prevalence in the general population (estimated to be between .5 and 1 per cent. In clinical settings, the disorder has been noted in 10 per cent of outpatients. The reason for this discrepancy is that the presence of a personality disorder increases the likelihood (to some degree) of suffering from other psychiatric problems (particularly with APD, depression and anxiety).

Avoidant Personality Disorder can be recognized by the following behavioral and interpersonal style, thinking or cognitive style, and emotional or affective style.

Social withdrawal, shyness, distrustfulness, and aloofness characterize Avoidant patients behavioral style. Their behavior and speech are controlled, and they appear to be apprehensive and awkward. Interpersonally, they are sensitive to rejection. Even though they strongly desire closeness to others, they keep their distance and require unconditional approval before they are willing to "open up" to others. They tend to "test" others to see who can be trusted to like them.

The cognitive style of avoidants can be described as perceptually vigilant. This means that they scan the environment for clues to potential threats or acceptance. Their thoughts are often distracted by their hypersensitivity. They have low self-esteem because of their devaluation of their accomplishments and the overemphasis of their shortcomings.

Their affective or emotional style is marked by a shy and apprehensive quality. Because unconditional acceptance is relatively rare, they routinely experience sadness, loneliness, and tenseness. When more distressed, they will describe feelings of emptiness and depersonalization.

It should be noted that many more people have avoidant styles as opposed to having the personality disorder. The major difference has to do with how seriously an individual's functioning in everyday life is affected. The avoidant personality can be thought of as spanning a continuum from healthy to pathological. The avoidant style is at the healthy end, while the avoidant personality disorder lies at the unhealthy end.

DSM-IV Criteria for Avoidant Personality Disorder (301.82)*

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection
is unwilling to get involved with people unless certain of being liked
shows restraint within intimate relationships because of the fear of being shamed or ridiculed
is preoccupied with being criticized or rejected in social settings
is inhibited in new interpersonal situations because of feelings of inadequacy
views self as socially inept, personally unappealing, or inferior to others
is unusually reluctant to take personal risks or to engage in any new activities because they might prove embarrassing.
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). American Psychiatric Association

The most common syndromes seen with APD include agoraphobia, social phobia (some clinicians see APD as possibly a generalized form of social phobia), generalized anxiety disorder, dysthymia (an emotion of depression), major depressive disorder (the syndrome with all the associated signs and symptoms), hypochondriasis, conversion disorder, dissociative disorder, and schizophrenia.

It is now believed that avoidant personality disorder patients are excellent candidates for treatment (as opposed to some of the other personality disorders - this is probably due to the healthy desire and longing for close relationships). Various psychotherapeutic approaches can be successful, depending on the patients goals, preferences, and psychological mindedness, and the clinician's expertise.

Generally, the goal of therapy is to increase the patients self-esteem and confidence in relationship to others, and to desensitize the individual to the criticism of others. One must beware of the clinician that is overprotective of the patient and holds up progress - this sustains the poor view of self that the patient has come to treatment to remedy. The other clinician to beware is the one who forces the patient to face new situations prematurely, without proper preparation, and who then criticizes the patient for not being "brave" enough.

Until fairly recently, most publications spoke only of psychotherapeutic interventions, and only a few spoke of pharmacological treatments. Some of the problem is that many patients fear medications and their side effects just as they do any other new experience. Nevertheless, recent data indicates that some aspects of extreme social anxiety may be highly drug responsive. Since APD overlaps greatly with generalized social phobia (which is very responsive to MAOIs - a type of antidepressant). There are many documented cases of the successful treatment of APD with MAOIs (such as Parnate, Marplan, and Nardil). The use of Nardil (phenelzine) often shows improvement in specific fears and in confidence and assertiveness in social settings. The best medication intervention should be accompanied by psychotherapeutic methods appropriate to the individual patient. Medications alone will not give the kind of lasting improvement that combined treatment can provide. It is important to remember that medications are not always indicated in every case and that other considerations (such as general physical health, dietary restrictions, etc) matter in determining the need for, and possible efficacy, of medications. Psychotherapy alone works best with the higher functioning APDs, but combined treatment (psychotherapy and medications) seems to provide the best results for moderate and more severely disordered patients.

[sacredmeow]

This is me to a T. I am on celexa for anxiety/obsessive thoughts that accompany my being in a relationship. I drive myself insane with worry when I am with someone... always questioning their and my intentions/behaviors. I am incapable of being the level of vulnerable that my partner wants to see from me... she has no idea who I am, what I value. To be honest, I have no idea myself. My therapist, while we've only been meeting for a brief time, is able to see the self-loathing in every action I take/describe to her in my sessions. This is who I am. I will always do whatever I think someone else wants or say what someone (I think) wants to hear. This makes me seem dishonest, when in reality I just don't want to upset anyone. I can deal with disappointment more than someone else, so I spare them. I have zero self esteem and struggle to make and keep friends. I even feel like an outsider around my own family. I don't know what I need to do in order to change... I'm just sensitive and ashamed.

[itfeelslikehometome]

Hi you all
This is my very first time in this forum and I'm so glad I found it.
My story?
Let's start introducing myself to you all. I'm 34 years old, single guy living in DC. I work a lot (which is not fine with me, makes me feel like modern slavery is in the highest point in history these days!) I don't like my boss anymore because I believe he just thinks about himself (the center of the drama attention) and explode every single one as much as he can for his own benefits .

Work is not as fun as used to be or as I tough it was at one point. I'm a very smart guy however, people may think because I'm quiet all the time that I'm not enough to be a manager! plus I really don't want to be a manager LOL. hate it. it's so hard to work with people!!!! and the drama it's just enough. -I super hate drama.

It's hard for me to socialize with co workers so I keep my self quiet and distance, but I would love to have the hability to know what to say or how to approach them to start a nice cool conversation.

I don't feel like talking with family at all AT ALL, friends? i have very few left anyway I even didn't want to have a cel. so for several months i didn't use a cel. yeah I know it's hard to believe but now im trying to go back so i got a new cel. please I need help. the only things I want right now is no talk and sleep and don't go to work. and don't talk to my family and just be in my room all day/night. in front my computer.

I believe this is not new, I been feeling like this now for years but I always though was depression and because i was always mostly by myself. but know reading the stories here looks like this may have a name and hope they will be ways to get better.
if you serious about helping please respond to this post. I would love to hear from you and there i would love to talk LOL

Edited by AquaViolet, 22 April 2012 - 07:08 PM.
TOS

[tormentedsoul]

I have been a long timer sufferer of depression (or should i say major depressive disorder since a psychiatrist recently told me that social security disability isn't given for just depression alone (as if that isn't enough to suffer from "just" depression?))

Anywho, i digress. I have suffered from depression since roughly middle school, anxiety since elementary school. I didn't start psychotherapy and medication until high school when i was introduced to the school psychologist by my brother and explained the problems i was having. I also started going to a center outside of school. I continued going after i graduated from high school.

when i was in my early 20's i remember i was standing waiting to make an appointment and my file was on the desk. The appointment person had stepped away from the desk so i thought i would take a quick peak at my file and i noticed my diagnosis as: personality disorder, major depressive disorder.

It didn't state which personality disorder. I didn't even know what a personality disorder was. no one had ever told me i had a personality disorder. when i saw my therapist i told him i saw my file and that it stated i have a personality disorder. he explained the basics and said that there are many kinds of personality disorders. a few years later when the world wide web had been created i found a site that listed them and i tried to ascertain which one i could be. i read through all of them and thought none of them really fit me completely.

this brings me to now and i would say that APD fits me perfectly, not because i'm a hypochondriac but because i am aware of my behavior and personal characteristics. Thank you for writing this. i am learning more and more about myself.

[Girly]

Hi tormentedsoul

I'm glad that this article has helped you and that you have been able to be aware enough of yourself to know which PD fits you. When I finally realised the PD I had it was such a relief to me to know and to build on myself from there.

I do hope that you find this Personality Disorder room useful.

Girly

[memyselfi10]

Before I found the right med that worked for me, the chemical imbalance in my brain made it impossible for me to think positively. Now that I am correctly medicated, my perceptions have changed and I am able to have a very positive outlook on things. It's made a world of difference. It's like I can think clearly for the first in a very long time.

Like tormentedsoul, I have found this article very helpful in understanding myself better. It definitely fits me, and explains a lot about my behavior and thoughts and the connection with my troubled childhood. This new insight is another step in my healing process. I'm glad this old post came up to the top again.

[Girly]

Hi memyselfi10, I'm glad to read that the article has helped you to understand yourself better.

Take good care

[snm301392]

I have some traits of AvPD and I have a strange situation that I was wondering if anyone here could relate to.

My (former) best friend has an extremely high superiority complex. I don't think she intends to come off that way, but the girl just isn't insecure whatsoever and makes it clear as day to the rest of the world. As a woman, I tend to feed off of people who engage in self-deprecation (not good) but I honestly can't help it. Being around her just makes me feel like I am totally worthless, even though I know I'm causing myself to feel that way. I feel like I am more valued and my presence is wanted by people who are less confident about themselves as well, maybe because I can relate? Anyway, I've pretty much ruined this friendship and I'm not really sure what to do at this point. Any suggestions? 

[evanm65]

Snm301392, I can't give you any suggestions but I kinda understand where you are coming from. I avoid social contact with most other people because I feel ashamed of myself. I know it's not constructive but I have thoughts of being a hopeless failure and I do not want to get into conversations with all but a couple of people who know my situation and even then it's often too painful and anxiety provoking. I feel embarrased if someone innocently asks me questions about myself.

One thing that I have found useful is using DBT. This method helps me accept the situation and deal with painful thoughts and feelings as they arise. I  know I need to learn new ways of looking at situations and that is not easy. It's a struggle - day to day or hour to hour but i have no choice except more loneliness, SI and depression. I have felt inferior my whole life and felt like I had to put on an act of being self confident. This way of living sucks!. I hope things get better for you.

E