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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.

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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?

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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

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Heather, maybe you don't need to know if you really have APD or not... But I do recommend therapy because you can't change dysfunctional thought patterns and behaviors with medication alone. If you suffer from a lot of social anxiety and avoidant behaviors, then therapy could help change those behaviors.

So far, I've been on 100mg of Zoloft and I think it helps. My thoughts actually became less negative and less distorted with the help of medication alone. But it is hard to tell because I developed severe mood swings after starting the Zoloft. My pdoc said that sometimes ony those around you can tell whether the AD works for you. My friends said I became more calm. However, with the help of intensive psychotherapy my moods swings evened out and my mood stabilized. Now I feeel more happy, but not in a hyped-up way.

My therapist didn't want to give me a diagnosis other than depression because he said it would be like a self-fulfilling prophecy. But of course I got curious and started researching into personality disorders. I wanted to know why I've been so hard on myself all my life and unable to be close to people. Why I can't deal with being criticized at all.

APD does sound like me. Even my therapist fell victim to my distrust of people: I constantly would perceive him as critisizing me, not valuing me as a person and I thought he would force his opinion on me. Then I kept confronting him with what he had said to me last week and how it had made me feel...

So far, I've never had real close relationships with other people, since the time I had been emotionally abused as a child. And I've always been hypersensitive to everything around me. I don't know if I just perceived my mom as constantly criticizing and emotionally abusing me or if it was a reality.

Anyway, I think personality disorders are an interesting topic. Heather, I hope you will find all the help you need and the right medication, regardless of your diagnosis!

I'm continuing my meds for another 6 months at least because I'm scared of relapsing back into depression.

All the best,

MartyrGirl

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Oh my God!! I've been diagnosed with BPD, but in all honesty, I have every one of these traits, including the living in the fantasy in my head. I always put these symptoms down to a result of BPD, but it sounds like I have a bit of BPD and all of APD.

This has encouraged me to seek therapy. I stopped therapy a few years back because I don't feel I can go any further with it, but I've changed my mind now! I'm going to go and see my GP with this list and ask for a recommendation!

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Definitely speak to your GP. Remember that with PDs it is possible to have a lot of one and symptoms of several others. You need to deal with the symptoms and try not to worry too much about the specific diagnosis if that makes sense as they overlap sometimes.

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Pretty sure I'm avoidant. Looking at the other posts about this, it really sounds like me, and how I've lived most of my life.... being upfront about the negatives in my life so people won't find out about them later, avoiding every social situation, the longing for close relationships, and the feelings of worthlessness...

I'm seeing my doc in a month, I'd been getting sleep testing done because I sleep 10+ hours a day and have no energy.. I'd forgotten about how severely I react to rejection, so it would appear atypical depression is a likely cause, but after reading this, AvPD seems likely as well.

Feeling pretty bummed, I was hoping it was physical and there'd be a simple fix. Nothin's ever easy I guess lol.

Likely going to be on an SSRI, but mostly to deal with the physical symptoms, I have no energy/interest in things lately, and extremely tired all the time. I don't think psychotherapy's right for me, I don't really want to talk to someone about how I feel, especially about how I view myself because I can't trust them to be objective, and I "know" that how I feel about myself is "right" (even though it's irrational).

Maybe bummed isn't the right word... Devastated is probably closer to it. The one light at the end of the tunnel for me was finding one special woman to love, but who would want to be with someone with 0 confidence. 8 years single, 3 "dates" that were disasters and maybe 10ish online attempts that didn't end in meeting because I flipped assuming they had either found someone better, or should.

What I really want help with, is how to bottle up the lonliness.

I don't even know why I'm writing this lol.

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I think I definitely have this, among other possible personality disorders.

I am ok in general settings like going out to dinner, shopping, etc, and interacting slightly with people there, but at a deeper level? No thanks. I avoid majorly.

I have one friend where I live and we met online and see each other every few months but talk a lot online each day. My other friends are in a different state (where I come from) and I see them twice a year but it exhausts me to socialise.

My intimate relationships have all started online and developed into deep love online before ever meeting in person. I cannot even imagine why I would go out and meet someone I don't know well. I need to know them and have strong feelings first to bother.

I have no job. Never had a career and as a teenager and kid never aspired to "be" anything. I never wanted to work. When I did have a job, I could only bear to work 20 hours a week. Even that was exhausting. I would be much better working alone from home, or only dealing with people in emails or online. I'm good in writing.

I am smart, talented and have a psychology degree, but feel I have wasted my life career-wise as I have only been a part time typist since age 21 due to my total avoidance of...doing anything.

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46 minutes ago, dearie23 said:

I am ok in general settings like going out to dinner, shopping, etc, and interacting slightly with people there, but at a deeper level? No thanks. I avoid majorly.

Yeah, this is me, exactly. I was diagnosed with AvPD last fall, but didn't really know what it meant. I just had a conversation with another member of my therapy group tonight, who has similar issues, that really made it hit home for me.

I can look back and think that I have/had close friends, when really there was so much of myself that I was suppressing in those relationships. Things could get to a certain point, but no deeper, and at the same time, I am usually good at drawing out other people to confide in me, so in some ways it seemed like we were really close. And there was no possibility of conflict/asking for help/having uncomfortable emotional conversations.

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I have noticed over the years that although I have had some friends for almost 20 years...

1. They are ALL friends made through my one best friend who I've had since I was 14. I have made only ONE friend on my own since then apart from online ones,

2. I hardly ever see them since I moved away 13 years ago and would be ok not really seeing them again in person, and

3. Even when I did see them regularly and after all these years, it is like I appear friendly on the surface but just underneath is a brick wall. Even after 20 years. I only show people beyond the brick wall online (early on) or if I'm in love / intimately attracted to someone.

Edited by dearie23

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On 4/25/2017 at 2:21 AM, dearie23 said:

3. Even when I did see them regularly and after all these years, it is like I appear friendly on the surface but just underneath is a brick wall. Even after 20 years. I only show people beyond the brick wall online (early on) or if I'm in love / intimately attracted to someone.

Yeah, that's how I've been. I'm trying to remove the wall, but it's hard and scary. :dontgetit:

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I started showing symptoms of social anxiety disorder when i was a teenager and was diagnosed with AvPD as adult. It's the root of all my problems, but after all these years i've sort of given up and made peace with the thought that this is a part of me now for the rest of my life. Sometimes it's tiring to hear well-meaning phrases like "Your illness isn't you / doesn't define you" etc. and i understand that it's meant to be encouraging, but the thing is, it is a part of my personality and who i am. My brain's wirings has been scrambled, and meds + therapy only eases the symptoms and gives tools to cope but can't modify my brain back to normal.

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On 10/30/2004 at 0:01 PM, Lindsay said:
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Thanks

 

Thanks! from my understanding the personality disorders such as BPD, OCD and APD can overlap, so it's very difficult completely differientating them all. 

I've been diagnosed BPD, but I also believe  I have APD characteristics for sure.

 

 

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 shamed)

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.

 

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It's crazy to see something that fits me 100% I havnt officially been diagnosed with this but my psychiatrist sees me for about 5 minutes every few months but I know I have it I know it comes from being sexually abused as a child and then the kids in school made fun of me for being raped in the 6th grade and I'm also very overweight so I was harassed for that to and I'm still treated like im nothing by society it's no wonder I'm messed up lol I'm on meds now and therapy my therapist is frustrated with me because I can't seem to budge out the hole I'm in but she's sticking with me I like her

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