Social Anxiety Vs. Avoidant Personality Disorder: Similarities And Differences
Both avoidant personality disorder (AVPD) and social anxiety disorder (SAD) usually involve a sense of fear or anxiety in relation to social situations, as well as a desire to avoid situations that trigger those unpleasant feelings. Non-clinical social anxiety normally involves fear and anxiety related to social interaction, but it doesn't affect or limit a person significantly enough to be considered a disorder.
Since many people experience anxiety related to social situations from time to time, they may wonder how to determine when their symptoms are severe enough to be viewed as a disorder, and how social anxiety disorder and avoidant personality disorder differ from one another. Regardless of whether you have an official diagnosis, therapy may help you cope with and overcome social anxiety symptoms.
Prevalence: Social anxiety vs. avoidant personality disorder
About 7% of U.S. adults have social anxiety disorder in any given year, and about 12% have it at some point in their lifetime. The disorder is somewhat more common among women than men. Young adults between the ages of 18 and 29 are typically the most likely to have social anxiety disorder, and the risk tends to lessen with age. Only about 3% of adults over 60 have social anxiety disorder.
Avoidant personality disorder appears to be much less common than social anxiety disorder. Most experts estimate that between 1.5% and 2.5% of people have AVPD, though some studies suggest that up to about 9% of people may have it. As with SAD, some studies suggest AVPD is more common in women than in men.
Diagnostic criteria: Social anxiety vs. avoidant personality disorder
Social anxiety disorder and avoidant personality disorder have different diagnostic criteria. Identifying which set of criteria fits a person's symptoms may offer an indication of which of the disorders a person with social anxiety may have, but only a licensed mental health professional can make an official diagnosis.
Social anxiety disorder
To be diagnosed with social anxiety disorder, a person must experience fear or anxiety about social situations in which people may scrutinize or evaluate them. This fear or anxiety must happen consistently for at least six months and involve worry of being negatively judged or of being embarrassed, rejected, or ashamed. An individual must also meet the following criteria:
- The same social situations almost always prompt anxiety
- They actively avoid the situations they associate with anxiety
- The anxiety or fear is disproportionate to any actual threats associated with the situation
- The anxiety, fear, or tendency to avoid situations causes distress or impairs functioning
- The anxiety isn't better described by another disorder, like panic disorder
Avoidant personality disorder
People with avoidant personality disorder must have a long-term pattern of a sense of inadequacy, hypersensitivity to criticism, and social inhibition. Symptoms often develop in early adulthood, cause major distress, and limit a person’s ability to function. To be diagnosed, a person must meet four of the following seven criteria:
- Tendency to avoid social connection or interpersonal activities due to a fear of being rejected or criticized
- Unwillingness to form relationships in which there's a risk of rejection
- Restraint in close relationships due to a fear of being shamed or made fun of
- Preoccupation with the prospect of rejection or criticism
- Inhibition in social situations because of poor self-esteem or negative self-image
- Low self-esteem and a sense of being inferior to others or disliked by others
- Hesitation to take part in activities that could result in failure or embarrassment
Despite often avoiding social situations, people with AVPD usually long for social connection. It's not necessarily that they prefer spending time alone or only with people they know won't reject them. Rather, their fear typically leads them to deem all other situations too risky or unsafe. As a result, people with AVPD may feel sad about their lives or unfulfilled, on top of experiencing anxiety and fear.
People with AVPD often have other mental health disorders, too. For example, someone with AVPD could also have depression, an anxiety disorder, or a second personality disorder. Diagnosing and treating any comorbid disorders may improve AVPD symptoms as well.
Differences between social anxiety disorder and avoidant personality disorder
AVPD tends to last a long time, usually years. Although treatment can help, some people with AVPD have it for life once they develop it. Instead of being viewed as temporary symptoms, the anxiety and fear experienced in AVPD are generally considered part of the person's personality. A person with AVPD isn't simply afraid of being rejected or embarrassed in certain situations; they often have a deeply negative outlook on themselves and believe they deserve rejection or embarrassment because it reflects their inherent worth.
Another major difference between the two disorders may be the breadth of feared situations. Often, people with SAD become anxious about a handful of specific social situations. For example, they may deeply fear speaking up in work meetings or going on dates. By contrast, people with AVPD may fear speaking to anyone outside of their immediate family, and any social situation with those who they do not know extremely well may trigger anxiety.
Determining whether a person has social anxiety disorder or avoidant personality disorder can take time. A doctor or therapist may diagnose someone with social anxiety disorder at first and then, over time, revise that diagnosis to avoidant personality disorder if they realize the symptoms are more pervasive and long-lasting than originally thought.
Negative impacts of social anxiety disorder and avoidant personality disorder
Both social anxiety disorder and avoidant personality disorder can put limitations on a person's ability to enjoy life and grow as a person. For example, people with severe SAD may fail classes despite being intelligent or choose not to pursue further education because of fears they have related to social aspects of the process.
Although updated evidence may be needed, one study found that people with SAD make 10% less money than average, likely due to a fear of embarrassment or failure holding them back. People with SAD may also have fewer friends than average and tend to be less likely to get married and have children.
Generally, people with AVPD avoid social situations to a greater degree than people with SAD do, often leading to an even more limited life. People with AVPD may have a deep fear of the risks of intimacy and, as a result, stay single despite a deep desire for a romantic relationship. AVPD could leave a person perceiving themselves too negatively to try to form friendships with people to whom they are drawn or apply for jobs at which they believe they could do well. Often, people with AVPD keep their social circles very small and limit interactions with people outside of them as much as possible. Some people with AVPD have very few people in their lives and spend much of their time alone.
When is social anxiety a disorder?
Sometimes, people confuse social anxiety disorder with more common experiences, like shyness or nervousness before a presentation. These experiences are sometimes referred to as "social anxiety," but they do not mean a person has social anxiety disorder unless they meet the diagnostic criteria discussed previously.
It can be normal to feel nervous in social situations from time to time. Most people have butterflies in their stomach on a first date or sweaty palms when speaking in front of an audience. These experiences can be seen as natural, whereas clinical levels of social anxiety would typically cause a person to worry about such events for weeks in advance or avoid them altogether. To be a disorder, symptoms of social anxiety must be present regularly for over six months.
Remote therapy for social anxiety
Whether a person has social anxiety disorder, avoidant personality disorder, or occasional non-clinical levels of social anxiety, they may want to seek treatment to better cope and perform in nervousness-inducing situations. Remote therapy can be an excellent option, as it doesn't require a person to travel somewhere and enter a potentially anxiety-provoking situation to undergo a treatment session. Instead, remote therapy can be accessed from the comfort of home or anywhere with an internet connection. If you're interested in remote therapy, BetterHelp is a platform that can connect you with the best therapist for you.
Researchers haven't yet directly studied how remote therapy helps people with social anxiety. However, experts have speculated that therapies found to improve social anxiety can be easily adapted for remote delivery. A large body of research shows that cognitive therapy can be highly effective at treating social anxiety. However, many people with social anxiety may resist treatment because their fears make them reluctant to attend sessions. Remote therapy may be a viable option that could provide help without requiring a person with social anxiety to enter a more stressful in-person situation first.
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