Avoidant Personality Disorder vs. Social Anxiety: Understanding the Differences in Symptoms and Treatment

Social anxiety disorder is very distressing for those who deal with it in their daily lives. Typically, they understand that their fears of rejection and criticism are out of proportion with reality, but these reactive thought patterns persist. They may give a lot of energy to imagining worst-case scenarios but never venture out of the house to face these possibilities. These habits make forming and maintaining friendships and other kinds of relationships very difficult, and people with advanced social anxiety disorder may live very isolated lives. The resulting stress may also lead to nervous physical symptoms, such as sweating, dizziness, trembling, difficulty breathing, upset stomach, increased heart rate, and tension in the body. The overwhelming symptoms of social anxiety can contribute to the trauma of social situations in the end, generating more fear and anxiety for the future.

Symptoms of avoidant personality disorder mirror those of social anxiety disorder but reach further into a person’s understanding of their own identity and their dysfunction in everyday life. People with avoidant personality disorder:

• Have severely low self-esteem because they believe themselves to be inferior, incompetent, and deserving of the rejection they anticipate from others.
• Are sensitive to criticism, whether real or imagined, to the point where it is so crippling that they have very few or even no social interactions on a regular basis.
• May not be able to succeed in a job because of the socialization it requires.
• Are often without friendships and romantic relationships, even if they want these connections in their lives. Looking for real connections with people raises the stakes, and people with avoidant personality disorder may feel extreme anxiety about interacting with these people.

Those with social anxiety disorder may have low self-esteem in social situations but do not actually believe they are inferior or worthy of the outside judgments they fear. People with avoidant personality disorder internalize this criticism so completely that they believe the pending hostile perspective is justified. Their perception is distorted to the point that they do not even see themselves as they are in reality—let alone how the world and the people around them really are. It is as if avoiding others and social situations is a way of avoiding themselves. Yet, they continue to live with these fears and distress, withdrawing further and becoming severely isolated. They may develop overwhelming anxiety in anticipation of going to the grocery store, simply walking out to the mailbox, or having an unexpected visitor show up at the door.

Because social anxiety disorder and avoidant personality disorder present so many overlapping symptoms, they can be difficult to distinguish from each other. But it is critical that people receive accurate diagnoses, so they can find the appropriate treatment paths. A professional can not only interpret a client’s symptoms and properly diagnose, but they can also identify the best treatment options and modalities for the individual’s overall recovery.

The original challenges of avoidant personality disorder and social anxiety disorder are also likely to present barriers to therapy and other critical support. Getting out and facing the unknown is challenging enough for people with these disorders. And they may develop particular anxiety around having a therapist or clinician evaluate them. If you have a friend or loved one who needs help, you can encourage them to focus on the positive outcomes possible through a healing treatment path—including fulfilling relationships and freedom from the fears that plague them endlessly. If you are still at a loss for how to help them find the recovery path, you can reach out to a treatment center directly. Knowledgeable staff will have experience with these particular challenges and be able to guide you through next steps.

Recovery for both disorders calls for long-term treatment that guides clients to greater awareness of their disordered perspective and effective self-management of the reactions and thought processes that deter them from social contact. Medications may be helpful in treating symptoms of anxiety. Within an integrative, holistic care plan, dedicated therapy will be primarily important to untangle the problematic thought and behavior patterns.

Cognitive Behavioral Therapy

Cognitive behavioral therapy is an effective treatment approach to redirecting beliefs, thoughts, and behaviors. Over time, a client can develop a trusting relationship with a therapist and learn strategies for modifying the course their disorder imposes. They can begin to orient their perception to the reality of their own personal value and their social interactions. And a therapist can help them desensitize to the triggers that stimulate anxiety, fear, and avoidance.

Trauma-Focused Therapies

Depending on the causes of the disorder, trauma therapy may help a client to process deeply ingrained triggers and pain from past trauma. These underlying imbalances may be limiting an individual’s relational capacity. Healing trauma in a welcoming and supportive environment can open the door to progress with positive self-esteem and socialization.

Alternative and Creative Therapies

Especially if talk therapy is too difficult for a client to approach at first, creative and alternative therapies can be a more gradual approach to treatment. Clients may feel more comfortable relating to art, equine, adventure, or music therapy to begin with. Experiential therapy can help individuals to build their confidence and openness to self-exploration and, eventually, to develop a working relationship with an individual therapist.

Though the way may not be easy for them to see at first or on their own, people who struggle with social anxiety disorder or avoidant personality disorder can break free from the fear that isolates them. Empowering long-term treatment can set them on a course toward recovery and a life of rewarding relationships and integrated feelings of self-worth and self-esteem. The relationships they establish will then serve as lasting support for positive perspective into the future.