Social Anxiety vs Avoidant Personality Disorder: What’s the Difference?

2022-02-16

social anxiety vs avoidant personality disorder

Out of all the human conditions we can feel, no one seems exempt from experiencing some sort of anxiety. However, when these anxious feelings interfere with your life, they become debilitating. Some of them even blur together due to similar symptoms as is the case with social anxiety vs avoidant personality disorder (APD).

Some may confuse the two, but they are different mental disorders. If you or anyone you know seems like they are suffering, then it’s important to seek help. Understanding a little bit about both avoidant personality and social anxiety may give you some peace of mind in the meantime.

Quick Rundown

Before we take a thorough look into social anxiety vs avoidant personality disorder, let’s address some of the basics. This should give you a good idea about the two conditions.

The difference is seen in how a person feels. One case has you feeling anxious over interaction yet knowing that this fear is often irrational. In the other, your fears manifest internally as you feel inferior to others, thus avoiding interactions.

With both disorders, you can feel intense anxiety when interacting with others. However, those with avoidant personality disorder can also feel inadequate or have low self-esteem in thinking they’re worth less than others.

Does anxiety cause avoidant personality disorder?

Although researchers are still looking for a specific cause, there’s no indication that anxiety alone causes this disorder. It is certainly a symptom though, but this is true for many other disorders. That’s why it’s important to reach out to a healthcare professional as they can help you determine when your symptoms began and what environmental or genetic issue could have contributed to everything.

These conditions share similarities, but upon closer inspection, the differences are apparent. Let’s take a closer look at them individually to understand more about them and recognize the symptoms. From there, you can learn about management and treatment options.

Social anxiety disorder, also known as social phobia, is characterized as experiencing severe anxiety and fear over common social interactions.

It’s different than feeling the occasional anxiety over an upcoming job interview or presentation at school. This is overwhelming, and it can quickly disrupt your relationships and your life.

You may begin avoiding these situations out of fear of being embarrassed or humiliating yourself. It can cause you to stop speaking with others whether strangers or loved ones. You may even avoid eye contact or find yourself a bundle of nerves just returning something to a store or speaking to a waiter at a restaurant.

These feelings can manifest physical symptoms too such as an upset stomach, nausea, rapid heartbeat, and sweating.

Symptoms even adapt over time in those with the disorder. They can worsen or new ones can show up depending on what’s going on in your life such as your stress levels.

What is Avoidant Personality Disorder?

According to the DSM V personality disorders, avoidant personality disorder falls under the “Negative Emotionality” and “Detachment” psychopathology domains.

Those that have this disorder typically don’t just feel intense anxiety involving social interactions, but they also fear rejection from others. There is a sense of inadequacy, of feeling hypersensitive to how others will perceive you because you don’t believe you’re worthy.

This distortion of your self-image can readily interrupt your life from work, to school, and to your relationships.

Signs and Symptoms

When you look at social anxiety vs avoidant personality disorder, it is easy to see the similarities. However, let’s separate their signs and symptoms as that is key to noting the differences. This way, you have an easier time of being diagnosed with the right condition.

Social Anxiety Symptoms

We touched on them before, but let’s dive deeper into the obvious and common signs of social phobia.

The physical signs include:

Rapid heart rate
Shortness of breath
Muscle tension
Fatigue
Headaches
Nausea
Sweating

As for the behavior and emotional signs, people may experience the following:

Irritability
Feeling intense dread or anxiety over future situations
Feeling self-conscious, especially in front of others
Restlessness
Feeling jumpy

Avoidant Personality Disorder

With the APD, the DSM V personality disorders criteria approves of the following symptoms when it comes to making a diagnosis:

Over sensitivity to disapproval or criticism
Poor self-image and self-esteem
Awkward or self-conscious in social situations
Extreme anxiety in social settings
Avoiding social settings and interactions due to anxiety and fear
Exaggerating potential problems
Self-loathing
Extreme feelings of inadequacy

These can lead to many of the same physical symptoms as those with social anxiety experience. This may be why many can confuse the two for one another.

However, it is important to keep in mind about self-feelings when it comes to discerning them. One will always involve you feeling not just socially awkward, but also that you just aren’t worth as much as the people around you.

Symptoms from APD don’t just cut into your daily life, it can make it difficult to lead a normal life. People with the disorder can have these feelings equally around strangers as they do those in their lives such as friends and family.

In such events, it can make it tough to hold onto relationships. It can even make having a job difficult as you find yourself more often than not fretting over everything you say or do rather than actually doing your job.

It worsens when those with APD experience a self-imposed isolation. Many decide to choose to be lonely rather than risk any sort of rejection from those around them.

Causes

Although the DSM V personality disorders continue to categorize these disorders separately, there is no denying that the risk factors and causes can overlap too.

Researchers have looked into genetics for both disorders. They can be found within families, but there is no accounting for why some members get it while others don’t. Because of this, they’re still researching the genetics side of things.

However, there is strong indication that environmental factors can play a role in causing both disorders.

People can begin to feel anxious in social situations as well as avoiding them based on negative experiences. Perhaps you were humiliated in your past, and the feelings from that situation continue to manifest to the point that it’s all you think about sometimes.

In other cases, there can be childhood trauma whether abuse or neglect that can lead to APD or social anxiety. Growing up in a household where you weren’t given the emotional care you should have had can lead to anxious and self-conscious feelings.

The rejection can start there and translate into other symptoms found in APD such as avoiding situations unless you know the outcome and reaction to you will be positive.

Of course, not everyone with these disorders will have childhood trauma. So, the exact causes are difficult to nail down.

This is why it is vital to reach out to a healthcare professional as they will help figure out a diagnosis for you by looking at your history.

Diagnosis

Whether you are looking to diagnose social anxiety disorder or APD, it starts with speaking to a doctor. No matter the case, a healthcare professional will begin by completing a full physical exam as well as consulting with your history, both personal and your family health history.

Performing a physical exam is important as this will rule out anything else from being the cause of your symptoms.

When any physical health conditions are ruled out, there is a strong chance you will be referred to see a mental health expert like a psychologist or psychiatrist.

Going from there, you will undergo further examination. This time though, it will focus more on any symptoms you’ve been experiencing as well as when you’ve experienced them.

They will most likely use the DSM V criteria for diagnosing you.

For social anxiety, it requires you exhibit the following concerns:

Severe fear and anxiety about social situations
Your feelings are out of proportion to the threat at hand (e.g. social situation)
Anxiety symptoms are nearly always caused by social situations
Avoiding the social interactions and situations that cause anxiety
Symptoms aren’t caused by another health condition or substance abuse

As for APD, there are seven criterions mentioned, but a person needs to only meet four to receive a diagnosis:

Avoiding occupational activities that involves significant contact due to anxiety over rejection and criticism
Showing restraint in intimate relationships because of fears of ridicule and shame
Considers themselves as inferior or socially inept to others
Unwilling to get involved with others unless certain the reaction will be positive or acceptance
Feelings of inadequacy hinders new interpersonal situations
Preoccupied with fears over being rejected in social situations
Unusually reluctant to engage in new activities or take risks over fears of being embarrassed

Once you consider social anxiety vs avoidant personality disorder at this level, the differences between the pair are more obvious than ever.

It is these differences that can help you get a firm diagnosis. Understanding what you have can help many people feel a bit more at ease even before treatment since your condition is no longer a mystery.

Also, something to make note of is that a person can have both social anxiety and APD. It’s easy for social anxiety symptoms to prop up in those with APD. However, not everyone with social anxiety will have APD as well.

Those diagnosed with either can even see future diagnoses in the future due to the severity of their symptoms and how it’s impacting their lives.

For instance, you can also begin showing signs of depression, especially considering APD and self-isolating yourself.

Treatment and Management

Once you receive an official diagnosis, you can begin working on treatment and management plans.

Whether you are diagnosed with social phobia or APD, the best treatment recommendation is psychotherapy.

Psychotherapy is also referred to talk therapy. It is helpful for a broad range of emotional difficulties or mental disorders. This is because it works to hone in on the troubling problems, helping you to either control them better or eliminate them completely so that your day-to-day life sees improvement.

There are multiple types of psychotherapy too, so one type may work best for your condition and symptoms than another. Many therapists even opt to combine some of the types together depending on the specific patient.

Cognitive behavioral therapy (CBT) is perhaps the most common one recommended. This type of talk therapy works to help people better identify the problem. From there, you can begin changing your way of thinking and behaving.

A wonderful thing about CBT is that it can address issues like social anxiety while also tackling other symptoms as in the case of developing depression from your disorder.

These tend to be done in individual sessions, so it can be easier for those with severe anxiety to focus on a single person. However, if you’re comfortable enough with it, this type of talk therapy is also completed in a group setting.

Many people may feel more relief when discussing their problems and listening to others with the same situation. This can help them feel less alone or isolated in their concerns.

When it comes to APD though, it is important for treatment to tread more lightly. Those with APD may not even seek treatment in the first place or remain highly reluctant to it due to their own low feelings of self-worth.

This is why the treatment for APD should start out a bit slow so that a therapist can properly gain the trust of the patient in question. Those with the disorder can easily feel as though the therapist is judging them or will reject them, so a foundation of mutual trust and respect is vital for improvement in treatment.

From there, patients can gradually learn to address their concerns, understand the negative thinking processes, and learn to control them or take them out of the picture entirely.

A good way for this to happen can be with supportive therapy. It is another type of talk therapy that focuses on encouragement and future management of their condition.

This can work on building self-esteem, a vital aspect in those with APD. This, in turn, can help lower anxiety, so it is a useful treatment plan for those with APD as well as social anxiety.

Supportive therapy works on ensuring you lead a healthier and more successful life. It can work to improve how you function socially, which can help in terms of forming or improving relationships. This is even useful when it comes to making it easier to go to school or work.

Many therapists may even recommend exposure therapy as a way to treat either disorder.

Although this can be a form of CBT, exposure therapy is more about confrontation. In the case of those with social anxiety and APD, your therapist may recommend gradually exposing yourself to things that make you anxious.

This can help break avoidance habits and lead to less self-isolation. Of course, it should be done at a pace the specific patient can handle as to not experience any major setbacks in treatment.

Medication

Many healthcare professionals can recommend medication as part of the treatment plan. This can be with or without therapy intervention as well, but there may be more success if the medication is taken alongside it.

When prescribed medication, it’s more about dealing with the severe symptoms that come from both disorders. This includes anxiety as well as potential depression-related symptoms.

Common medications for these disorders include:

SSRIs (selective serotonin reuptake inhibitors): Type of antidepressants that have fewer side effects. Can also work to treat social phobia.
SNRIs (serotonin and norepinephrine reuptake inhibitors): These antidepressants handle depression symptoms like irritability as well as anxiety symptoms.
Anti-anxiety medications: These medications, as per their name, help with those with severe anxiety-related symptoms.

If you are prescribed any medication, it is important that you follow your doctor’s orders in how you take them. There is a chance that many of these medications can come with side effects that can worsen your condition, so be sure to also inform your doctor in case your behavior or thinking patterns change in any way.

Takeaway

There are cases where everyone will experience some type of anxiety, but with social anxiety and avoidance personality disorder, these feelings are more extreme. They are intense and come with both emotional and physical symptoms, and they can interfere with your daily life and relationships.

What is important is establishing a difference between social anxiety vs avoidance personality disorder. They share a slew of similarities at first glance, but they are offset by how you feel about the situation.

Anxiety is commonly found, but those with APD tend to feel inadequate. There are major self-esteem issues and avoiding of social situations out of fear of rejection. These things are true even if the social situation includes those you know like family and friends.

In fact, APD can make it difficult to form intimate relationships because of your own feelings of self-doubt. Meanwhile, with social anxiety, those anxious feelings are more rooted in specific social situations rather than feelings of self-loathing.

Regardless of which disorder you may have, it is important to seek medical treatment as these conditions can worsen without any sort of interference. In the case of social anxiety vs avoidance personality disorder, a consistent treatment and management plan is best to help you live a healthy life.

PL

Social Anxiety vs Avoidant Personality Disorder: What’s the Difference?

Quick Rundown

Does anxiety cause avoidant personality disorder?