Avoidant personality disorder (APD) is not just the everyday worries that the majority of us suffer from.

We all fear rejection and embarrassment in social situations, these are classed as normal feelings, but what if you had a lifelong and deeply ingrained fear of being rejected that was so rooted in your psyche that it affected your everyday life?

People who suffer from APD have a crippling sensitivity to rejection, are typically extremely shy in nature and have an innate sense of distrust to those around them.

This affects their everyday life in countless ways, from avoiding social situations, shunning relationships, to essentially becoming isolated in their own homes.

So how do you separate the symptoms of avoidant personality disorder from normal everyday worries?

Those people that suffer from APD will have an enormous struggle when it comes to social and work situations. This is because they are extremely worried about the following:

  • rejection
  • criticism
  • disapproval
  • ridicule
  • embarrassment

Avoidant personality disorder affects every part of a person’s life because the person who is suffering from it believes they are simply not good enough. This can, therefore, manifest itself in relationships, work and social situations. A person with APD will typically be on their own and not form relationships easily, but when they do, it will be with a partner who they think will not reject them.

This might lead them into forming unhealthy relationships or, rather than risk being rejected or humiliated, they will choose to be on their own.

Experts have defined what characteristics make up an APD diagnosis:

  • Starts early – the symptoms begin in early adulthood (around the 20’s)
  • Avoids people – the person starts to withdraw from people unless they are certain they will be liked
  • Withdraws from activities – the sufferer starts to withdraw from any kind of social activity that involves personal contact
  • Overly sensitive to criticism – begins to experience severe anxiety when criticised
  • Thinks they are socially inept – as they become more inhibited they view themselves as inferior and retreat even further
  • Permeates all situations – the feelings of inadequacy occur at home, work and any social situation
  • Severe distress & impairment – the person’s whole life is affected

Causes of Avoidant Personality Disorder

It is thought that around 2.4% of the population suffer from APD, this is according to 2002 NESARC research. APD is at its most intense during a person’s early twenties and tends to decrease in their late 40’s and 50’s.

As for the causes, researchers still do not know exactly why it starts but believe it is a combination of nature and nurture factors with no one explanation for why the disorder affects a person. In fact, there could be several reasons. One could a physical reason and the other could be a psychological one, for instance:

  1. People who suffer from a particular genetic illness that affects their appearance could be at risk
  1. Those who have suffered abuse in the form of extreme criticism and bullying from their parents are at risk.

In the case of the physical aspect, a genetic deformity that makes a child stand out from his or her peers would affect how they interact and develop during their informative stages. If they were shunned and ridiculed at an early age, they may not have the skills to then interact as a young adult.

As for psychological abuse, if a child was constantly bullied and criticised by its parents for not being good enough it would grow up with a sense of inadequacy that would remain during their adult years.

Of course, we also have to take into account the child itself. If it had a strong temperament and personality and learned coping skills, it would not develop APD.

So the reasoning is clear, it is possible that no one factor is responsible for APD and it is more likely that a combination or possibly all three factors are required for a child to develop the condition.

How to treat Avoidant Personality Disorder

APD is very hard to treat because the way to break the cycle of a fear of rejection is to build up a sufferer’s confidence, but a lifetime of crushing low self-esteem makes this extremely difficult.

Most treatment of avoidant personality disorder involves psychotherapy (also known as talking therapy or counselling). It works well when the person suffering has gone into therapy of their own accord. The therapist will set small goals that they feel are achievable and only after much counselling.

They will concentrate on building self-confidence and self-esteem and focus on the person feeling better about themselves. This could be by giving them coping skills and tools to help. This type of treatment is typically short-term.

Longer treatments would involve more intense sessions, possibly with groups, in order for the person to develop the ability to relate to others and engage in society.


  1. http://www.ncbi.nlm.nih.gov/
  2. https://psychcentral.com/ (2002 NESARC research)

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This Post Has One Comment

  1. Julie

    Thank you Janey. Yes. Helpful information. Of projection.

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