Avoidant personality disorder

Causes of avoidant personality disorder are unknown. Genes or a physical illness that changed the person's appearance may play a role.

People with this disorder cannot stop thinking about their own shortcomings. They form relationships with other people only if they believe they will not be rejected. Loss and rejection are so painful that these people choose to be lonely rather than risk trying to connect with others.

A person with avoidant personality disorder may:

• Be easily hurt when people criticize or disapprove of them
• Hold back too much in intimate relationships
• Be reluctant to become involved with people
• Avoid activities or jobs that involve contact with others
• Be shy in social situations out of fear of doing something wrong
• Make potential difficulties seem worse than they are
• Hold the view they are not good socially, not as good as other people, or unappealing

Avoidant personality disorder is diagnosed based on a psychological evaluation. The health care provider will consider how long and how severe the person's symptoms have been.

Talk therapy is considered to be the most effective treatment for this condition. It helps people with this disorder be less sensitive to rejection. Antidepressant medicines may be used in addition.

People with this disorder may develop some ability to relate to others. With treatment this can be improved.

Without treatment, a person with avoidant personality disorder may lead a life of near or total isolation. They may go on to develop a second mental health disorder, such as substance use or depression and may be at higher risk for suicide.

See your provider or a mental health professional if shyness or fear of rejection overwhelms your ability to function in life and have relationships.

If you or someone you know is thinking about suicide, call or text 988 or chat 988lifeline.org. You can also call 1-800-273-8255 (1-800-273-TALK). The 988 Suicide and Crisis Lifeline provides free and confidential support 24/7, anytime day or night.

You can also call 911 or the local emergency number or go to the hospital emergency room. DO NOT delay.

If someone you know has attempted suicide, call 911 or the local emergency number right away. DO NOT leave the person alone, even after you have called for help.

Personality disorder - avoidant

American Psychiatric Association website. Personality disorders. Diagnostic and Statistical Manual of Mental Disorders. 5th ed. Text Revision (DSM-5-TR), Washington, DC: American Psychiatric Association Publishing; 2022.

Blais MA, Smallwood P, Groves JE, Rivas-Vazquez RA, Hopwood CJ. Personality and personality disorders. In: Stern TA, Fava M, Wilens TE, Rosenbaum JF, eds. Massachusetts General Hospital Comprehensive Clinical Psychiatry. 2nd ed. Philadelphia, PA: Elsevier; 2016:chap 39.

Updated by: Fred K. Berger, MD, addiction and forensic psychiatrist, Scripps Memorial Hospital, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.