Find care near you in 10 minutes with our online assessment.
Social anxiety vs avoidant personality disorder: How can you tell them apart?

Social anxiety vs avoidant personality disorder: How can you tell them apart?

Reviewed by:
Austin Lin, MD
View bio
June 24, 2024
Original source:

Key takeaways

In this article

Social interaction and close relationships are fundamental aspects of human nature, but they don’t come easily to everyone. For many people, the simplest social interactions can be extremely anxiety-inducing. Some people might even avoid relationships altogether for fear of rejection and getting hurt.

Two mental health disorders that cause trouble with socializing and relationships are social anxiety disorder and avoidant personality disorder. Both conditions share many features, which can make it tricky to distinguish which one you or a loved one might have.  

Read on to learn about the symptoms of social anxiety disorder, and avoidant personality disorder, as well as their similarities and differences.  

Get virtual care from psychiatrists that take insurance.

Get started

What is social anxiety disorder?

Social anxiety disorder, sometimes called social phobia, is an anxiety disorder revolving around social interactions. Although most people experience some anxiety in certain social situations from time to time, people with social anxiety disorder feel an intense, irrational level of anxiety that makes it extremely hard to socialize.  

It’s more than just shyness as a personality trait. There’s a major fear of being judged, rejected, or embarrassed. It can affect any social interaction, ranging from going to parties, dating, eating in front of people, or even just talking to an employee in a store.

Symptoms of social anxiety disorder are emotional, physical, and behavioral.  

Emotional symptoms include:

  • Intense fear and anxiety surrounding social interactions
  • Fear of embarrassing yourself, being judged, or getting rejected
  • Feeling self-conscious and worried about how people perceive you
  • Worry that other people will notice your anxiety  

Physical symptoms include:

  • Blushing
  • Nausea
  • Dizziness
  • Fast heartbeat
  • Trembling
  • Chest pain
  • Shortness of breath
  • Sweating

Behavioral symptoms include:

  • Trouble making eye contact with others
  • Avoidance of social situations
  • Difficulty talking or talking very quietly
  • Missing obligations like work or school due to anxiety
  • Feeling like you need to drink alcohol or consume another substance before social situations
  • Rigid posture  

Symptoms of social phobia can start as early as late childhood or early teen years and continue into adulthood, especially if not treated.

What is avoidant personality disorder?

If you have a personality disorder, the way you think, feel, and act cause you to have trouble functioning and cause you significant distress. In the case of avoidant personality disorder (AVPD), there are a few key distinguishing characteristics, including:

  • Having ongoing social anxiety
  • Hypersensitivity to criticism and fear of criticisms
  • Intense fear of rejection
  • Persistent feelings of inadequacy
  • Desire for deep connections with others

Due to their severe social anxiety and fear of rejection, they often avoid new relationships, even though they do want to experience meaningful, close relationships. If you have AVPD, this creates a tough dynamic because while you want to connect with others, your intense fear of being judged or rejected keeps you away, and this in turn can leave you feeling isolated and lonely.

Some other signs of avoidant personality disorder

  • Social inhibition (holding back in social situations)
  • Trouble trusting overs
  • Extreme avoidance of social situations or relationships where rejection or embarrassment could occur
  • Avoiding intimate relationships for fear of getting hurt
  • Intense feelings of inadequacy that go beyond poor self-esteem

Symptoms typically appear in early adulthood, but childhood experiences such as severe childhood neglect are thought to play a part in the development of the personality disorder.  

Can you have both?

Yes, you can have both social anxiety disorder and avoidant personality disorder. Research has found that many people with social anxietyalso have AVPD. It’s estimated that at least 36% of people with AVPD also have social anxiety.  

People with both disorders at once have more debilitating symptoms and experience more impairment in their lives.

It can be very difficult to tell the difference between these two disorders, which is why it’s so important to work with a qualified, experienced mental health professional who can provide an accurate diagnosis. They can determine if you have AVPD, social phobia, or both.  

There are specific diagnostic criteria for these disorders, outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). To get diagnosed with any mental health condition, you’ll have to meet a certain number of symptoms. Your provider will take your history, ask about your family history of mental health conditions, and ask about all your symptoms. From here, they’ll determine if you meet the DSM-5 criteria for a diagnosis.  

Social anxiety disorder vs avoidant personality disorder: Overlap and differences

As you can see, there are many similarities between social phobia and AVPD. The main similarities include:

  • Social anxiety: Both disorders involve intense social anxiety in social settings, along with a fear of being rejected, embarrassed, or judged.
  • Avoidance behaviors: Individuals with both disorders tend to avoid social interactions to avoid the anxiety and distress these situations cause.
  • Impact on daily life: Both disorders significantly impact day-to-day life. They can make it hard to form and maintain relationships, interact with people, and go to work or school.  
  • Emotional distress: Both disorders involve a high level of emotional distress related to social interactions and self-perception.  

Some facets of the disorders are so similar that some experts in the field argue that AVPD is just a more extreme form of social anxiety while others argue that they are two distinct conditions.  

See the chart below to see some of the differences between the disorders.

Social Anxiety Disorder (SAD) Avoidant Personality Disorder (AVPD)
Type of disorder Anxiety disorder Personality disorder
Core features Fear of social interactions and being judged or embarrassed in specific social situations Deep feelings of inadequacy, fear of being rejected, hypersensitivity to criticism
Onset Typically late childhood Typically by early adulthood
Avoidance behaviors Avoiding triggering social situations Avoiding not only certain social situations, but also avoiding relationships in general in an attempt to not get hurt
Physical anxiety symptoms present? More likely to have physical symptoms like blushing, shaking, or shortness of breath Less likely to have physical symptoms (unless there is comorbid SAD)
Hypersensitivity to criticism Not a key feature Is a key feature
Prevalence 7.1% 2.36%

What are the treatment options?

With treatment, people with social anxiety disorder and AVPD can live less anxious, more fulfilling lives. Here’s an overview of popular treatment options for these disorders.

Social anxiety disorder treatment

A form of talk therapy called cognitive behavioral therapy (CBT) is a common treatment for social phobia. You will learn to identify unhealthy, unhelpful thought patterns that fuel your social anxiety. You’ll learn to challenge these thoughts and replace them with more realistic and positive ones to help you feel less anxious in social situations.  

Exposure therapy is also important, which involves exposing yourself to triggering social situations on purpose, in a gradual way. A therapist will help you determine the best plan to do this. By doing these exposures, you’ll gain confidence, boost social skills, and learn that you can be more comfortable with social interactions. You’ll also decrease avoidance behaviors that fuel your anxiety.  

Medication can also play a role in recovery. Some medications used for social anxiety are:

  • Anti-anxiety medications such as benzodiazepines, which are typically only prescribed short-term and as-needed due to risk for physical dependence
  • Beta-blockers like propranolol, prescribed off-label and as needed (off-label means prescribed for something other than it’s FDA-approved use, based on scientific studies)  

Avoidant personality disorder treatment

There isn’t as much research surrounding AVPD treatment compared to social anxiety treatment treatment, however, CBT and exposure therapy can also theoretically help AVPD by addressing social anxiety, distorted thoughts, and poor self-esteem.  

Another type of therapy used for personality disorders is psychodynamic therapy, which is based on the premise that your unconscious thoughts impact your behavior. This type of therapy focuses on finding the root causes of why you feel and think the way you do. By diving deep into your childhood, past experiences, and relationships, psychodynamic therapy helps you uncover the root of your avoidant behavior and how it is causing similar patterns in the present day. From there, you can develop healthier ways to view yourself and relate to others.

There isn’t any FDA-approved medication to treat AVPD. However, if you have co-occurring social anxiety disorder or any other mental health conditions, taking medications can help reduce your symptom load overall and improve general well-being.

If you think you might have social anxiety disorder or avoidant personality disorder, it’s important to get help from a mental health professional to get an accurate diagnosis and determine a treatment plan.  

Looking for a psychiatrist who can help you with a diagnosis and treatment? Consider Talkiatry. We’re a national psychiatry practice that treats a variety of mental health conditions, including social anxiety disorder and avoidant personality disorder. We provide virtual, in-network services so you can get the care you need from home. To get started, complete our free online assessment to get matched with a psychiatrist.

The information in this article is for education and informational purposes only and should never be substituted for medical advice, diagnoses, or treatment. If you or someone you know may be in danger, call 911 or the National Suicide and Crisis Lifeline at 988 right away.

Learn about the conditions we treat

How it works
Tip #1
Tell us about you
Take 10 min to tell us about why you’re seeking care and what you’re looking for.
Tip #2
Explore your matches
We’ll show you the bios and treatment approaches of doctors who are a match for you.
Tip #3
Schedule your visit
Find a time that works for you. We can usually see you in just days.
Tip #4
Start your journey
Join your visit from the comfort of home and get a personalized treatment plan.
Laptop computer simulation showing a psychiatry session with a psychiatrist
Start our short assessment

Frequently asked questions

Does Talkiatry take my insurance?

We're in network with major insurers, including:

  • Aetna
  • Blue Cross Blue Shield
  • Cigna
  • Humana
  • Medicare
  • Oscar
  • United Healthcare
  • Optum
  • Compsych

Even if your insurer isn't on the list, we might still accept it. Use the insurance eligibility checker in our online assessment to learn more.

Can I get an estimate of my visit cost?

The best way to get a detailed estimate of your cost is to contact your insurance company directly, since your cost will depend on the details of your insurance.  

For some, it’s just a co-pay. If you have an unmet deductible it could be more.  

Call the number on your insurance card and ask about your plan’s coverage for outpatient psychiatric services.

How does Talkiatry compare to face-to-face treatment?

For most patients, Talkiatry treatment is just as effective as in-person psychiatry (American Psychiatric Association, 2021), and much more convenient. That said, we don’t currently provide treatment for schizophrenia, primary eating disorder treatment, or Medication Assisted Treatment for substance use disorders.

What kind of treatment does Talkiatry provide?

At Talkiatry, we specialize in psychiatry, meaning the diagnosis and treatment of mental health conditions. Your psychiatrist will meet with you virtually on a schedule you set together, devise a treatment plan tailored to your specific needs and preferences, and work with you to adjust your plan as you meet your goals.

If your treatment plan includes medication, your psychiatrist will prescribe and manage it. If needed, your psychiatrist can also refer you to a Talkiatry therapist.

What's the difference between a therapist and psychiatrist?

Psychiatrists are doctors who have specialized training in diagnosing and treating complex mental health conditions through medication management. If you are experiencing symptoms of a mental health condition such as depression, anxiety, bipolar disorder, PTSD, or similar, a psychiatrist may be a good place to start.  

Other signs that you should see a psychiatrist include:  

  • Your primary care doctor or another doctor thinks you may benefit from the services of a psychiatrist and provides a referral    
  • You are interested in taking medication to treat a mental health condition  
  • Your symptoms are severe enough to regularly interfere with your everyday life

The term “therapist” can apply to a range of professionals including social workers, mental health counselors, psychologists, professional counselors, marriage and family therapists, and psychoanalysts. Working with a therapist generally involves regular talk therapy sessions where you discuss your feelings, problem-solving strategies, and coping mechanisms to help with your condition.

Who can prescribe medication?

All our psychiatrists (and all psychiatrists in general) are medical doctors with additional training in mental health. They can prescribe any medication they think can help their patients. In order to find out which medications might be appropriate, they need to conduct a full evaluation. At Talkiatry, first visits are generally scheduled for 60 minutes or more to give your psychiatrist time to learn about you, work on a treatment plan, and discuss any medications that might be included.

Austin Lin, MD

Dr. Austin Lin is a double board-certified adult and addiction psychiatrist who has been in practice for over 9 years. At the center of Dr. Lin’s clinical approach is a strong emphasis on establishing trust and using a collaborative approach to help patients develop an individualized and cohesive plan so that they are able to achieve their goals.

Dr. Lin's practice focuses on medication management. Typically, he offers this in conjunction with supportive therapy, motivational interviewing, and/or cognitive behavioral therapy in 30-minute follow-up visits. Occasionally, Dr. Lin may recommend that additional therapy is needed and ask that you bring a therapist into your care team in order to provide the best outcome.

Dr. Lin received his medical degree from St. George’s University School of Medicine. He went on to complete his residency in psychiatry at Harvard South Shore, an affiliate of Harvard Medical School, where he served as Chief Resident and earned his 360° Professionalism award. He then had additional training in Addiction Psychiatry through his fellowship at the University of Texas Southwestern Medical Center. After completing training, Dr. Lin has worked as an Addiction Psychiatrist and Director of Adult Services in the Trauma and Resilience Center (TRC) at the University of Texas Health Science Center at Houston (UTHealth). He specialized in treating patients with a history of depression, anxiety, trauma, and substance use disorders.

Dr. Lin has held an academic appointment at UTHealth, and he has spent his professional career supervising and teaching medical students and psychiatry residents.

Read more
Article sources
Related posts
June 28, 2024

How long does Lexapro take to work?

Read more ›
June 27, 2024

Paxil vs Zoloft: Comparing medications

Read more ›
June 27, 2024

Why do I wake up angry? How do I stop?

Read more ›
June 24, 2024

Social anxiety vs avoidant personality disorder: How can you tell them apart?

Read more ›
June 22, 2024

Mind always racing? Here’s why and how to stop racing thoughts

Read more ›
June 22, 2024

Does Lexapro help with social anxiety?

Read more ›

Mental health is personal.
So is our approach to psychiatry.

Get started