The line between Social Anxiety Disorder and AvPD

My psychologist seems to think that I have Social Anxiety Disorder. I was doing a search of SAD and I came across Avoidant Personality Disorder and thought oh my god that's me. One website I was on listed these symptoms:

-Social inhibition; retreating from others in anticipation of rejection
-Preoccupation with being rejected or criticized in social situations
-Fear of embarrassment results in avoidance of new activities
-Poor self-image; feelings of social ineptitude
-Desire for improved social relations
-Appear to others as self-involved and unfriendly
-Creation of elaborate fantasy lives
-Exaggerating potential difficulties of new situations to rationalize avoiding them

And every single one describes me perfectly (I could go on and on about my "symptoms" and they all seem to fit with this disorder).. So I'm just wondering, is there a big difference between these disorders? Do people with SAD make up fantasy lives as well? How do you differentiate between them?

Can you even differentiate between them? Most of the symtoms overlap besides the fantasy thing. Unless someone can eloborate how the two disorders are significantly different, then you would have to assume they are almost one in the same.

I would have to say that because the symptoms overlap... so much that they are not soo distinct, the treatment is pretty much the same. You can decide if you have AvPD or SAD but the same treatment processes are pretty identical

AVPD resembles severe, generalized social phobia, but not all cases of social phobia are generalized or severe.

Peptron answered this in detail a while back.

AvPD is an axis II disorder. SAD is an axis I. But they do have lots of overlap in symptoms. Most people who have AvPD develop SAD or GAD. I think I'm more in the GAD category. But a person could have SAD without having AvPD. Here's the way I have heard the difference from peptrons post:

In Personality Disorders in Modern Life, they explain very well the difference between Axis I disorders and Axis II disorders. With that information people should distinguish easily an Axis I disorder like Social Anxiety and an Axis II disorder like Avoidant Personality Disorder.


They explain that:
Axis I disorders are analogous to diseases. They are ultimately the reason why you end up in psychiatric treatment. Those are depression, anxiety, depersonalisation, psychosis, and all those mental disorders that you can have. So they are analogous to the flu, the cold, the plague, etc: this is why you end up in the hospital.

Axis II disorders are analogous to the immune system. Personality disorders are analogous to a compromised immune system. In normal people, events in life are unlikely to lead to an Axis I disorder. However, if you have a personality disorder, you are almost certain to develop Axis I disorders, since it's as if you have a weakened immune system: any minimal infection leads to development of a disease. And like with compromised immune systems, you can also have something analogous to auto-immune diseases where the mere fact of having a personality disorder will lead to an Axis I disorder without requiring any life event at all. ; similar to auto-immune diseases like Lupus and Multiple Sclerosis, where the disease is caused by the immune system itself. The "immune system" is so overreactive that it ends up destroying instead of protecting the person.


For example, if you see Avoidant Personality Disorder as a compromised immune system (a defense mechanism, because that's really what it is), then you can see what "diseases" it makes you particularly prone to. A defense strategy that involves avoiding difficulties will simply reinforce the tendency to "avoid", such as increasing the fight or flight response, making you more and more prone to anxiety over time. It will become very easy to develop a "disease" like social anxiety even under minimal pressure, and with strong cases of avoidance, the "immune system" itself can end up spawning social anxiety by itself without even needing an outside agent. Same thing that this immune system makes you very likely to develop depression over minimal life event, and even develop depression "just like that" with no life event attached to it.

So Social Anxiety Disorder and AvPD are not even the same "category" of disorders. Axis I and Axis II are not based on the same assumptions. "Anybody" is at risk of developping SAD when under suffisant pressure, but somebody with AvPD will need significantly less pressure, and AvPD can go as far as to spawn SAD by its mere presence.

In other words, if you have an Axis II disorder, Axis I disorders will be the story of your life. You can get immediate help for Axis I disorders, but Axis II disorders tend to be particularly hard to solve and many people simply take the easy route of solving the Axis I disorders that the Axis II spawns.

Here's another way I saw someone explain it. They said their psychiatrist said AVPD is a pattern of behavior that has existed for a long long time. It starts out as SAD but becomes AVPD without treatment. AVPD is where the person deals with anxiety through avoidance. However the person still feels anxiety if they have to do things they don't like. It's just that they try to structure their lives in ways to avoid the things that make them feel anxiety.

Parador wrote:Here's another way I saw someone explain it. They said their psychiatrist said AVPD is a pattern of behavior that has existed for a long long time. It starts out as SAD but becomes AVPD without treatment. AVPD is where the person deals with anxiety through avoidance. However the person still feels anxiety if they have to do things they don't like. It's just that they try to structure their lives in ways to avoid the things that make them feel anxiety.

That makes complete sense to me.

...and it also makes me want to take a trip to the "what would you have done differently?" thread

Also, I think that Social Anxiety Disorder doesn't include "why" you are anxious in social situations, simply that you "are" anxious. In AvPD it's more about "why" you are anxious and that as a side-effect you will usually have social anxiety disorder. Schizotypal PD, Paranoid PD and the likes often also include social anxiety disorder, but for reasons completely different than AvPD; schizotypals and paranoids usually are not anxious out of imagining other people laughing at their ineptude.

People with SAD know that their thoughts and behaviors are irrational but they can't do anything to change them. People with AvPD, on the other hand, could write a book full of logical facts (from the patients perspective at least) about why they are inferior to everyone else. So with AvPD it doesn't even feel like you have a disorder, but that you're a failure as a human being and don't deserve to be, or are incapable of being around other people.

I've always referred to myself as having SAD. But upon reading the Wiki article about AvPD, it fits me to a 'tee'. I wouldn't be surprised if I fall in the category of having AvPD. I believe it said that one can have both.