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Avoidant Personality Disorder: Social Anxiety on Steroids

“Avoidant personality disorder is most definitely anxiety-based. It’s similar to social anxiety disorder but magnified. APD is like social anxiety on steroids.” Dr. Beth Greene gently informs Brian Cunningham that he’s living with avoidant personality disorder.
My Life in a Nutshell: A Novel is Brian’s story, the story of the struggles and loneliness of living with avoidant personality disorder. Social anxiety is an anxiety disorder that can limit someone’s life. It involves a fear of negative judgement and/or embarrassment and can cause anxiety, tension, self-doubt, racing thoughts, unpleasant physical sensations, and more. Social anxiety as a general concept occurs in varying intensities. People who experience social anxiety can experience it anywhere on a spectrum from shy to avoidant. Someone can be shy and uncomfortable in once social situation without qualifying for an official diagnosis of social anxiety disorder.
On the other end of the spectrum is a disorder that involves extremely debilitating anxiety. Because at this level it impacts the entire person, is pervasive, and severely impacts life, it’s actually classified as a personality disorder rather than an anxiety disorder. This debilitating, anxiety-based illness is avoidant personality disorder. The American Psychiatric Association’s (2013) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) defines avoidant personality disorder as “A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts…” Here’s a look at what avoidant personality feels like:
The moment I step onto my own property with its protective landscaping, I feel my muscles loosen a bit. My heart continues to hammer my chest, and I know from experience that it won’t let up until I verify that the danger has vanished; well, given that there’s always danger lurking, I suppose it’s more accurate to say that I need to ensure that the imminent danger has receded. Accordingly, I chance a glance across and up and down the street. The three sidewalk loafers haven’t left. They’re not looking in my direction, but they’re over there and I’m out here and what if that prompts them to come over here? I have lived here as long as I’ve worked at Hayden. With my parents’ co-signature on the loan and their gift of a down payment, I bought it shortly after I was hired that summer after I left college, and in the entire time I’ve been here I haven’t had to talk to a single neighbor. Ever. I certainly don’t want to start now.
I glance at Abigail, who is running around the yard and doing somewhat-crooked cartwheels. This is definitely going to attract attention. My landscaping keeps us fairly camouflaged, but I doubt that even giant sequoias and a massive hedge labyrinth, neither of which I have anyway, would conceal a boisterous, energetic seven-year-old girl. “Hey Abigail,” I call. She ignores me. “Abigail?” No response other than continued cartwheeling. I would think she’d be dizzy by this point. “Abigail. Let’s go inside.” Nothing. I glance nervously across the street to check on the sidewalk partiers. Why haven’t they left? Are they planning their trip across the street to where the neighborhood’s own Boo Radley has shown himself? I need to get out of my front yard. I can feel myself shifting on my feet. “Abigail!” I try to sound friendly and enthusiastic rather than alarmed and upset.
Avoidant personality disorder is an anxiety-based disorder so extreme that someone with APD, like Brian, can’t even be comfortably out in the front yard of his own house. Life restricted to the backyard is very limiting indeed.

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