Understanding Avoidant Personality Disorder | Dr. Syl

Join Dr. Syl, a junior doctor from Australia training to become a psychiatrist, as we explore Avoidant Personality Disorder (AvPD). Uncover the symptoms, diagnosis, and treatments for AvPD, shedding light on this often-misunderstood condition. Discover practical strategies for managing AvPD symptoms and promoting mental health awareness. Don't miss out—subscribe and stay tuned for more insightful content!

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** The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional. If anything in this video was distressing please consider calling LifeLine 131114 **

Timestamps
00:00 - Introduction

[amoghkm]

Thanks, Dr. Syl, that was a great video! I have a diagnosis of AvPD from my past therapist. Unfortunately, despite years of therapy, I didn't seem to get any better. One of the main reasons is that - my avoidance patterns would pop up during therapy, too. When I was seated in front of my therapist, I was never able to relate to my mental state during the week before. No matter how strongly I felt and how intensely I experienced it, it would suddenly seem insignificant at the moment of talking about it, and I would magically forget how I had felt when everything was in flux. Even if I had my journal before me, I would skip mentioning parts that seemed unrelatable, strange, or just embarrassing. As a result, what I presented to my therapist was always a highly sanitised version of myself and was devoid of any ugliness.

For the longest time, they knew I had AvPD, but none of the therapists had grasped how bad it was. I would go around looking for a therapist who would "get me". But luckily, a couple of months ago, with my current therapist, I was just unable to compose myself during the session. The mask of being a put-together individual fell off, and it helped them realise that I'm struggling with it. My therapist, who was earlier misled to believe that I was a reasonably well-regulated person, really got to see how stifled I felt, and I told them that therapy wasn't working. Since then, their approach has been more comprehensive, and we're also working on a few other diagnoses, too.

AvPD is certainly not as "sexy" as some other disorders, but the constant push and pull of emotions and thoughts is hard to manage and confusing to deal with. To have it does really suck to some extent, at least.

[isabellefaguy]

As you brought autism, I see a lot of autistic people who also have a dx of avoidant personality disorder. But most professionnal I talk to have no clue that for many autistic people it's not an irrationnal belief that people will over criticize them. I know quite a lot of autistic individuals whom the only social interactions they get are harsh critics (often about stuff they can't change or do otherwise because of their deficits). They won't be told any other words in their whole days, for decades. And then, the professionnal (let's say the social worker) meet their caregivers, mother, father, spouse, etc. And the professionnal concludes "these are nice people, they can't say only bad stuff to the autistic person, the autistic person has irrationnal beliefs about that". But theses people are nice to the professionnal because they "are alike", "align in thoughts and actions". As soon as they're confronted to the autistic person who can't comply to their requests or social norms, because of some deficit, they get extremely irritated and act in very poor ways.

[blackpienus]

I've got AvPD and was diagnosed about 15 years ago. I always coupled this to perfectionism and stage fright. Because it's not just other people's expectations that cause major anxiety, it's also my own expectations. If I think I can't do it 'perfect', I don't do it at all. Cause any less makes me feel like I failed (again). And I've always kept friends at an arms length distance. I'd hang out with this friend group and also that friend group while never feeling I ever became a part of any of those friend groups. When I get the feeling a friend expects certain things from me, I'm out. So it's kind of a miracle I have my best friend in my life for decades now. In social situations I'm either quiet in the corner or I'm the life of the party. It all depends on safe company or not. There was a time I often used xtc to be able to feel more relaxed in the social scene. Suddenly I was an extravert that could talk to just anybody. That feeling was very addictive. After a couple years of partying, I just quit all that one day. Enough was enough. Now I'm 43 years old and I've accepted that I'm perfectly fine being alone and spending a lot of time alone. I hardly ever feel bored or lonely. I may not have a job because of my AvPD, but I'm ok with that now too. I've got my cat, my art, my computer and a great best friend. Accepting things are ok as they are was a very big thing for me and helped me a lot.

[dementedproductions]

I Have BPD, very much none defensive and willing to talk about it. mental health awareness NEEDS to be spoken about more.

[nobodyimportant]

I wish there were psychiatrists in the US like you.

All the ones I have had sound like they are reciting things out of a book, with no understanding or empathy behind it. That goes doubly so in the common case that I have to ween off meds. It is a fight every time to get them to write prescriptions to ween off in a way that minimizes the pain. I always end up telling them that they may have read it in a book, but I am living it and no one on this earth understands how I need to ween off meds better than I do.

They know psychiatry better than me but I know my symptoms and how they affect me better than they ever could and they don't use me as a resource. It is frustrating.

It is one reason I am med-free and just dealing with the symptoms by ignoring them as much as possible.

For reference, I have PDD w/psychotic features, GAD, and AvPD.

Therapists are slightly better, and I enjoy talking to my current one. The problem is that she has the default that everything I say is wrong or I misinterpreted it. Since psychosis showed up and the diagnosis changed, even my primary doctor disbelieved most of what I said.

As a former Coast Guard(and Army), I kind of understand how empathy is lost. After the umpteenth time that I had to risk my life because people, who had no business being out at sea, or greedy fishermen, get in trouble and need help, it gets tiring. But, I never let it stop me from actually helping them by doing everything that was needed to get them safe. I would be annoyed AF, but never let the people who needed help know that. Whether I was in an active combat zone or on a search and rescue, I never let my empathy disappear - or let it negatively impact what needed to be done. We all used gallows humor - especially when all we could do was pull dead bodies out of the water -to cope - but some people I worked with let it affect them too much and they would act out in non-helpful ways.

I see that behavior in mental and medical people a lot. When that happens it is time to retire.

[Jane]

I really appreciate this video, thank you. There aren’t a lot of videos on the subject and its nuances. I was diagnosed in 2021 after really being pushed by a traumatic experience and my GP noticing that I seemed depressed. I’ve come a very long way, and I’m really proud. I’ve worked really hard at being brave and I feel like a different person experiencing all kinds of joyful and fulfilling things that I felt agonized to miss out on. I think if I didn’t have a bit of stubbornness in me, I wouldn’t have been as motivated to be brave. I love to prove people wrong. Even myself 😅

[andreaeast]

Thank you SO much for your video on AVPD!!! I have this and there just isn't a lot of study or information about it! Very happy that you talked about this very painful condition and definitely interested in the CBT online course when you get it ready! Thank you again!

[LesterBrunt]

I 100% have this. I have gotten way better at it over the years though, to the point where I'm taking trips around the world, meet new people, go on dates, etc. but I still really struggle with the opening up part. It is like I have avoided opening up for so long that I kinda forgot what it is even like, so even when I'm with people that I really like and trust I have a hard time opening up to them, unless I knew them from way back like high school. That is still some sort of self image of inadequacy, I lost it for a almost 10 years and therefor I'm 'far behind' the rest. And also the fear that people now like me for my 'tempered' self and maybe would not like me if I open up more. That is what is holding me back the most these days.
Things that really helped me was trying to be aware of my thought processes, and stopping myself from going on those ruminating, self pittying, shame spirals. I realized that I'm the one in control of my own thoughts, I don't actually need to go through every hypothetical dialogue tree while in the shower, I don't need to dissect every interaction to see where I might have messed up or where somebody maybe had a bad thought about me. I can just decide not to think about it. I also figured, if constantly reliving old memories of inadequacy, shame, etc. telling yourself that you are bad, a moron, boring, etc. is causing a negative self imagine, why not do the same in reverse? I started doing self confirmations like 'you are cool, you are smart, you are fun', and it does seem to help a lot.
Another thing that greatly helped was writing down my worries whenever I was in a worry spiral. One time I noticed myself going down a spiral because I was avoiding getting work done and whatnot. So I decided to write down all the things that need to be done and just try to do at least one of them. I grabbed pen and paper, wrote down 1 thing and then got stuck, I couldn't even think of more stuff that actually needed to be done. My entire worry spiral was thinking about all kinds of things that didn't even happen yet, it was something like "omg if I can't finish this project in time that means I can't do Y later on in the week, which will mean I will get behind with D and E, and that will mean I won't have time to visit my sister, and it will be another thing on my mind, and I probably won't have the energy to do G and H and then that will cause problems down the line omg, I'm really in trouble this time, how the f can I finish all this? I'm losing it".
When I was staring at that paper that only had 1 task it was so obvious how almost all my worrying was just a delusion. Such a stark contrast between the objective words on the paper and the crazy stormy thought space in my head.

[Lindah]

Thank you for sharing, i lost my relationship with my boyfriend because of mental illness (schizophrenia) i pray God protect him.

[dehro]

I have been diagnosed with avoidant personality traits (not the full blown disorder.. because apparently I''m half-assing this as well)
I guess it's on brand that I have had this video open in a tab on my browser for a few days now, and still have to watch it.

[monilangeKootenays]

I don't have a personality disorder. I have seen a psychiatrist, many therapists.

I avoid people who live nearest to me. I live in a sparsely populated, remote community. I despise small-minded/big gossips.

It's a very strong avoidance. I believe I'm healthy because I have great self-esteem. Enough to protect myself from maladaptive idiots with too much time on there hands.

I have been diagnosed with GAD and PTSD. Chronic physical pain as well. I'm permitted to block certain people off. If necessary, persistent, prying, nosey, trespassing folks will experience may experience some of my strong language.

I feel for people with this personality disorder. My heart goes out to all who struggle with conditions and diseases. 😢

[adaslesniak]

I definitely had it, probably some parts of it are still there deep in my soul. For some time I even could be very social. So it's not about not-being-social and definitely not about not wanting to be in relation. There was nothing I carved for more that to be in relation with someone who will accept me, who will let me feel "I'm not some unwanted piece of awkwardness", but I never were able to make a single move into this direction, as fear that I will be rejected was so paralyzing, that... it was impossible.

[motulifelikefigures]

I can tell its hell. one of the worst disorders that completely destroys your life and happiness. It has nothing to do with aspergers or autism. Cause you truly suffer from your isolation and loneliness. And like he said, still today i have a hard time to believe its a disorder cause im convinced im just a boring worthless person no one is interested in. I had so many rejections in my life, for me that is proof enough my concerns to be worthless are justified and i have to deal with it. A life long in isolation, no friends, no partners, no social life, no love, no happiness. I kinda gave up. I also think that this disorder is still lesser known and studied, it just comes up now more and more. but therapists i have been never supposed that.

[AspergersSyndromeDaily]

Yep... Was a serious problem when in school

[sarahk]

Thanks Dr. Syl! I hope someday for the biomarkers too. There are so many factors than can impact social functioning as you mentioned. Trauma, experiences of bullying or discrimination, neurodiversity, social anxiety, shyness, introversion, etc. It’s strange that we would diagnose someone with negative core beliefs about themselves as having a “disordered” personality because wouldn’t that confirm/reinforce their negative beliefs?

[bonariablackie]

I have actually been rejected all my life. In my family, I am the definition of a black sheep. My Father told me when I was 9, that I was so stupid, and he wished I wasn;t his daughter. That was the kind of thing that happened every day until I left home at 19. I have lost jobs because of backstabbing and truly unpleasant managers. This has left me with zero self esteem, it never developed. I haven't worked for the last five years, because, frankly, I can't face dealing with backstabbers and unpleasant bosses, for a pittance of pay and no possibility of promotion again. live in the UK, so this is the norm at work, but after 25 years, I am done. That's not avoidant personality disorder, that is 52 years of a miserable life experience.

[CasualPhoenix]

What about those of us who avoid relationships with others, not so much because we care about what other's think, but because we fear the negative impact of potentially toxic people and behaviors. I have had multiple cycles in my life where I have either been fooled into thinking I was supported by family and friends, only to find out the complete opposite, whether that be hateful words or prioritizing their mind games over their relationship with me. Even if a red flag may not lead to more abusive behavior, I still find myself either avoiding them or becoming completely guarded to where it impacts my perspective of the entire relationship.

[WouldntULikeToKnow.]

This sounds a lot like me but I'm more closed off to family and friends. I value their opinions of me and their possible rejection makes me anxious, I guess.

[maz]

I love watching your channel. Thank you for your videos. You are going to be a wonderful doctor and help many people. There is such a great need for good psychologists.
I am a late diagnosed Audhd (ADHD/Autisim) having actually sought out help as I thought I had early onset dementia. As it turns out after menopause, the lack of estrogen often has this effect on females. I am passionate about supporting the mental health community by understanding more about the things our brains do when they get hijacked by any one of the plethora of things out there that can affect us mentally. Some things are so very tragic :( My three children are also affected and suffer various levels of ADHD &/or Autism - although not officially diagnosed yet it is plainly obvious) my youngest suffers anxiety and panic attacks which stem primarily from this. She remains undiagnosed because of the anxiety and struggle. By learning as much as I can via these types of videos and my own therapist. I am getting a better understanding and skills on how best to help her and get her closer to getting the help she needs. I wished I had known she had this when she was younger and I could have just taken her to the Dr. As a female, we mask and adapt incredibly well which is why it is common to be missed. Anyway keep up the good work :D
More on this topic would also be great.

[coffeecat]

Some of these remind me of some things in Asperger’s. Especially if you’ve been excessively criticized for social mishaps.