Tag Archives: Isolation

Avoidant Personality Disorder (AvPD) #Write31Days

31 Days of Mental Health

Welcome to day 16 in the 31-day writing challenge on mental health. I am still tired and a lot is on my mind today. Still, I am resuming my writing on personality disorders today. After we’ve discussed the cluster B personality disorders (well, all except for borderline personality disorder, since I’ve discussed that a lot before), it’s now time to move on to cluster C. (I will discuss the personality disorders in cluster A after I write about psychosis and schzophrenia later this month.) People with cluster C personality disorders are predominately anxious or fearful. The most well-known personality disorder in this cluster, which I’ll discuss today, is avoidant personality disorder.

Avoidant personality disorder (AvPD) referst o a pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to criticism. People with AvPD meet four or more of the followign criteria:


  1. Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection.

  2. Is unwilling to get involved with people unless certain of being liked.

  3. Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.

  4. Is preoccupied with being criticized or rejected in social situations.

  5. Is inhibited in new interpersonal situations because of feelings of inadequacy.

  6. Views self as socially inept, personally unappealing, or inferior to others.

  7. Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.


Individuals with avoidant personality disorder avoid work, school or other activities that might lead them to be embarrassed or criticized. As a result, they often live an isolated life. When they do engage in social interacitons, they are often hypervigilant to the actions of others. This may in turn elicit criticism or ridicule, which then worsens the AvPD sufferer’s hypervigilance. For clarity’s sake: AvPD sufferers do want to have friends and often feel extremely lonely. The problem is they feel too anxious to attempt to make friends.

Avoidant personality disorder occurs in 2.4% of the population. It commonly co-occurs with social anxiety disorder (social phobia). It is not clear in fact whether social phobia and avoidant personality disorder are distinct conditions or essentially fall on the same spectrum.

Avoidant personality disorder may also co-occur with or be confused with panic disorder with agoraphobia, major depression, or dependent personality disorder, which I’ll discuss later on. It is often confused with autism spectrum disorders. After all, people with AvPD, especially if they already had social phobia when growing up, may have developed social skills problems because of their lack of involvement in social situations.

Loneliness in Autistic People #AtoZChallenge

Welcome to day twelve in the A to Z Challenge on autism. Sorry for being late to publish my post again. Today, my post deals with a common experience in autisitc people: loneliness.

Autistic people by definition have trouble forming friendships, especially with non-autistic people. For this reason, many autistic people feel isolated and lonely. I am no exception. Other than my husband, I have no close friends, though I have a ton of Facebook friends. Most I don’t really know.

in adolescence particularly, I felt lonely. I remember writing in my diary a month into starting secondary school that I realized everyone had built friendships already and I hadn’t. In elementary school, I had usually had one or two friends, though I had trouble interacting with them too. Most of my elementary school friends were themselves quite isolated too.

It is a myth that autistic people are not affected by loneliness. In fact, many adults with autism experience depression and low self-esteem because of their lack of quality friendships. However, depression and anxiety also commonly cause autistic people to feel lonely and to self-isolate. I, for one, did not attempt to socialize anymore after I realized I clung too much to peoople who didn’t in fact considier me a friend. By the end of eighth grade, I was seemingly fine with the fact that I had no friends, but was actually quite depressed.

Even autistics who do have friends, can feel lonely. This is because autistic people have a different perception of friendship than neurotypicals. For example, neurotypical people usually associate friendship with affection, companionship and intimacy. Autistic people often don’t experience these qualities, or experience them to a lesser degree, in their friendships. They may therefore be lonely because of having a poorer quality friendship. For example, I sometimes refer to some of my Facebook friends as actual friends in conversation, but I recognize that the relationship I have with them is not as close as that of other people with their friends.

There are many ways to cope with loneliness. For example, autistic people might want to connect to other autistic people. There are play groups for autistic children and social and support groups for teens and adults with autism in most urban areas. This not only will help autistic people connect to others, but they wil also be able to find someone whose experience is similar to theirs. Hence, they may feel less disconnected from their environments, which can also be a form of loneliness.

Of course, it is also important that autistic people develop their interpersonal skills. In the Netherlands, many mental health agencies provide specific programs for adults with autism, where they can also follow social skills training. This may help them build and keep friendships and thereby lessen loneliness.

Lastly, many autistic people find that pets can help them feel less lonely. I for one don’t have a particularly close connection to our two cats, but that is possibly because they’re at our apartment, where my husband primarily cares for them.

Gender and Autism Stereotypes: Problems for Autistic Girls

Yesterday, I bought Parenting Girls on the Autism Spectrum by Eileen Riley-Hall. I’ve only read bits and pieces of it yet, but what struck a chord with me are the problems faced by both passive and aggressive autistic girls due to gender stereotypes and stereotypes about what autism should be.

First, most girls on the autism spectrum are passive. This can easily lead to them being ignored in a classroom or even at home. I notice this on my ward, too, because I’m fairly withdrawn. Because of this, my needs are not always met, as there are many patients who act out to get what they need. In the book, Riley-Hall talks about a girl in her daughter’s nursery who was so shy that she could easily be isolated if not for her attentive teacher. Passive autistic girls, according to Riley-Hall, need as much one-on-one attention as possible. This seems coutnerintuitive, because they aren’t causing any trouble or being a danger to themselves or others. Then again, they too need to learn to relate to others. It is sad in this respect that isolation is no longer a ground for care in the Netherlands. Apparently, you need to be aggressive to be seen. Please note that, in DSM-IV, passive autism is seen as more severe than the active-but-odd type.

Yet aggressive autistic girls are also often mistreated. According to Riley-Hall, gender stereotypes dictate that less aggression should be expected and tolerated from girls than from boys. Consequently, if an autistic girl acts out, she’s punished more harshly than a boy. Riley-Hall does not say this, but it is my expereince that aggression in women and girls is also interpreted differently than in males. For example, many more women are diagnosed with borderline personality disorder rather than for example ADHD. Fortunately, researchers and clinicians are becoming more and more aware of gender differences in the symptoms of psychiatric and neurodevelopmental disorders.