# Anxiety Disorders > Social Anxiety Disorder >  >  Difference between SAD and AvPD?

## Yellow

Can someone tell me what the difference between the two is? I recently got diagnosed with both social anxiety disorder and avoidant personality disorder from the same therapist and i'm having trouble differentiating from the two.

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## CityofAngels

This is a controversial subject. My own view is that avpd is just more extreme SA but some people flip out when you say that and insist there is a difference beyond being more extreme. But since they use the same treatment(CBT) for SA and avpd it doesn't really matter if its different.

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## FraidyCat

Well, according to the DSM, which is basically the encyclopedia of mental illness, they classify disorders into Axes, or categories. Axis I, which are generally acute disorders, also called clinical disorders. They are generally believed to be more 'treatable' mental conditions, and are often treated with medication. Axis II conditions, are considered to be underlying personality traits, developed over the course of the patients growth and development. They are considered more difficult to change, and are more often treated with longer-term psychotherapy. There are 5 axes altogether. Some insurance policies will only reimburse for treatment of Axis I disorders, with the dubious rationale that they are more likely 'biologically based' than are Axis II conditions.

Social anxiety disorder is Axis I; Avoidant personality disorder (along with about 5 other personality disorders) are Axis II.

Having said all that, as you noticed, they sound pretty similar. A lot of the distinctions in the DSM are pretty arbitrary, and they almost entirely based on theory. Anti-psychiatry critics are quick to point out the numerous shortcomings of it as a scientific volume. Basically the DSM is an attempt to give names to groupings of symptoms that patients report, and those names, or diagnoses, include things like, schizophrenia, bipolar disorder, borderline personality disorder, etc, etc. Of course since it's mostly based upon subjective reporting by patients, there's a lot of gray area. Where does one begin and the other end? The names are artificial. What is real, are the symptoms which you experience, and that's really what matters. When dealing with your therapist or psych, focus less on the 'name' than on what's happening to you (although it might be interesting to see what they think about this question). And your treatment should focus on helping your symptoms, and not revolve around whether you're Axis I or Axis II.

One of the worst aspects of mental health care is the vocabulary. People get so hung up on, and argue about, and stigmatize, based on the words and labels, when they really should focus on the people and the symptoms. As you experienced, just the terminology change from an "anxiety disorder" to a "personality disorder" caused you to worry and lose self-esteem. But nothing really changed! They're both just made-up names for the collection of symptoms you feel. Labels are for jars, not for people. You're fine. But you have these social/avoidance issues. You can work on them and get past them. Good luck.

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## Yellow

Wow, that's a lot to take in, but I totally understand what you mean! I guess I will focus less on the name and all about getting better since they do seem to be very similar. Thanks Fraidy!

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## UltraShy

AvPD is generally just a less common way of saying severe SA.

While there is much debate on this, it doesn't really matter.  The treatment will be the same.  AvPD looks very much the same as severe SA, so much so that many experts question is they actually are different things.  It's about as pointless as debating whether something is a used car or a pre-owned vehicle.  You can call something whatever you want, but that doesn't change what it is.

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## distancing

I would say it's a bit different than just "severe SA", personally, though it does sometimes get used in that sense. I think it has some different underlying cognitive processes, though -- people with social anxiety don't necessarily feel defective in some form, and social anxiety often refers to fear of crowds. For people with AvPD, one-on-one interactions often create more stress than simply being in public, because there's more of an opportunity for the other person to scrutinize you, if that makes sense. 

Also, since it's an Axis II disorder, the avoidant "coping" skills get generalized from just interactions with people to avoiding other/most other areas of life, particularly involving an opportunity for failure or rejection.

Eh... I don't know if this post makes sense, but I hope it does. I can't English today.

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## Equinox

I'm not sure what the difference is but I'd be interested to find out as I think I have some AvPD symptoms.





> Well, according to the DSM, which is basically the encyclopedia of mental illness, they classify disorders into Axes, or categories. Axis I, which are generally acute disorders, also called clinical disorders. They are generally believed to be more 'treatable' mental conditions, and are often treated with medication. Axis II conditions, are considered to be underlying personality traits, developed over the course of the patients growth and development. They are considered more difficult to change, and are more often treated with longer-term psychotherapy. There are 5 axes altogether. Some insurance policies will only reimburse for treatment of Axis I disorders, with the dubious rationale that they are more likely 'biologically based' than are Axis II conditions.
> 
> Social anxiety disorder is Axis I; Avoidant personality disorder (along with about 5 other personality disorders) are Axis II.



This is interesting, thanks.

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## ChrisIsaCoolGuy

Wow that was really informative fraidy cat

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## pam

I haven't looked it up to know for sure but in college I learned that Avoidant personality disorder is ego-syntonic and SA is ego-dystonic. So the anxiety disorder causes much more subjective distress than the personality disorder.

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## Antidote

Personally I don't really think there is a difference other than that one is a more extreme form of the other. I've seen many abstracts indicating evidence that social anxiety and Avoidant PD are on a spectrum, and I found this from the linked review on this subject: 





> ''Although much more information is needed, studies that have directly compared these disorders have found little evidence of qualitative differences between them with respect to etiology, demographics, phenomenology, course, or treatment. Some investigations however have found evidence that Avoidant Personality Disorder may represent a more severe form of general social phobia in terms of levels of social phobia symptoms, anxiety, avoidance, depression and fear of criticism. Rates of comorbidity have ranged from 25% to nearly 100% leading one to question whether one could have avoidant PD but not general social phobia.''



http://www.akademipress.com/egitim_b..._Disorders.pdf

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