Medicated,

I can relate to the things you describe. I was first diagnosed with severe social phobia and major depressive disorder when I was 22. I've been in therapy for nearly 3 years now and am making progress albeit rather slowly. At a certain point I asked my therapist what was 'really' wrong with me (my feeling was that my behavioural patterns were too pervasive to be captured by the social anxiety diagnosis). At this point he brought up AvPD and this seems to represent my symptoms more fully. I think I have some other quirks too - after all diagnostic criteria are necessarily reductive and simplistic. People are inherently more complex than that diagnostic manual.

Diagnoses can be dangerous things - if you get a 'bad' or 'inappropriate' label it can stick with you for a long time and affect self-esteem. I imagine personality disorders are notoriously difficult to diagnose and it is a rough business. From what I've read, the distinction between social phobia and AvPD is that AvPD is more pervasive and social phobia is often isolated to particular types of situations (such as performance anxiety for specific tasks). AvPD is more a set of behaviours and beliefs in relation to social functioning, such as those things you describe about yourself. You have a strong desire to function socially and be popular but you feel enormous anxiety in social situations. This conflict and the feelings of distrust are, in my opinion, at the heart of AvPD.

I'm sorry you had such an awful experience at school. This is traumatic and horrifying for a young child and I'm sure this has profoundly affected you - I'm sorry you had to go through this experience. I hated school and found it very difficult to fit in. By the end of my school career I mostly stayed at home. My home situation was abusive but the security of hiding away in my bedroom was far more attractive than the tremendous shame and vulnerability I felt sitting alone eating lunch at school or being surrounded by the other students in the common room. My biggest problem is lack of trust and low self-esteem. I consider myself to be inept socially and expect people to think negatively of me and to see the worst in me. Do I find myself bad to the core? Sometimes I do, sometimes I feel utter contempt for myself, when I'm feeling my worst but this is balanced by a belief in my own goodness. At times I feel an extraordinary feeling of injustice and self-pity for my experiences.

Remember that AvPD is a 'rare' condition (by rare I mean there are not that many people diagnosed with it - this could just be that many people who have it don't seek out help because the idea of doing that is too distressing). What it does mean is that therapists and psychiatrists might first look at other diagnoses before coming to this one. I think it takes a good professional who really knows you well to hit the nail on the head.

As for treatment. I'm fairing much better since I started therapy. I've definitely improved but I'm still a long way to living life free of problems (and maybe it's idealistic to think that that will ever be the case). I've been doing psychoanalytic psychotherapy (something like toned down psychoanalysis crossed with psychodynamic therapy) for nearly 3 years. I've been able to form a fairly trusting relationship with my therapist - but the problems with constant distrust make therapy difficult and slow. Realistically, I'm going to be in long-term therapy. I'm considering trying group therapy - ('considering' is quite a way off from 'doing' so we'll see) - I can imagine this can be a useful thing if you can tolerate it.

One last thing... you are 26... you have your whole life ahead of you to find a lovely guy. Don't beat yourself up about not having had an intimate relationship and don't try to force it. It really isn't so uncommon for guys or girls to be mid-20s or even much older before they find the right person (and just think of all the people who have had countless turbulent flings and are no closer to forming a close genuine relationship).

Onzi