Spectrum of symptoms - and "Social PTSD"?

So, do I have it or don't I!?!?

I am not sure that I would ever meet clear diagnostic criteria for Avoidant Personality Disorder. I don't literally avoid socializing or risks of criticism/ridicule to that degree. I have friends, I CAN be quite the social butterfly, I generally have warm feelings towards people, I feel secure about certain aspects of myself, and I successfully work with the public in a very busy environment (although at times I do find that highly stressful).

However, I have learned that many people have traits of personality disorders - I seem to fit somewhere in a diagnostic no-man's land between social anxiety and recognizable AvPD. I can answer "sometimes and mildly" to most of the diagnostic questions, and "frequently" only to those involving risk avoidance and feelings of inferiority and being unappealing. I have noticed other forum posters mention that under specific situations their social anxiety symptoms can suddenly balloon and they enter a sort of "Avoidant Personality Mode" where their thinking and behavior DOES fully match diagnostic criteria for a limited time. Me too! It makes me want to call it "Social PTSD", because there are specific triggers (which btw I never see coming!) causing sudden radical increase in symptoms including social hypervigilance, deep feelings of inadequacy and humiliation, sudden loss of all assertiveness, defensiveness, and desire to remove oneself from the situation. I find these reactions can persist anywhere from a couple of hours to a couple of days, if they are triggered severely enough.

What really bugs me is that on the "back end" of the disorder - the underlying and chronic tendency to see oneself as inept, unappealing, inferior; the fantasizing about an idealized self and life with the neurotic thinking and behaviors removed; the self-directed anger and frustration; the shaky faith in one's abilities; the ridiculous tendency to fall for "guilt trips"; the overabsorption of criticism; the feeling that there is some "core of Self" that it is too risky to fully reveal to anyone else unless it is absolutely safe to do so; the risk aversion and passive lifestyle; making big plans with insufficient actual action; the chronic low assertiveness, etc. - I fit THAT description of the disorder all too well!!! I sometimes think the diagnostic criteria are frankly too strict and overly focused on lack of socializing specifically.

Many of the Avoidants' stories I have read in articles include more risk avoidance, unwelcome social inhibition and lack of faith in one's abilities than overt social avoidance per se. I am beginning to think what we call AvPD is actually a psychological syndrome that manifests itself a bit differently in different people, has a wide spectrum of severity, and has several "entry vectors" as I call them - ways of developing the syndrome. It only gets called a Disorder if the number and severity of symptoms hit a specific, chronic threshold. What complicates things, so I have read, is that some Dependent Personality traits are often comorbid with Avoidant Personality Traits.

Okay, so I'll say I have significant Avoidant Personality TRAITS, then (and probably a handful of Dependent ones too), and be content with that (my last PDoc did mention I have "classic AvP traits").

At any rate, I have come to recognize that my issues with depression and anxiety seem to be directly influenced by (and I strongly suspect they are caused by) these AvP traits (I see it as primarily a poor self-image problem combined with social anxiety), interacting with learned helplessness (the all too common "defeatist attitude"). What gets me down is how I act - the self-defeating repetitive behaviors that perpetually shoot me in the foot, based upon how I see myself and my (former!) lack of insight into how learned helplessness works.

I find it interesting and revealing that, prior to and overlapping with my first couple of (undiagnosed) depressive episodes, I had recurrent and terrifying nightmares ALL of which included themes of being personally powerless, negatively judged, and/or socially irrelevant. It wasn't so obvious to me then; it is now!

I am educating myself daily about how to disrupt these negative thinking patterns and self-defeating, habitual behaviors, and looking for an affordable therapist - multiple medications have so far proven ineffective except in the very short term and in alleviating a narrow range of symptoms only (don't even get me started on the laundry list of side effects).

Does anyone else see themselves in what I've written here? Perhaps I am simply getting too obsessed with identifying and labeling a "major maladjustment"? It does feel somehow comforting to be able to say, "I have disorder X".

Yeah, I can relate to what you are talking about. For me, depression is connected to anxiety and hopelessness about never belonging or being accepted. I never had confidence in myself or especially in my abilities to be socially competent. I've literally been afraid of people since experiences starting around kindergarten or first grade, including getting yelled at by the teacher when I didn't know I was doing anything wrong, getting bullied by other kids, and my parents actively encouraging fear and mistrust of other kids and generally most people. While there isn't a diagnostic category of "social ptsd," I can see where you're coming from. There is a proposed category of "complex ptsd," which could be a good fit for this complex of symptoms. Also, people with personality disorders tend to also have at least one or more axis I disorders such as depression and anxiety or some kind.

Ultimately, labels are just labels, although it can be validating to find a dx that feels like it is a good fit and explains you. Good treatment for depression, anxiety, or anything else should teach you how to address the specific situations, thoughts, and feelings that you struggle with, no matter what they are. When it goes deep, treatment needs to address where those thoughts/feelings/symptoms are coming from.

You might get something out of reading about Schema Therapy. It is a new therapy that I'm just learning about, which uses cognitive therapy techniques, but goes deeper and identifies clusters of negative or self-defeating beliefs that are learned in childhood and persist into adulthood. A lot of them have to do with social or connection issues. It was developed for treating personality disorders, but is appropriate for any related problems. Everyone has schemas - some to a greater or lesser degree than others.

http://www.davidbricker.com/clientsg...emaTherapy.pdf
http://www.schematherapy.com/id201.htm

There don't seem to be a lot of therapists practicing Schema Therapy, but it is easy to learn, so you can introduce it, especially if the therapist already uses cognitive therapy techniques. There is also a book, "Reinventing Your Life," which explains it well and is very readable.

I also fall into a couple of different disorder's also. But I am 100 percent sure that it is because of trauma I have suffered throughout my life and they begin with Complex PTSD.

Like you I can be very social also. But only as long as it is with people I know and am comfortable with.
I never initiate contact with anyone. No matter how long I have known them. I except almost all invitations, but I never extend them.
I will go to someone's home, but I will never invite anyone to my own.
There are no exceptions. Siblings and my adult children are treated the same.

The reason is always the same. The fear of rejection. And I will always reject someone first if I think for one minute they are going to reject me.

So, no clear label. I am just glad that I know where it comes from.

I relate very well to you. My problems lie in work and my career, rather than being based on social situations. I do have small social problems but I think my desire to be around others drives me to overcome a lot of that. I have realized that when I zone out I am coming into a "I don't care" frame of mind to protect myself from my intrusive thoughts. So while I may feel self-conscious in a situation I just chant "I don't give a ****" in my mind and I seem to be able to hold my chin up high regardless of the situation.
Mostly I am terrified of failure, in a nut shell. My career choice is a demanding one and I always wanted to be the best. Making a mistake is not an option for me bc the consequences are to vast. People say you have to learn how to deal bc you are going to make mistakes and that is how you learn, you just have to accept it. Well I can't accept it. So I am running basically. I can't be perfect so I refuse to try a job that demands perfection. There are alternate paths and so that is what I am chosing to take. I have moved mountains to alter the career path I have chosen at this late point in the game.

But you are right, we don't always just fit into the box. I know I don't. Being social is probably one of my smallest issues. I used to have terrible self-confidence but it is getting better. I actually like to get dressed up and go out, even if it is just to the grocery store (lame I know, lol). My sweet husband has convinced me that I can look nice and I really enjoy walking around and wondering who might be noticing

Doc

I can relate to that as well. I do not complete avoid people or social situations. Its just that when I get in some social situation i just get blindsided at random by these intense paralyzing feelings of fear. I cant talk freely and i start to hyper ventilate. All it is is conversation but my fight or flight mode kicks in and i just want to run. i dont like myself because of these 20 plus year struggle to just feel confident and relax around others. i am not warm and open, people invite me over, i dont invite them. I just want to be in control of myself. I was not growing up with a very emotional abusive and lacking family life. We never talked to each other, and if i did, my father would criticize me. He raised some very low self esteem kids, i see it in my brother and sister.

sometimes when im around people and i start to freeze up while they look all relaxed in front of me i feel like an idiot.

Why do I freeze up? I am unsure if that person will like me, I read into everything they say or do to see if they like me. Constant critical thoughts in my head keeep me from liking myself. I instead judge myself and keep myself chasing a carrot on a string. never satisfied.