Do you care if it's avoidant or social phobia?

I am currently in the process of being diagnosed for personality disorders at the psychiatric district in my city, and I have had one session already. Basically, it was just a lot of standard questions, none which really dealt with anything I thought was important to me. Anyway, next time they will focus specifically on personality disorders (there's just a 4 months waiting time, but no biggy). So I went online and found out I could log in and read what they wrote about me.. at first I was a bit offended, because the doctor I had spoken to had written that I seemed "insecure and immature". Fine, I'm insecure, but I was immature as well? Okay, blow aside, her final diagnosis was social phobia. I was a bit breathless, to say the least. First of all, it was the very first session, didn't even last an hour. Second of all, she hasn't even assessed me for personality disorders and hadn't even gotten all the way around. How can she have a final diagnosis of me? When I am still going back for further diagnosing? Well, anyway.. I do agree that I have social phobia. But I also suspect avoidant (and possibly "quiet" borderline), so I had a small breakdown. I am SO scared of being misunderstood and being told it's just a phobia, and that I just need to be thrown out there, exposed, overcome it, when I feel it's so much deeper and more ingrained in me. Long story short, I told someone in a support group on FB and they told me I shouldn't care for diagnoses and that social phobia is fine. But I feel a need to describe WHO I am, not just how I feel scared sometimes. Fear is not my only problem.

Can any of you explain why you're here and not in the social phobia forum? To me there just seems to be a big difference between phobias and personality disorders.. In a way I feel I could overcome all my anxiety and still be "ill". How would you explain the difference here?

That's tough to answer. I'm not diagnosed with either, although my T and I both believe that I fit avoidant - but I would never fit in with social phobia. To me, Avoidant is how I feel and think about myself, whereas social phobia (to me) is based more on a fear of others.

Like... I think I'm massively inferior. I don't act it - I learned how to behave "normally" as a survival method. I'm glad of it, because I can go out and do things and enjoy them...but there's always the "you're not good enough to be doing this. Everyone around here is going to see that and wish you weren't here" or other such thoughts. But with me... it's more of an internal thing. My thoughts and emotions fit very well with Avoidant PD - I really avoid more intimate situations that would involve sharing my true emotions and thoughts.

I'm not sure if I'm making any sense. But having an actual diagnosis doesn't matter much for me (in fact, I'd rather not have it on record). But knowing that my T believes that... WITHOUT me having brought it up first... is more than enough for me.

Interesting post! First of all you should be glad you are getting diagnosed, I get the feeling not many in here have actually gotten a professional diagnose (me included). Secondly I think your psychiatrist may be right, it doesnt take that long to diagnose a person for social phobia (typical scared of social events, avoiding meeting friends family etc because of anxiety and being nervous), on the other hand, I think it takes longer do specifically diagnose a personality disorder. So hang in there and wait to see what the outcome is, but dont forget not to put too much stress into "diagnose", its just a way of explaining why you are like you are.

To answer your second question, I think social phobia is more of a thing that people avoid specific social situations because it makes them nervous/anxiuos. While they can be totally relaxed and social in other situations. It depends who they are with and the situations. And the anxiety comes as a result of irrational thinking, which can be treated and totally dissappear for that person to later have absolutely no problems with social situations.

AvPD on the other hand has more to do with each individuals personality, which hardly can be treated (maybe learn some tricks to get the focus away from the social situations). I think it's more of how you perceive reality, other people and yourself.
I am on this forum because I have been treated for social phobia many times, but havent gotten any better, its just sitting in me like never before! I avoid pretty much any social confrontation, and have been doing it pretty much my whole life, and also like Panda I take on this mask to try to be normal when I am around other people..its just not about anxiety. But again like i mentioned I have never been diagnosed with it, but my doctor agrees

Thanks, guys! Your explanations make a lot of sense.
Red Panda, that's exactly how I feel! It is less about fear and so much more about inferiority. I may not even necessarily feel anxious in a given situation, but I will feel inferior, like I better not speak, my words don't carry value anyway, I'm in the way, etc. It's definitely about showing emotions and thoughts, I never tell people the truth because I'm afraid of either rejection, misunderstanding or them taking offense, but less about embarrassment. And you're right, it matters so much that someone with authority agrees and confirms that you're not making stuff up.

Hoasis, I really am! I have -avoided- such confrontations before: talking to psychologists, doctors, getting help and diagnoses, and this time I am finally daring to come out of my cave and admit to someone that I have problems (I have a tendency to belittle my problems and sweep them under the rug). But now that I'm finally in that situation, my anxiety is up; I am so afraid of feeling misunderstood and getting the wrong diagnosis. The doctor I spoke with nearly said I had ADHD, because I mentioned my concentration issues (due to stress and depression). I am just afraid of a doctor saying it is less severe than it really is and the rest will be me feeling like a hypochondriac. But you're right, that WOULD be the easy assessment (social phobia)!
And what you describe is exactly what I feel!! I've overcome so much in terms of anxiety, but I just KNOW it's more than that. It's really hard to put words on. It's just more than fear of people. Just because I can go up and talk to people doesn't make me part of them and doesn't make me be able to open up and be me, to be emotionally exposed. And yes, wearing masks and avoiding confrontations, even with people you'd usually be socially comfortable with..

Thanks for giving me more ways of describing this distinction and the way I feel . Really boosted my mood that someone understands.

I'm going to try to take a bite. I'm a bit hyped on caffeine, so can't focus enough to read the other replies. But maybe my own experience will help you feel a bit more at ease.

First of all, I wouldn't stress too much about the notes. In normal terms, insecure and immature may be seen as insults. However, in psychology/psychiatry, not so much. They're used a bit differently. It's kind of hard to explain, and I don't feel like trying to because of my caffeine hype. But don't think too much of it.

Now, to the topic at hand. I honestly would have preferred to be diagnosed with a social phobia. Personality disorders are a bit tougher to treat. They are part of your personality (hence 'personality' disorder). I don't think I was supposed to see my diagnosis. Not yet anyway. (Different therapy probably) But I did. My eyes wander and they wandered to his notes and I saw on the axis where personality disorders are written Avoidant personality disorder. Ouch. That hurt. I'll try to explain why.

It was easier for me to accept that I might be bipolar II or cyclothymic (I doubt the latter as I have had major depressive episodes, as described by my previous psychiatrist). I kind of suspected, for a long time, that I might have been bipolar. I tried to act as though it was hard for me to accept, but only because it distracted me from AvPD. I still suspect there's something underlying. I wasn't always so... well, 'avoidant'. It has gotten progressively worse in the past year. But I have always been socially awkward (as defined by my friends and family, not myself). My psychiatrist and I agree that being told I'm awkward so often likely led to my avoidance of others. We've talked about that. But of course, if I have a personality disorder, I was always avoidant. I suspect.

With a personality disorder, I felt like... I'd be like this forever. I felt unhelpable (I realize that's not a word, but it's the only thing I can think of to explain it). I felt like no matter how much therapy I sat through, things would never change. I denied that I was avoidant for the first several months. Recently, I joined a support group and the pieces all started to fall into place. And I realized how much I could relate to those people. The finding hobbies inside. The isolation. The overeating or under eating to deal with emotions. The making excuses to avoid going to social gatherings last minute. And I realized I was avoidant, that it wasn't just a social phobia. And for several days after I realized that, I was depressed. Because I remember thinking I'm going to be like this forever. This is going to be my life.

I am slowly accepting it, though. I think there is hope. I know that I will never be 100% comfortable around people, and maybe that's okay? I don't know. But I know that with the right therapy, I may become comfortable enough to meet people, at the very least. My point in all this is that it's hard for many of us to accept our diagnosis. I spent years wondering, wanting to know. And now I do know, and it was scary. Because I had to step out of what I 'thought' and into what I 'know'.

I much prefer the term "social phobia" (implying a learned fear) over "social anxiety disorder" (implying some genetic issue causing excessive fear/inhibition around people). They may well coexist, though. The core issues with AvPD seem to my mind, to be expectations of social failure, very negative self-image, and behavioral avoidance of risk (especially social risk). Withdrawal into fantasizing/planning over useful action and other ineffective but "safe" attempts to feel more socially acceptable or important are other likely factors, from what I have read.

Based on (unofficial) tests, observation and therapy, I seem to have moderate social phobia and SOME Avoidant personality features, which never developed into a personality disorder (I am very grateful for that!) I notice I have evident "triggers" for the assumptions/behaviors that remind me of AvPD.

I find the concept of "Schema Theory" really interesting. It theorizes that common learned fears can become enmeshed in a set of negative assumptions, and then cause self-defeating behaviors based on those assumptions. It's like CBT except for stronger emphasis on deciphering the events which caused, essentially, a fear of powerful and valid psychological needs not being met. Schemas, amplified to the strongest degrees, seem like a potential catalyst for personality disorders. One can have schemas, but never develop a personality disorder. Think of someone with abandonment fears causing a degree of situational difficulty, versus someone with all the features of Borderline, for example.

Bronzeowl: Thank you so much for your story!
Thank you for clearing up her notes - that actually made me feel more calm about it too. I don't know why I didn't think about it that way.. instead I just looked at it as in a personal attack from her side. I also remember thinking she seemed to want to hurry from one question to the next and didn't seem very interested in my explanations, so I guess I'm a bit colored by that. I pick up a lot on people's signals and if I feel they're not interested, especially if I am talking about really personal stuff, I can clam right up and feel like just leaving and avoiding them. Like it's a lost cause talking to them or something. Complete exaggeration though, I know!
Anyway, I really understand your experience though. I read that axis I are like 'diseases' that are curable, whereas you say that axis II disorders are more like an immune deficit disorder or something, which makes you more prone to get the axis I 'diseases'. I can imagine that's not good news if you were hoping that it wasn't too bad and that you could go to a psychiatrist, get help and get 'fixed'. I guess what I feel is different.. I feel I have tried so much.. and so hard and I just know I can't change. Kinda like thinking you can cure your allergy with medicine, but really you're intolerant and you suffer from a more chronic state that no medicine can fix. Bad analogy maybe. Anyway, I don't want that to be misunderstood though. I HAVE changed, a lot. I just feel there's a limit though. On some points I know I can push harder still, but on others I know I've reached my limit - and if it was 'just' a "disease", just a fear, I would have overcome it more by now, I'd be closer to goal. I have had to give up so many times where I REALLY drove myself hard. I don't know if that makes sense? I need the confirmation that there's a legit reason to why I can't succeed at this, that there's something else stopping me. I'm scared though that the doctors and psychiatrists will assume a diagnosis will make me sad and withhold it, whereas instead I feel it would answer all of my questions. Thank you for writing to me though, it really meant a great deal =).

Onward2wards: I agree, the two definitely overlap.. I guess the delineation exists where exposure therapy can't suffice. I mean, you can keep doing something over and over and you can get used to it, but what if you're just getting used to putting yourself through a state of anxiety and all you really do is trying to learn how to tolerate that constant anxiety? And the real problem exists inside yourself, not just in the amygdale. I don't know if it makes any sense.
I am not entirely sure I understand "schema theory". But the 'self-defeating behavior' rings a bell in terms of borderline, like you're trying to protect yourself against a fear, but instead you actually end up making matters worse. But those feelings are almost automatically triggered. Is a 'schema' the learned fear or the mix of a learned fear and the negative assumptions?

Thank you guys for replying, though. I actually feel like I'm not even being judged, but understood, and that feels supporting. You are actually saying things that make sense! And which are clearing up misunderstandings. You've made my day.

yes I care bcos when I received a copy of the letter sent to my gp, I thought it sounded like it was about someone else, cos the pdoc had made so much of it up. I later realise that he did this to try to make it seem as tho I fitted the criteria for personality disorder, but I don't. the thing is they can very much use a personality disorder against you. if you say you don't agree with your doctor or you want to complain about him, youre told you feel that way cos you have a pd, but they cant do this to you if it is just social phobia. im fed up of the way ive been treated.

You shoudl be careful thinking this way. yes the truth might hurt, but remember these are professionals, we are not. And selfdiagnose is maybe not the right way to go. yes we know ourselves better than they know us, but they know a hell of a lot better how to diagnose a person than we do. If you really feel your gp is "making" things up, I think you should try someone else.

oh Hoasis, please read posts properly before commenting. there are some vulnerable people on here who could take you seriously, which wouldn't do them any good. I know there are people who think all doctors are wonderful god like creatures who never make mistakes and who think that patients are all imbeciles but that isn't always true.

Just sayin, truth hurts I guess. No need to take that out on people in here

He's just saying you can't crap on a psychiatrist's opinion just because you don't like it... he's more qualified than you are (unless you're a mental health professional of course). Sure, the doctor might be wrong but you might be wrong too.

You have accused the doctor of "telling lies" which I don't know why they would be interested in doing that - surely it's their best expert opinion because I don't think they're out to get you. Also not sure if AvPD is one of the PD's where denial can be used as proof of the PD... seems like it wouldn't be.

I'm pretty sure that you both have valid points - psychiatrists are experts in their field and thus have more knowledge and understand the difference better than we do. However, they're not infallible and they will ocassionally make mistakes - especially as we very rarely tell them and show them everything there is to know about us.

If you believe that their diagnosis is wrong, then you have the right to advocate for yourself. I think that calling them a liar isn't doing anything helpful for anyone - it's creating a divide when you should be trying to work as a team. They likely do believe that you have Avoidant PD and not social phobia - that's likely their genuine assessment. I'm sorry if people have treated you poorly, and don't give up on advocating for yourself.

But Hoasis didn't say anything wrong to you. Hoasis advised against self-diagnosis (which is what everyone on here will tell you and everyone else, even if loads of us are guilty of doing it!) and has a valid point that psychiatrists DO have more knowledge about different disorders than we do. (As I said above though, that doesn't mean that they know US better and they can only diagnose based off what they see and hear from us).

To Ithilanar: I'm glad that you're feeling supported and understood!! That's a great feeling to have. Feeling judged is the worst thing ever (ha! Part of AvPD right there!) so I am glad that you're not feeling that way. Keep posting and exploring the forum.