What is avoidant personality disorder

Avoidant personality disorder is characterized by extensive avoidance of social interaction driven by fears of rejection and feelings of personal inadequacy ¹⁾. Avoidant personality disorder is a pattern of extreme shyness, feelings of inadequacy and extreme sensitivity to criticism ²⁾. People with avoidant personality disorder may be unwilling to get involved with people unless they are certain of being liked, be preoccupied with being criticized or rejected, or may view themselves as not being good enough or socially inept. Someone with an avoidant personality disorder will appear shy and timid. They may avoid people because they feel inadequate, even though they secretly wish to have company. They are very sensitive to negative judgements by others.

• The key cognitive features of avoidant personality disorder are a sense of inferiority coupled with a fear and expectation of rejection. Behaviorally, this manifests as widespread avoidance of social interaction, the other key feature of avoidant personality disorder.
• Avoidant personality disorder onset can be traced back to early adulthood or adolescence.
• Like most personality disorders, avoidant personality disorder typically will decrease in intensity with age, with many people experiencing few of the most extreme symptoms by the time they are in their 40s or 50s.

Avoidant personality disorder is a chronic disorder with an early age at onset and a lifelong impact ³⁾. Yet it is underrecognized and poorly studied. Little is known regarding the most effective treatment ⁴⁾.

Avoidant personality disorder is a relatively common disorder that is associated with significant distress, impairment, and disability. Data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions suggest a prevalence of about 2.4% for avoidant personality disorder ⁵⁾. In terms of prevalence in clinical populations, there are numerous reports regarding avoidant personality disorder in anxiety samples with social anxiety disorder, but few in clinical samples with other diagnoses, such as depression or other personality disorders ⁶⁾. In a study of major depression with and without personality disorder (personality disorder), 29% of those diagnosed with avoidant personality disorder met the criteria for social anxiety disorder ⁷⁾. In a clinical sample of patients attending day hospitals for the treatment of personality disorder, 48% of those diagnosed with avoidant personality disorder met the criteria for social anxiety disorder ⁸⁾.

Many people with avoidant personality disorder don’t seek out treatment. People with personality disorders, in general, do not often seek out treatment until the disorder starts to significantly interfere or otherwise impact a person’s life. This most often happens when a person’s coping resources are stretched too thin to deal with stress or other life events.

The main form of treatment for avoidant personality disorder is long-term psychological therapy (psychotherapy) such as psychodynamic therapy and cognitive behavioral therapy (CBT) with a therapist that has experience in treating avoidant personality disorder. Interpersonal therapy is also used.

Some people with avoidant personality disorder have other problems, such as anxiety and depression. These will need treatment too.

While some people with a personality disorder may be able to tolerate long-term therapy, most people with avoidant personality disorder typically go into therapy only when they feel overwhelmed by stress, which usually exacerbates the symptoms of the avoidant personality disorder. Such shorter-term therapy will typically focus on the immediate problems in the person’s life, giving them some additional coping skills and tools to help. Once the problem that brought the person into therapy is resolved, a person will typically leave treatment.

Do I have avoidant personality disorder?

The diagnosis of avoidant personality disorder is best made by a trained mental health professional, such as a psychologist or psychiatrist, who gets to know you over time. Family physicians and general practitioners are generally not trained or well-equipped to make this type of psychological diagnosis. So while you can initially consult a family physician about this problem, they should refer you to a mental health professional for diagnosis and treatment.

Personality is the way of thinking, feeling and behaving that makes a person different from other people. An individual’s personality is influenced by experiences, environment (surroundings, life situations) and inherited characteristics. A personality disorder is a way of thinking, feeling and behaving that deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time.

People with avoidant personality disorder experience long-standing feelings of inadequacy and are extremely sensitive to what others think about them. These feelings of inadequacy lead the person to be socially inhibited and feel socially inept. Because of these feelings of inadequacy and inhibition, the person with avoidant personality disorder will regularly seek to avoid work, school, and any activities that involve socializing or interacting with others.

Diagnostic criteria of avoidant personality disorder (American Psychiatric Association – Diagnostic and Statistical Manual of Mental Disorders: DSM-5) ⁹⁾:

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

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.

The major problems associated with avoidant personality disorder occur in social and occupational (work) functioning. The low self-esteem and hypersensitivity to rejection often cause a person with avoidant personality disorder to restrict personal, social, and work contacts.

These individuals may become relatively isolated and usually do not have a large social support network that can help them weather crises. Despite their isolation, a person with avoidant personality disorder actually does desire affection and acceptance. They may even fantasize about idealized relationships with others.

The avoidant behaviors can also adversely affect their functioning at work because these individuals try to avoid the types of social situations that may be important for meeting the basic demands of the job or for advancement. For instance, they may avoid meetings as much as possible, and any social interactions with their co-workers or boss.

Avoidant personality disorder causes

The cause of avoidant personality disorder is not completely known. Some people with avoidant personality disorder have come from families where personality disorders are common. Others have had childhoods that involved abuse, trauma or neglect. Some come from normal and happy families.

Most professionals subscribe to a biopsychosocial model of causation — that is, the causes are likely due to biological and genetic factors, social factors (such as how a person interacts in their early development with their family and friends and other children), and psychological factors (the individual’s personality and temperament, shaped by their environment and learned coping skills to deal with stress). This suggests that no single factor is responsible — rather, it is the complex and likely intertwined nature of all three factors that are important.

If a person has avoidant personality disorder, research suggests that there is a slightly increased risk for this disorder to be “passed down” to their children.

Avoidant personality disorder symptoms

People with avoidant personality disorder often:

• Avoid work situations that involve contact with others because of fear of criticism, disapproval or rejection
• Don’t want to get involved with people unless they are sure of being liked
• Hold back from intimate relationships because they fear being shamed or ridiculed
• Become preoccupied with being criticized or rejected in social situations
• Are inhibited when meeting new people, due to their feeling inadequate
• View themselves as socially inadequate, personally unappealing, or inferior to others
• Are reluctant to take personal risks or become involved in new activities because they may become embarrassed.

Many people have some of these traits but are still able to function normally and do not have a personality disorder. A personality disorder is a long-term pattern of behavior, thinking and emotions that causes distress and makes it difficult to function in everyday life. People with personality disorders find it hard to change their behavior or adapt to different situations. They may have trouble forming positive relationships with others or sustaining a job.

Because personality disorders describe long-standing and enduring patterns of behavior, they are most often diagnosed in adulthood. It is uncommon for them to be diagnosed in childhood or adolescence, because a child or teen is under constant development, personality changes, and maturation. However, if it is diagnosed in a child or teen, the features must have been present for at least 1 year.

Additional disorders co-occurring with avoidant personality disorder

Avoidant personality disorder is often coexist with depression and substance abuse, and is likely to be associated with increased odds of suicidal ideation and attempts ¹⁰⁾, explaining, perhaps in part, why avoidant personality disorder may be a significant predictor of chronic depression ¹¹⁾. Intriguingly, in association with dysfunctional perfectionism, avoidant personality disorder has been reported to increase the risk of postpartum depression, possibly mediated by raised levels of antepartum anxiety and depression ¹²⁾. In a similar vein, avoidant personality disorder and obsessive–compulsive personality disorder (OCPD) are often found in association with anorexia nervosa and binge eating disorder ¹³⁾.

Comorbidity with other personality disorders is also common, especially within Cluster C. Possible explanations for the apparent high level of comorbidity include shared vulnerability factors ¹⁴⁾, criterion overlap ¹⁵⁾, inherent aspects of the disorder ¹⁵⁾, and disorder severity as a risk factor ¹⁶⁾.

Avoidant personality disorder diagnosis

The diagnosis of avoidant personality disorder is best made by a trained mental health professional, such as a psychologist or psychiatrist, who gets to know you over time. Family physicians and general practitioners are generally not trained or well-equipped to make this type of psychological diagnosis. So while you can initially consult a family physician about this problem, they should refer you to a mental health professional for diagnosis and treatment.

Diagnostic criteria of avoidant personality disorder (American Psychiatric Association – Diagnostic and Statistical Manual of Mental Disorders: DSM-5) ¹⁷⁾:

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

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.

Diagnostic features

The essential feature of avoidant personality disorder is a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation that begins by early adulthood and is present in a variety of contexts.

Individuals with avoidant personality disorder avoid work activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection (Criterion 1 above). Offers of job promotions may be declined because the new responsibilities might result in criticism from co-workers. These individuals avoid making new friends unless they are certain they will be liked and accepted without criticism (Criterion 2). Until they pass stringent tests proving the contrary, other people are assumed to be critical and disapproving. Individuals with avoidant personality disorder will not join in group activities unless there are repeated and generous offers of support and nurturance. Interpersonal intimacy is often difficult for these individuals, although they are able to establish intimate relationships when there is assurance of uncritical acceptance. They may act with restraint, have difficulty talking about themselves, and withhold intimate feelings for fear of being exposed, ridiculed, or shamed (Criterion 3).

Because individuals with avoidant personality disorder are preoccupied with being criticized or rejected in social situations, they may have a markedly low threshold for detecting such reactions (Criterion 4) . If someone is even slightly disapproving or critical, they may feel extremely hurt. They tend to be shy, quiet, inhibited, and “invisible” because of the fear that any attention would be degrading or rejecting. They expect that no matter what they say, others will see it as “wrong,” and so they may say nothing at all. They react strongly to subtle cues that are suggestive of mockery or derision. Despite their longing to be active participants in social life, they fear placing their welfare in the hands of others. Individuals with avoidant personality disorder are inhibited in new interpersonal situations because they feel inadequate and have low self-esteem (Criterion 5). Doubts concerning social competence and personal appeal become especially manifest in settings involving interactions with strangers. These individuals believe themselves to be socially inept, personally unappealing, or inferior to others (Criterion 6). They are unusually reluctant to take personal risks or to engage in any new activities because these may prove embarrassing (Criterion 7) . They are prone to exaggerate the potential dangers of ordinary situations, and a restricted lifestyle may result from their need for certainty and security. Someone with avoidant personality disorder may cancel a job interview for fear of being embarrassed by not dressing appropriately. Marginal somatic symptoms or other problems may become the reason for avoiding new activities.

Associated features supporting diagnosis

Individuals with avoidant personality disorder often vigilantly appraise the movements and expressions of those with whom they come into contact. Their fearful and tense demeanor may elicit ridicule and derision from others, which in turn confirms their self doubts. These individuals are very anxious about the possibility that they will react to criticism with blushing or crying. They are described by others as being “shy, ” “timid,”, “lonely,” and “isolated.” The major problems associated with avoidant personality disorder occur in social and occupational functioning. The low self-esteem and hypersensitivity to rejection are associated with restricted interpersonal contacts. These individuals may become relatively isolated and usually do not have a large social support network that can help them weather crises. They desire affection and acceptance and may fantasize about idealized relationships with others. The avoidant behaviors can also adversely affect occupational functioning because these individuals try to avoid the types of social situations that may be important for meeting the basic demands of the job or for advancement.

Other disorders that are commonly diagnosed with avoidant personality disorder include depressive, bipolar, and anxiety disorders, especially social anxiety disorder (social phobia). Avoidant personality disorder is often diagnosed with dependent personality disorder, because individuals with avoidant personality disorder become very attached to and dependent on those few other people with whom they are friends. Avoidant personality disorder also tends to be diagnosed with borderline personality disorder and with the Cluster A personality disorders (i.e., paranoid, schizoid, or schizotypal personality disorders).

Avoidant personality disorder test

There are no laboratory, blood, or genetic tests that are used to diagnose avoidant personality disorder.

Avoidant personality disorder treatment

Apart from case reports, there is little research into the treatment of avoidant personality disorder specifically ¹⁸⁾. Most of the empirical research is derived from treatment studies of social anxiety disorder, where outcome for social anxiety disorder with and without avoidant personality disorder has been reported. There are mixed findings: some studies report no effect on treatment outcome ¹⁹⁾, while others report less likelihood of remission from social anxiety disorder ²⁰⁾ and failure to reach normative levels of functioning ²¹⁾; some studies suggest an increased risk of persistent symptoms of social anxiety disorder when comorbid with avoidant personality disorder ²²⁾. There is also a report of a poorer outcome unrelated to severity of social anxiety disorder symptoms ²³⁾. However, overall these studies support the value of cognitive behavioral approaches in relieving symptoms of avoidant personality disorder to at least some extent.

Pharmacotherapy is generally not thought to be effective in personality disorder, and there are no trials of its use specifically in avoidant personality disorder reported in the literature ²⁴⁾. However, clinical recommendations exist for using similar pharmacotherapeutic approaches as for social anxiety disorder ²⁵⁾. In social anxiety disorder, the serotonin-specific reuptake inhibitors and serotonin noradrenaline reuptake inhibitors have a robust efficacy literature ²⁶⁾, and clearly pharmacotherapy is likely to be of value for comorbidity, such as depression.

In terms of psychological treatment, graded exposure, cognitive behavior therapy (CBT), social skills training, psychodynamic psychotherapy, schema therapy, and supportive–expressive psychotherapy have all been reported to be helpful, although the number of studies is small ²⁷⁾. Case reports of other psychological approaches exist [e.g., Acceptance and Commitment Therapy ²⁸⁾, Emotion Focused Therapy ²⁹⁾, and Wilderness Therapy ³⁰⁾] but randomized, controlled trials are lacking for these other approaches.

Case reports of successful therapy emphasized a formulation that included experiential avoidance as a key maladaptive coping strategy requiring recognition by the therapist and targeted intervention. In relevant cognitive research, a more threat-avoidant attention focus, compared to threat-focused, has been reported in association with poorer outcome in social anxiety disorder and may therefore be a relevant consideration for cognitive behavioral therapy (CBT) ³¹⁾. The formulations in these case reports incorporated hypothesized deficits in social cognition, which were also targeted in therapy ³²⁾. Notable aspects of this research include the congruence with recommendations for social skills training in avoidant personality disorder made by early investigators ³³⁾ and the long-term (years) time frame of the therapy.

Currently, it appears that a problem-focused approach is the best basis for treatment planning. Selection of treatment strategies should be based on a comprehensive, individualized formulation that takes account of symptoms, emotional functioning (including mentalization and alexithymia), relational functioning (including attachment style), and current coping strategies (including behavioral and experiential avoidance). Development and testing of interventions which specifically target the identified symptoms and difficulties of avoidant personality disorder is urgently needed. The research into social cognition appears particularly promising for avoidant personality disorder and other personality disorders.

Avoidant personality disorder treatment self help

There are not any self-help support groups or communities that experts are aware of that would be conducive to someone suffering from avoidant personality disorder ³⁴⁾. Such approaches would likely not be very effective because a person with avoidant personality disorder may be inclined to avoid attending such sessions, due to increased anxiety and difficulty interacting socially. However, you may want to try this self help technique if you also suffer from social anxiety or social phobia.

Challenge negative thoughts

The first step is to identify the automatic negative thoughts that underlie your fear of social situations. For example, if you’re worried about an upcoming work presentation, the underlying negative thought might be: “I’m going to blow it. Everyone will think I’m completely incompetent.”

The next step is to analyze and challenge them. It helps to ask yourself questions about the negative thoughts: “Do I know for sure that I’m going to blow the presentation?” or “Even if I’m nervous, will people necessarily think I’m incompetent?” Through this logical evaluation of your negative thoughts, you can gradually replace them with more realistic and positive ways of looking at social situations that trigger your anxiety.

It can be incredibly scary to think about why you feel and think the way you do, but understanding the reasons for your anxieties will help lessen their negative impact on your life.

Unhelpful thinking styles that fuel social anxiety

Ask yourself if you’re engaging in any of the following unhelpful thinking styles:

• Mind reading – Assuming you know what other people are thinking, and that they see you in the same negative way that you see yourself.
• Fortune telling – Predicting the future, usually while assuming the worst will happen. You just “know” that things will go horribly, so you’re already anxious before you’re even in the situation.
• Catastrophizing – Blowing things out of proportion. For example, if people notice that you’re nervous, it will be “awful”, “terrible”, or “disastrous.”
• Personalizing – Assuming that people are focusing on you in a negative way or that what’s going on with other people has to do with you.

Focus on others, not yourself

When we’re in a social situation that makes us nervous, we tend to get caught up in our anxious thoughts and feelings. We monitor our bodily sensations and do our best to control them—all the while fearing that the people around us can tell we’re nervous and are judging us for it.

The hope is that by paying extra close attention we can better manage the situation. But this excessive self-focus just makes us more aware of how horrible we’re feeling, triggering worse anxiety! What’s more, it prevents us from fully concentrating on the conversations around us or the performance we’re giving.

How can I stop thinking that everyone is looking at me?

Switching from an internal to an external focus can go a long way toward reducing social anxiety. This is easier said than done, but you can’t pay attention to two things at once. The more you concentrate on what’s happening around you, the less you’ll be affected by anxiety.

• Focus your attention on other people—but not on what they’re thinking of you! Instead, do your best to engage them and make a genuine connection.
• Remember that anxiety isn’t as visible as you think. And even if someone notices that you’re nervous, that doesn’t mean they’ll think badly of you.
• Really listen to what is being said—not to your own negative thoughts.
• Focus on the present moment, rather than worrying about what you’re going to say or beating yourself up for a flub that’s already passed.
• Release the pressure to be perfect. Instead, focus on being genuine and attentive—qualities that other people will appreciate.

Learn to control your breath

Many changes happen in your body when you become anxious. One of the first changes is that you begin to breathe quickly. Overbreathing throws off the balance of oxygen and carbon dioxide in your body—leading to more physical symptoms of anxiety, such as dizziness, a feeling of suffocation, increased heart rate, and muscle tension.

Learning to slow your breathing down can help you bring your physical symptoms of anxiety back under control. Practicing the following breathing exercise will help you stay calm when you’re the center of attention.

A breathing exercise to help you stay calm in social situations

• Sit comfortably with your back straight and your shoulders relaxed. Put one hand on your chest and the other on your stomach.
• Inhale slowly and deeply through your nose for 4 seconds. The hand on your stomach should rise, while the hand on your chest should move very little.
• Hold the breath for 2 seconds.
• Exhale slowly through your mouth for 6 seconds, pushing out at much air as you can. The hand on your stomach should move in as you exhale, but your other hand should move very little.
• Continue to breathe in through your nose and out through your mouth. Focus on keeping a slow and steady breathing pattern of 4-in, 2-hold, and 6-out.

Face your fears

One of the most helpful things you can do to overcome social anxiety is to face the social situations you fear rather than avoid them. Avoidance keeps social anxiety disorder going. It is okay to have feelings that cause you anxiety, but if these feelings are not addressed it will be increasingly difficult to move past them.

Avoidance leads to more problems

While avoiding nerve-wracking situations may help you feel better in the short term, it prevents you from becoming more comfortable in social situations and learning how to cope in the long term. In fact, the more you avoid a feared social situation, the more frightening it becomes.

Avoidance may also prevent you from doing things you’d like to do or reaching certain goals. For example, a fear of speaking up may prevent you from sharing your ideas at work, standing out in the classroom, or making new friends.

Challenging social anxiety one step at a time

While it may seem impossible to overcome a feared social situation, you can do it by taking it one small step at a time. The key is to start with a situation that you can handle and gradually work your way up to more challenging situations, building your confidence and coping skills as you move up the “anxiety ladder.”

For example, if socializing with strangers makes you anxious, you might start by accompanying an outgoing friend to a party. Once you’re comfortable with that step, you might try introducing yourself to one new person, and so on.

Working your way up the “anxiety ladder”

• Don’t try to face your biggest fear right away. It’s never a good idea to move too fast, take on too much, or force things. This may backfire and reinforce your anxiety.
• Be patient. Overcoming social anxiety takes time and practice. It’s a gradual step-by-step progress.
• Use the skills you’ve learned to stay calm, such as focusing on your breathing and challenging negative assumptions.

Make an effort to be more social

Actively seeking out supportive social environments is another effective way of challenging your fears and overcoming social anxiety. The following suggestions are good ways to start interacting with others in positive ways:

• Take a social skills class or an assertiveness training class. These classes are often offered at local adult education centers or community colleges.
• Volunteer doing something you enjoy, such as walking dogs in a shelter, or stuffing envelopes for a campaign—anything that will give you an activity to focus on while you are also engaging with a small number of like-minded people.
• Work on your communication skills. Good relationships depend on clear, emotionally-intelligent communication. If you find that you have trouble connecting to others, learning the basic skills or emotional intelligence can help.

Tips for making friends even if you’re shy or socially awkward

No matter how awkward or nervous you feel in the company of others, you can learn to silence self-critical thoughts, boost your self-esteem, and become more confident and secure in your interactions with others. You don’t have to change your personality. By simply learning new skills and adopting a different outlook you can overcome your fears and build rewarding friendships.

Adopt an anti-anxiety lifestyle

The mind and the body are intrinsically linked—and more and more evidence suggests that how you treat your body can have a significant effect on your anxiety levels, your ability to manage anxiety symptoms, and your overall self-confidence.

While lifestyle changes alone aren’t enough to overcome social phobia or social anxiety disorder, they can support your overall treatment progress. The following lifestyle tips will help you reduce your overall anxiety levels and set the stage for successful treatment.

Lifestyle changes to reduce anxiety

• Avoid or limit caffeine – Coffee, tea, soda, and energy drinks act as stimulants that increase anxiety symptoms. Consider cutting out caffeine entirely, or keeping your intake low and limited to the morning.
• Get active – Make physical activity a priority—30 minutes per day if possible. If you hate to exercise, try pairing it with something you do enjoy, such as window shopping while walking laps around the mall or dancing to your favorite music.
• Add more omega-3 fats to your diet – Omega-3 fatty acids support brain health and can improve your mood, outlook, and ability to handle anxiety. The best sources are fatty fish (salmon, herring, mackerel, anchovies, sardines), seaweed, flaxseed, and walnuts.
• Drink only in moderation – You may be tempted to drink before a social situation to calm your nerves, but alcohol increases your risk of having an anxiety attack.
• Quit smoking – Nicotine is a powerful stimulant. Contrary to popular belief, smoking leads to higher, not lower, levels of anxiety. If you need help kicking the habit, see: How to Quit Smoking.
• Get enough quality sleep – When you’re sleep deprived, you’re more vulnerable to anxiety. Being well rested will help you stay calm in social situations.

Living with avoidant personality disorder

Without treatment, a person with avoidant personality disorder may lead a life of near or total isolation ³⁵⁾. They may go on to develop a second mental health disorder, such as substance use, or a mood disorder, such as depression. See your healthcare provider or a mental health professional if shyness or fear of rejection overwhelms your ability to function in life and have relationships.

Along with your professional treatment plan, consider these lifestyle and self-care strategies:

• Be an active participant in your care. This can help your efforts to manage your personality disorder. Don’t skip therapy sessions, even if you don’t feel like going. Think about your goals for treatment and work toward achieving them.
• Take your medications as directed. Even if you’re feeling well, don’t skip your medications. If you stop, symptoms may come back. You could also experience withdrawal-like symptoms from stopping a medication too suddenly.
• Learn about your condition. Education about your condition can empower you and motivate you to stick to your treatment plan.
• Get active. Physical activity can help manage many symptoms, such as depression, stress and anxiety. Activity can also counteract the effects of some psychiatric medications that may cause weight gain. Consider walking, jogging, swimming, gardening or taking up another form of physical activity that you enjoy.
• Avoid drugs and alcohol. Alcohol and street drugs can worsen personality disorder symptoms or interact with medications.
• Get routine medical care. Don’t neglect checkups or skip visits to your primary care professional, especially if you aren’t feeling well. You may have a new health problem that needs to be addressed, or you may be experiencing side effects of medication.