AVOIDANT PERSONALITY DISORDER OR REJECTION SENSITIVITY DYSPHORIA? OR BOTH?
At the start of this blog, I thought I was suffering from Avoidant Personality Disorder. I had found the diagnostic criteria, brought it to my doctor, not a psychiatrist, and thought I had my answer. Once I finally went to a psychiatrist, he called that a misdiagnosis. I thought, What a big mistake I’d made. Surely, yes, you should bring your ideas and research to your doctor, but bring it to the right kind of doctor. Your gynecologist should not be setting your cast, and your GP should not be diagnosing your mental health issues, right? Maybe. Maybe not. Years later, after much tumult and strife, not only did I find out that I was autistic, I was also diagnosed with Inattentive ADHD. And part of that ADHD was a lovely thing called Rejection Sensitive Dysphoria.
So now, that my meds are working, and my diagnoses are hopefully settled, I’ve been looking through old posts with my supposedly 20/20 hindsight. And I couldn’t help but notice just how similar the symptoms for Avoidant Personality Disorder and Rejection Sensitive Dysphoria can feel. So this sent me searching for a connection between the two. One of the more interesting ideas I have found is that Avoidant Personality Disorder is the result of untreated childhood ADHD, much like my own. How interesting would that be? If I had been on the right path after all?
So with that idea, I’ve brought up an old post I called “I am not a Worm” where I looked up the definition of Avoidant Personality Disorder and responded to each symptom. Now the fact that I tried to refute any of it may tell you that I was misdiagnosed BUT you also have to understand the power of masking when you are autistic. I fought against these traits because I was “supposed” to… because I was supposed to be offended, not relieved. Anyway, let’s take a look…
2018- One month after the Avoidant Personality Disorder diagnosis, One week after starting this blog, and less than a week before I met my psychiatrist…
In writing this new blog, I’ve done some internet research on Avoidant Personality Disorder in order to help explain myself. Which, you know, is always a good idea. The internet and an anxiety disorder, what could go wrong?
One thing that has been bothering me is the blatantly whinged description of symptoms. And while they’re true, it sees almost rude to describe a person that way. I know, that’s silly. How can a medical description be rude? Like when you describe Irritable Bowel Syndrome you aren’t literally accusing a person of having a crabby intestine, right?
So, why does it feel like the internet is calling me a worm?
Personally, I’d like to set the record straight.
Okay, let’s start right there. Doesn’t this sound like the beginning of a redneck joke? Ok, maybe I’m just being sensitive…
- you tend to have low self-esteem, strong feelings of inadequacy and a sensitivity to rejection.
Uh, duh. Can we also note that they have a hyperlink for self-esteem? If you don’t know what self-esteem is you really have led a charm life. People with high self-esteem don’t need to talk about it, they just think they are the bee’s knees. Inadequacy? I work very hard at not feeling inadequate. So, seeing it there feels like an accusation… Ok, maybe I am proving the symptom again. Stupid internet… grumble, grumble…
Now you can see it right there in that first symptom: Sensitivity to Rejection, otherwise known as Rejection Sensitive Dysphoria. It is easy to see how the two could be intrinsically related. While I haven’t talked to my psychiatrist about the scientific differences between the two (mostly because I am afraid that he’ll think that I am second guessing him and so will not like me. Yeah, I get the irony) my understanding is it’s about severity. Does that feelings of inadequacy stop you from living your life? Yes. Maybe it’s AVPD? … Ok, back to 2018. This is like time travel!
- In new social settings, you will become extremely self-conscious, shy or inhibited and will be preoccupied with being criticized or rejected.
Preoccupied with being criticized? This seems so whiney again. All I can picture is a person standing at a party too obsessed with themselves to enjoy a little bit of shenanigans. For me personally, I’ve always called it a problem of protocol. Without knowing the protocol, I don’t know who I might offend. Who I might hurt or upset. So, for me it’s more of a preoccupation with other people. So, it’s not that I would be unduly criticized or rejected. It’s that they would be right in rebuking or disliking me for my behavior.
Now this one is a little easier to explain. My problems with protocol are directly tied in with my autism. It’s a rigidity issue where I feel very strongly about the rules of interacting with people, especially for myself. I have such a deep sense of compassion for other people’s suffering, so much so that I will take on the responsibility for that hurt, whether I inflicted it or not. So I am very careful with social situations. Careful = rigid.
- You tend to view yourself as socially inept, personally unappealing or inferior to others.
This one I say with absolute certainty— I do not feel inferior to others. Personally unappealing? Shut up, internet… Okay… well hold on… I am on anti-depressants but I wasn’t always. And I remember everyone of these feelings with unfortunate clarity. And if I slip on my diet, and go back to eating grains, I start to feel that way again… So, maybe they have a point?… Still, personally unappealing? Why don’t you just say ugly, internet? You don’t have enough incel neckbeards hidden in your folds that you have to pick on me on a wellness site? Hmmmm? (Note to self: stop proving internet symptoms correct while trying to refute them. Also don’t attract the ire of incels. Apparently it’s not safe. What a bunch of turds.)
Again, this directly ties in with my autistic sensibilities. I have problems processing and dealing with social situations, so of course, they bring me a lot of anxiety and wreak havoc on my self esteem.
- In interpersonal relationships, you will show restraint.
Yes. With exceptions. I have less than three people I do not show some kind of restraint with—one gave birth to me, one I married, and the other I gave birth to. And even them, I still have moments of fear and anxiety. This is not to say that I don’t love them or the rest of my family and friends. It’s just feelings. What can you do?
- You tend not to trust others and avoid relationships unless you are certain of being liked. Often, people with APD become socially isolated as a result of this avoidance.
Crap… this is also true….
Again, again, this a combination of autism, anxiety, and prolonged Rejection Sensitive Dysphoria. But whether it is from those particular issues or from AVPD, the result was the same. I lost relationships, I avoided new ones, and I retreated from most of society.
Sometimes I have to wonder… Why was my psychiatrist, and the required counselor that saw me first before him, why were they so sure that it was a misdiagnosis? I remember them both clearly saying, “no, it’s not that, because you are trying to change. A person with a disorder can’t change.” Perhaps that is true from some diagnostic point of view, but somehow that still seems really shortsighted. I use methods and tricks to get me through certain social situations but it’s never going to get “better.” I am never going to be “cured.” But I can still further my understanding of myself. I can change my understanding of why I am like this.
Honestly, why is it so easy for those in the psychiatric profession to downplay my experiences in the interest of what they think is wrong with me? My psychiatrist specializes in Bipolar Disorder, so he diagnosed me with Bipolar Disorder and put me through more than a years worth of horrible reactions to medications that just didn’t suit me. I lost that time, because I let him lead me away from my truth. Because I wanted him to like me. Is that a severe enough consequence for you?
Ok… okay. So, a lot of it is true. But perhaps the greater truth is that instead of being an “after” I may still be a “before.” I am doing my best to live beyond my mental illness. And I think at the heart of my umbrage at this description is a fear of relapse.
I write like I have been better for years but that’s not true. (That’s more of a writing thing than an honesty thing. You always start like you are in the middle of a story, instead of the beginning.) My battle with anxiety has been going on for more than 25 years but my successes are measured in weeks with relapses sprinkled in between like glitter. Have you ever tried to get rid of glitter? That shit sticks. You think you’ve got it all up, vacuumed, swept, wiped up, then you move the couch and BAM… glitter.
I am not my illness. I don’t put it on like an affectation to excuse my behavior or encourage sympathy. I really don’t want pity. But if my putting a name on it, my name, if my honesty helps anyone in the thick of it, I’ll take a little rude diagnostic evaluation from the internet.
Do you see that there at the end? “Please don’t judge me.” With every word that I wrote I said, “please, take me seriously.” And then at the very last I said, “Knowing what I am, that is what will get me through.” And yet, my psychiatrist and my counselor were fooled by the mask that I put up to pretend that I was one of them.
Even when I said to the counselor, “It’s not your fault that you think nothing is wrong with me. I just lied to you for half of this meeting so you would like me.” She and the doctor still only saw what the sick part of me wanted them to see. Sometimes I feel like they failed me. Sometimes I think I just wasn’t ready. Most of the time, I know that they were just people, and I was one appointment in a long day of many, many appointments. I was never going to matter to them as much as I did to myself.
And that’s the point that I want to say to you, faceless listener, because if you made it this far, maybe some of my words feel familiar to you… No one is ever going to care more about who and what you are than you. Stand up for your experience. Do your own research. And if your doctor won’t listen, find another doctor.
Get one for yourself! Emily McDowell’s Unresolved Issues Pouch, for loose change and personality disorders. $18 (The pouch, not the personality disorder. Have I mentioned that I love Emily McDowell?)
Check out my quest for an “official” diagnosis in my next post…