Social Anxiety

What is Social Anxiety Disorder?

Children and teens with social anxiety disorder have an excessive and persistent fear of social and/or performance situations such as school, parties, athletic activities, and more. They are extremely worried that they may do something embarrassing, or others will think badly of them. These children constantly feel "on stage," which can lead to a great deal of self-consciousness, distress, and avoidance. Some children are only afraid of speaking or performing in public, while others fear and avoid a wide range of social situations. Finally, being a shy or quiet child is not the same as having social anxiety disorder.

Facts

  • Social anxiety disorder usually begins in early adolescence although can start earlier during the elementary school years.
  • It can develop suddenly after a stressful or embarrassing experience, or slowly over time.
  • There is some evidence that social anxiety runs in families so there may be other members who share similar difficulties to your child.
  • An equal number of girls and boys experience social anxiety, and in any given school year about 7% of children will have a diagnosis of social anxiety.
  • Some of the problems associated with social anxiety disorder include poor school performance, low confidence in social situations, trouble developing and maintaining friendships, depression, and alcohol or drug use.

Signs & Symptoms

Thoughts (Note very young children may be unable to identify specific fear thoughts):

  • I'm going to say something stupid
  • They won't like me
  • I’m an idiot
  • People can tell I’m anxious

Physical sensations:

  • Stomachache
  • Blushing
  • Sweating
  • Shaking
  • Muscle tension
  • Irritability
  • Feeling detached from ones body (derealization)

Emotions:

  • Anxiety/worry/fear
  • Embarrassment
  • Shame
  • Helplessness
  • Sadness
  • Anger

 Behaviors:

  • School refusal
  • Avoiding participating in new activities or going places
  • Asking a parent to be present or available
  • Declining invitations to social events
  • Not answering in class
  • Crying or tantrumming
  • Refusing to go on a play date without a parent
  • Mumbling or poor eye contact
  • Staying home on weekends rather than hanging out with friends

Common Situations or Affected Areas

  • Public speaking or performing (e.g., presenting a book report in front of the class, or a recital)
  • Participating in class (e.g., asking or answering questions, reading aloud, writing on the board)
  • Eating in front of others
  • Using public washrooms
  • Joining in or talking to classmates or friends
  • Emailing, texting, calling
  • Going to social events (e.g., birthday parties or dances)
  • Talking to adults (e.g., teachers)
  • Dating
  • Being assertive or expressing opinions
  • Ordering food at a restaurant

Be sure to watch our video below for more information... press the play button to start.

How social anxiety impacts the child at different ages

Young children tend to experience a number of physical symptoms such as stomachaches or complaints about feeling ill. In addition, they may cry, whine, freeze, or cling to parents in social situations, begging the parent to stay. These children may even refuse to participate in social activities or attend school. They also might not speak in certain situations (e.g., when meeting new or unfamiliar people). [option for a link to selective mutism] Finally, for those children who are able to engage in the above activities and demands it is not without a fuss or fight, often ending with the child in tears and the parents feeling upset, guilty, and even angry. Despite such extreme behaviours, young children are often unable to say why they are so worried or to identify what it is that is so upsetting.

In middle childhood, children are starting to become more self-conscious and may begin to expect things to go "bad" when they are around other children. They might be overly concerned about others looking at them or talking about them in a bad way. While they may continue to experience many of the same feelings and behaviors as in younger children, now they are starting to be able to identify what is so upsetting for them.

Teens and young adults are typically more self-focused and may have harsh negative thoughts about themselves. They may be more likely to mumble or avoid eye contact. Teens often struggle with academics as they are unable to participate fully in class and engage in group and oral projects. This can lead to "skipping" school and/or using drugs or alcohol in order to cope. Finally, teens may also have trouble dating or experience problems at work (e.g., difficulty with job interviews and interacting with co-workers and bosses) due to extreme social fear or embarrassment. Unfortunately, not all kids and teens are able to recognize that their anxious response may be unreasonable given the situational demands, making it hard as parents to encourage their child to take a different perspective and gain courage to confront their fears.

Note:
The majority of children or teens with social anxiety go unnoticed by teachers or parents. They are not children who act out; rather, they are the children who try to remain invisible. These children tend to get recognized when they begin to miss school or their grades start to drop.

Click here for Home Management Strategies for Social Anxiety Disorder.

Stories

 

Chandra’s Story
Tim’s Story
Bob and Lucille’s Story
Rob's Story

Chandra is an 11-year-old girl in the fifth grade. According to her mother, Chandra has always been a quiet child. Although she has generally done well in school, this past year her grades have started to slip. She has also become more irritable and withdrawn. At school, Chandra will only sit with her two best friends whom she has known since preschool. She says she doesn’t want to hangout with other girls at lunch or between classes because she is afraid she will do something embarrassing. This fear started after one of the popular girls teased Chandra about wearing the “wrong” jeans. In addition, Chandra refuses to go to gym class, because she doesn’t want to change in front of the other girls and because she is afraid she will do something stupid in class. She has missed two birthday sleepovers with the excuse of having a stomachache, and is avoiding joining any after-school activities or clubs. Her best friends are starting to get annoyed because Chandra never wants to do anything with them outside of school. Chandra says she prefers to play with her younger sister. Finally, her mother has noticed that Chandra has trouble making eye contact and tends to mumble and speak quietly when she is around other kids or adults she doesn’t know. This has been going on for almost a year, but has worsened over the past five months.

 

Tim is 17 years old and in his last year of high school. Recently, he told his parents he is scared to give oral presentations or answer questions in class. Tim says he is afraid of making a mistake or saying something “stupid”. He feels that his classmates and teachers are constantly judging him, and he can’t stop thinking about this. In an effort to get Tim to participate, his teacher has started calling on him more in class. According to Tim, when the teacher asks him a question, his “mind goes blank” and he blushes. Tim is so worried about being embarrassed in class he has started skipping school. Before the end of the school year, Tim has to give an oral presentation in one of his classes. He says he is very worried about it and has been having trouble sleeping. He has heard from some other kids that drugs might help him, and he is thinking about how to score some.

 

Bob and Lucille have four children ranging in age from 4 to 14. They saw a counselor a few years ago due to concerns about their eldest daughter’s lack of friends and socially immature ways, including preferring to stay home with her younger sisters and not being into music and clothes like most other tweens. At the time the counselor recommended they give Isabella a chance to “catch up” and if they were really concerned, to have Isabella join a social skills summer camp however, Isabella refused. Now that Bob and Lucille’s second eldest child has started high school they can see major differences between their eldest girls and fear that Isabella is suffering socially. Lucille is very aware of this pattern as she herself was a shy child and highly anxious teen. Bob was her first and only boyfriend, and she lived with her parents until she married and moved in with Bob at 20. While Lucille is satisfied with her marriage and family life, she still struggles in social situations and does not want Isabella to repeat this pattern.