4 Symptoms Of Social Anxiety In Children, Causes & Treatment
Acquaint the child with measures that let them feel less anxious during social interactions.
Specialty: PediatricsExperience: 20 yearsDr. Mubina Agboatwalla is a well-known pediatrician, practicing paediatrics since the last 20 years in Karachi Pakistan. She is the head of the department of Pediatrics in Karachi Liaquat Hospital, as well as her private practice in three specialist clinics in Pediatrics.
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In This Article
Social anxiety in children and teenagers may cause them to skip social interactions. It is also called social anxiety disorder or social phobia. It is more than just shyness, as children with social anxiety are extremely self-conscious. They are constantly thinking about what others think of them.
Social phobia affects not only children but also teenagers. It may start as early as when a child is four years old. Read on to know more about the types, causes, symptoms, and treatment of social anxiety disorder in children. Also, read a few tips to help children with social anxiety.
Social anxiety in children can be classified into the following two types (1).
1. General social anxiety
- General social anxiety implies that the child is anxious in all social situations, even when not in the spotlight.
- They may be afraid of routine things such as going to school, eating in public, using a public restroom, or interacting with people.
2. Performance anxiety
- Children with performance anxiety experience fear of being in the spotlight.
- They may worry about performing on the stage or speaking in public.
- Most children with general social anxiety may suffer from performance anxiety as well.
The symptoms of social anxiety in children can be classified into the following four broad categories (2).
1. Physical sensations
- Stomach ache
- Blushing
- Perspiration
- Trembling
- Tension in muscles
- Shortness of breath
- Derealization (feeling detached from one’s body or surroundings)
- Palpitation
- Headaches
2. Emotions
- Agitation or irritability
- Anxiety
- Fear
- Fret
- Embarrassment
- Shame
- Helplessness
- Sadness
- Anger
3. Behavior
- Refusal to attend school
- Avoiding participation in school activities
- Declining invitations to social events
- Not participating in group activities
- Needing parental presence at all times
- Poor eye contact
- Mumbling
- Staying indoors even on weekends
- Avoid going outdoors in the park interacting with other children.
4. Thoughts
Children suffering from social anxiety disorder may have one or more of the following thoughts.
- “I might say something stupid.”
- “People won’t like me.”
- “They will say bad things about me behind my back.”
- “I will be a laughing stock.”
- “I am an idiot.”
- “Others can easily tell I am nervous.”
- “I look terrible”
- “My clothes are not good”
Pinpointing the exact cause of social anxiety in children can be difficult. However, the following factors may increase a child’s risk of developing social anxiety disorder (3).
- A mother with social anxiety
- Genetic predisposition to social anxiety—it may run in families
- Past episodes of unpleasant or embarrassing social interactions
- Victim of bullying, teasing, rejection, abuse, trauma, family conflict, parental separation, etc.
- Shy personality
- Visible facial disfigurement, differently-abled, or use of devices to help with disabilities such as hearing problems
- Bullying in school
A multidisciplinary approach is required for the diagnosis of social anxiety in children. The evaluation of the symptoms happens in several contexts, and the observations of parents, teachers, and caregivers are essential to reach the correct diagnosis.
It is easy to confuse shyness with social anxiety. However, as much as some shyness is normal in many individuals, children with social anxiety experience severe anxiety that is more than usual and on all occasions.
Extreme anxiety may impact how they function socially and leave them under a lot of distress. The diagnostic criteria require children to show the symptoms of anxiety around peers and not just with adults, and the symptoms must have lasted for six months or longer.
The pediatrician will evaluate the child and refer them to a psychologist to help reach a positive diagnosis.
A combination of behavioral therapy and medications may be used to treat social anxiety disorder (1).
1. Behavioral therapy
- Cognitive-behavioral therapy can be helpful for children with social anxiety disorder.
- This therapy helps children learn how to overcome their apprehensions and manage their anxious thoughts better.
- The therapy includes practicing social skills.
- Confidence building exercises
2. Medications
Medicines are generally not recommended unless necessary
- Medicines are used when behavioral therapy alone is not sufficient.
- Medicines reduce the symptoms of anxiety and help make behavioral therapy more efficient.
- Selective serotonin reuptake inhibitors (SSRIs), beta-blockers, etc., may be prescribed to reduce anxiety symptoms.
Note: Do not administer any medicines without the doctor’s advice.
Consider using the following steps and strategies to help children with social anxiety(4).
At home
- Identify the situations that make your child feel worried or fearful. Pretend to be in those situations and practice things the child can do to feel better.
- Share your stories about the times you have felt anxious in social situations and how you handled your fears and apprehensions. It will help them confide in you and share their feelings with you.
- Reassure them that their feelings are nothing to be ashamed of and that you understand and support them.
- Support the child and do not make the child feel conscious.
At school or in other social settings
- Use the stepladder approach to help children who suffer from social anxiety. The method involves tackling small things before facing the big fears or anxieties.
- Gently introduce the child to participate in social activities.
- Use gentle encouragement and do not push the children to interact with others.
- Do not speak for your child, as it can make the situation worse.
- Do not dominate the child or put excessive pressure on them.
- Tell your child’s teachers and caregivers about their condition. Tell them about the things you do to help your child as it will aid in providing a consistent support environment to the children at both home and school.
Talking to the child
- If the child voluntarily agrees to do something that would normally make them very anxious, appreciate them wholeheartedly.
- If there are other people around, do not make a big deal out of it, but praise them with lots of appreciation when alone.
- Do not bribe or force them to interact socially.
- Do not label them as “shy.”
- Do not compare your children with other extroverted children.
- Do not criticize or scold them when they falter in socially awkward situations.
Frequently Asked Questions
1. At what age does social anxiety begin?
Social anxiety in children can begin at any age, but it is more common during the beginning of adolescence. Generally, it might begin between eight and 15 (5).
2. Can strict parents cause social anxiety?
Parenting style could be the cause of social anxiety in children. Critical and harsh parenting styles may cause a child stress while performing a task, leading to anxiety disorders (6).
3. Is social anxiety curable?
Social anxiety is a treatable condition. However, the rate of recovery is dependent on choosing the proper intervention. The effect of social anxiety on the child’s life must be accurately evaluated to choose the optimal strategy (7).
4. How do schools deal with social anxiety?
Teaching a child with social anxiety might require a few additional strategies. Start by setting clear rules in the school against bullying, discrimination, and harassment. You could help them choose the groups to alleviate any possible stress they might feel while choosing a partner for activities. If they participate in challenging tasks, such as group discussions, make sure to appreciate and reward them (8).
Give your children enough time and support, as social anxiety is real and must be addressed in time. An untreated social anxiety disorder may lead to depression. If you or your child’s teachers suspect social anxiety in your child, do not hesitate to discuss it with the child’s doctor.
Key Pointers
- Social anxiety in children can be classified into two types – general social anxiety and performance anxiety.
- It manifests physical, behavioral, and emotional symptoms, such as palpitation, sweating, fear, anger, mumbling, and poor eye contact.
- Maternal social anxiety, unpleasant/embarrassing social interactions in the past, and genetic predisposition to social anxiety are the risk factors.
- Treating social anxiety in children works on a multidisciplinary approach involving treatment modalities, such as behavioral therapy and mediation.
- Encouraging a child to vent out emotions and providing them a positive home and school environment could help improve the condition.
References
- Social Anxiety Disorder Basics.
https://childmind.org/guide/social-anxiety-disorder/ - Social Anxiety.
https://www.anxietycanada.com/disorders/social-anxiety/ - Does Your Toddler Have Social Anxiety?
https://www.goodtherapy.org/blog/does-your-toddler-have-social-anxiety-heres-what-you-can-do-0609187 - Social anxiety in children.
https://raisingchildren.net.au/toddlers/health-daily-care/mental-health/social-anxiety - What is social anxiety?
https://childmind.org/article/what-is-social-anxiety/ - Lyndsey Juliane Chong et al; The association between parenting and the error-related negativity across childhood and adolescence;
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479325/ - Need help overcoming social anxiety? 6 tips from an expert.
https://health.clevelandclinic.org/how-to-overcome-social-anxiety/ - Helping students overcome social anxiety at school.
https://www.nu.edu/resources/helping-students-overcome-social-anxiety-in-school/
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Read full bio of Dr. Mubina Agboatwalla
