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. 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.
  • Social anxiety disorder 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 as 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 one’s 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 having a tantrum
  • 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

How social anxiety impacts the child at different ages

Young socially anxious 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). Even if children successfully 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 for 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.

My Anxiety Plan (MAPs)

MAP is designed to provide children/teens struggling with anxiety with practical strategies and tools to manage anxiety. To find out more, visit our My Anxiety Plan website.

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