Anxiety can be a normal reaction to stressful experiences and is a natural human emotion. Anxiety can warn us about dangers, help us prepare, and lead us to pay attention. Anxiety becomes a problem (i.e., a disorder) when it is long-lasting, intense, and interferes with a child’s or teen’s daily functioning.
There are various anxiety disorders, including specific phobias, social anxiety disorder, panic disorder, agoraphobia, generalized anxiety disorder and separation anxiety disorder.
Here, Dr. Courtney Kwan, a pediatric psychology postdoctoral fellow at CHOC, discusses social anxiety disorder, which some children and teens may struggle with.
Social anxiety can be common for kids and teens
Social anxiety disorder is extreme worry about being rejected or judged negatively by others. Many situations might cause someone with social anxiety to feel anxious (e.g., presenting in front of the class, starting at a new school, performing at a sports game, or being called on by a teacher).
A school-aged child might not notice that they are socially anxious until middle or high school when they start to become more anxious. In fact, 7% of youth are affected by a social anxiety disorder, with relatively higher rates found in adolescents. That means that in a class of 25 students, 1 to 2 youths may have symptoms of social anxiety that interfere with their daily life.
Sometimes children worry that other kids will look at them funny or be left out, but when these worries become frequent, long-lasting and more intense, these worries can begin to impair a child’s daily functioning, says Dr. Kwan.
Symptoms of social anxiety
- Worries about being judged, embarrassed, laughed at or rejected. Examples of worries about what others think about them could be, “What if someone laughs at me?” or “What if I do something silly in front of others?”
- Avoiding social situations. Social anxiety can result in a child avoiding making new friends, talking to strangers, or speaking up in class when they know the answer.
- Cyclical thoughts. A socially anxious child might repeat something they said or did over and over again to determine if it was ok, if it sounded silly, or if it made someone mad at them. Cyclical thoughts can also occur when imagining all the different ways a situation could go poorly (e.g., spilling a drink at a party, not knowing what to say at the party, dressing silly to the party).
- Withdrawal or isolation. A child who is socially anxious might keep themselves away from social interactions (e.g., not joining a group of kids at play, not texting friends back). Withdrawal and isolation can present as sitting away from others, avoiding eye contact, or hiding under clothing or accessories.
“A child might tell you that they don’t feel like hanging out with friends over the weekend because they are just too tired from the week. You know that they only went to school, came straight home from school, and then took a nap right after school every day of that week. So, it seems odd that your child is so tired. If this behavior is out of the norm for your child, this might be an early warning sign that your child might be socially anxious,” says Dr. Kwan.
Problematic Social Anxiety
- Persistence. Your child feels initially anxious during a social situation, but after the social situation is over, your child continues to feel anxious. When the anxiety occurs in a number of different types of social situations, this can demonstrate the persistence of social anxiety symptoms.
- Distress. Anxiety might occur before, during, and/or after a social situation. Social anxiety may present as stomachaches, nausea, and headaches.
- Impairment. When social anxiety stops a child from participating or attending school, interacting with peers or joining in family activities, your child’s social anxiety is causing impairment in their daily life. For example, your child might get distressed before an outing with extended family members and then refuse to attend.
What to do if my child is socially anxious?
If your child is demonstrating any of these behaviors, they may benefit from your help in learning how to manage and cope with their anxious distress.
How to help your child with their social anxiety:
- Gently encourage your child or teen to join in social situations.
- Do things in front of other people and start new activities with your child.
- Avoid speaking for your child when they are feeling socially anxious because sometimes it can make the issue worse.
- Praise your child after they do something that normally makes your child anxious. For example, if your child is nervous about talking on the phone and then talks on the phone, acknowledge your child’s bravery with plenty of praise.
If you see that these tips do not help your child/teen manage his/her/their social anxiety, then consider looking for additional support from a therapist or mental health provider.
For more information about ways to access outpatient mental health services to support your child’s mental health visit: CHOC’s pediatric mental health services page.
For more health and wellness resources from the pediatric experts at CHOC, sign up for the Kids Health newsletter.
How to prevent and treat respiratory illnesses this season
Unfortunately, many kids get infected with respiratory illnesses in the fall and winter seasons. CHOC experts highly encourage all eligible members of households to receive their annual flu shots. Other preventative measures like good hygiene and staying home when sick can help protect families from illness. The following articles and guides provide more information.
The mental health team at CHOC curated the following resources on mental health topics common to kids and teens, such as depression, anxiety, suicide prevention and more.