Social Anxiety Disorder in Children

Social Anxiety Disorder in Children Information

Social anxiety disorder, previously called social phobia, is a mental disorder. Children with social anxiety disorder often feel nervous, afraid, or embarrassed when they are around other people in social situations. They worry that other people are judging or criticizing them for how they look, what they say, or how they act.

Social anxiety disorder is more than just occasional shyness or self-consciousness. It can cause severe emotional distress. It can interfere with daily life activities. Social anxiety disorder may also lead to alcohol or drug use and even suicide.

Social anxiety disorder is a common mental disorder. It can develop at any time, but it usually starts in the teenage years.

What are the causes?

The cause of this condition is not known. It may involve genes that are passed through families. Stressful events may trigger anxiety.

What increases the risk?

This condition is more likely to develop in:

  • Children who have a family history of anxiety disorders.
  • Girls.
  • Children who have a condition that makes them feel self-conscious or nervous, such as a stutter or a chronic disease.

What are the signs or symptoms?

The main symptom of this condition is fear of being criticized or judged in social situations. Your child may be afraid to:

  • Perform or speak in front of others.
  • Play team sports or other group activities.
  • Go to school.
  • Use a restroom in public or at school.
  • Play with other children.
  • Go shopping.
  • Eat at a restaurant.
  • Meet adults.

Extreme fear and anxiety may cause physical symptoms, including:

  • Crying.
  • Temper tantrums.
  • Blushing.
  • Racing heart.
  • Sweating.
  • Shaky hands or voice.
  • Confusion.
  • Light-headedness.
  • Upset stomach, diarrhea, or vomiting.
  • Shortness of breath.
  • Refusing to speak.

How is this diagnosed?

Your child’s health care provider can diagnose this condition based on your child’s history, symptoms, and behavior in social situations. Your child’s health care provider may refer your child to a mental health specialist for further evaluation or treatment. Your child’s health care provider may also may want to talk with your child’s teachers and caregivers.

How is this treated?

Treatment for this condition may include:

  • Cognitive behavioral therapy. This type of talk therapy helps your child learn to replace negative thoughts and behaviors with positive ones. This may include learning better coping skills and ways to control anxiety.
  • Exposure therapy. This therapy involves exposing your child to social situations that cause fear. The treatment starts with situations that your child can manage. Over time, your child will learn to manage harder situations.
  • Antidepressant medicines. These medicines may be used for a short time along with other therapies.
  • Beta blockers. These medicines may help to control anxiety.
  • Biofeedback. This process trains your child to manage his or her body’s response (physiological response) through breathing techniques and relaxation methods. Your child will work with a therapist while machines are used to monitor your child’s physical symptoms.
  • Relaxation and coping techniques. These include deep breathing, self-talk, meditation, visual imagery, and yoga. Relaxation techniques help to keep your child calm in social situations.

These treatments are often used in combination.

Follow these instructions at home:

  • Give over-the-counter and prescription medicines only as told by your child’s health care provider.
  • Help your child practice relaxation and coping strategies.
  • Work closely with your child’s health care providers, including any therapists. You may learn ways to help your child deal with social situations.
  • Tell your child’s teachers or caregivers about your child’s social anxiety.
  • Let your child return to social activities as told by your child’s health care provider. Ask your child’s health care provider what social activities are safe for your child.
  • Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

  • Your child’s symptoms do not improve.
  • Your child’s symptoms get worse.
  • You think your child is using drugs or alcohol.
  • Your child has signs of depression, such as:
    • A persistently sad, cranky, or irritable mood.
    • Loss of enjoyment in activities that used to bring joy to him or her.
    • Change in weight or eating.
    • Changes in sleeping habits.
    • Avoiding friends or family members.
    • Loss of energy for normal tasks.
    • Feelings of guilt or worthlessness.
  • Your child becomes very isolated.
  • Your child will not speak or interact with you or others.
  • You cannot manage your child at home.

Get help right away if:

  • Your child self-harms.
  • Your child has serious thoughts about hurting himself or herself or others.

You can go to your nearest emergency department or call:

  • Your local emergency services (911 in the U.S.).
  • A suicide crisis helpline, such as the National Suicide Prevention Lifeline at 1-800-273-8255. This is open 24 hours a day.

Summary

  • Children with social anxiety disorder often feel nervous, afraid, or embarrassed when they are around other children or adults in social situations.
  • Social anxiety disorder is a common mental disorder. It can develop at any time, but it usually starts in the teenage years.
  • Treatment includes therapy, medicines, biofeedback, relaxation techniques, or a combination of two or more treatments.
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