Does your child feel extremely uncomfortable in social settings? You might assume they're simply more reserved than other kids. But while it's completely normal to feel self-conscious sometimes, like when speaking in front of the class, excessive shyness could actually indicate social anxiety disorder.
According to Keita Franklin, Ph.D., Chief Clinical Officer at Loyal Source, social anxiety is "a mental health condition in which upcoming social interactions can cause an increase in anxiety." Some kids with the disorder worry an unreasonable amount about meeting or talking to people, and they constantly fear being embarrassed, negatively judged, or rejected. Others are triggered by speaking or performing in public.
In some cases, social anxiety makes it difficult to complete everyday tasks like going to school, talking to peers, ordering at restaurants, and using public restrooms. That's why parents should learn the telltale symptoms of social anxiety and seek appropriate treatment when necessary—usually in the form of cognitive behavior therapy.
Keep reading to learn more about the causes and symptoms, as well as how to help with social anxiety in kids. We also explore whether the COVID-19 pandemic could be a trigger for social anxiety, which is sometimes known as social phobia.
Social Anxiety Symptoms in Kids
Dr. Franklin explains that social anxiety symptoms fall into three categories: physical, emotional, and behavioral. Parents know their children best, she adds, so pay attention to anything out of the ordinary. Here are some of the most common signs of social anxiety in kids.
- Fear of meeting or talking to people. The distress can start days or weeks before an event.
- Constant worry about embarrassment or judgement by others. “People with social anxiety disorder may worry about acting or appearing visibly anxious (e.g., blushing, stumbling over words), or being viewed as stupid, awkward, or boring,” says the Anxiety & Depression Association of America.
- Extreme self-consciousness in social or performance settings.
- Avoidance of triggering situations, like going to public restrooms, talking to teachers, or attending birthday parties.
- Throwing tantrums or acting clingy before/during social events.
- Physical symptoms like sweating, nausea, trembling, blushing, dizziness, or rapid heart rate. These often occur in social situations that children perceive as scary, and they can lead to panic attacks in extreme cases.
- Feeling helpless, sad, or angry in social settings.
- Regularly asking questions for reassurance (“What if I say the wrong thing in class?" "What if I do something embarrassing?”)
- Difficulty making friends or talking to peers.
- Refusal to speak in certain situations.
- Speaking softly and avoiding eye contact.
- School refusal, in extreme cases.
It's important to note that the disorder presents differently in all children. Some have symptoms in all social situations, while others have specific performance triggers, like eating in public or speaking in class.
What Causes Social Anxiety in Kids?
According to Dr. Franklin, the most common age of social anxiety onset is 13 years old. It makes sense when you consider the major life events happening at this time—starting high school, going through puberty, experiencing peer pressure, etc. That said, children younger than 8 or 9 years old might also suffer from social anxiety symptoms, says the Anxiety & Depression Association of America.
So what causes social anxiety disorder in kids? Some children are predisposed to anxiety from birth. Essentially, their brains are more sensitive to perceived danger, which triggers dramatic fight-or-flight responses, says psychologist Steven Kurtz, Ph.D., president of Kurtz Psychology Consulting in New York City, who specializes in childhood anxiety.
Genetics may also play a role, because studies show that kids with anxious parents are more likely to suffer from anxiety themselves. There might also be an environmental component to this trend; moms or dads who exhibit socially anxious tendencies could model this behavior to their children.
In some cases, mild social anxiety can get worse if kids are "triggered" by difficult situations, like bullying, moving houses, switching schools, or even the COVID-19 pandemic. "I definitely think that COVID-19 can be a cause of all things related to social anxiety," says Dr. Franklin. "Kids aren't used to being in social environments anymore, so they're not socialized in how to engage and interact." She adds that they aren't getting the "feedback loop" from other kids, which lets them know if they're behaving appropriately.
How to Overcome Social Anxiety
Kids with social anxiety usually act normal at home, so parents might not realize anything is wrong. Teachers might also write off social anxiety as normal shyness. This is why some kids suffer for years before getting the help they need.
If your kid is displaying signs of social anxiety, check out these at-home treatment options, and learn when to see a professional for therapy or medication.
Social Anxiety Treatment at Home
For social anxiety symptoms that appear mild—or that seem to have a direct cause, like social isolation from the COVID-19 pandemic— Dr. Franklin recommends communication and preparation. For example, if your child is nervous about summer camp after a year of virtual schooling, you can help by giving detailed descriptions. ("I will drive you there at 8 a.m. and pick you up at 1 p.m. There will be seven boys and five girls. Our neighbor Suzie will be there.") Knowing what to expect can make a huge difference, says Dr. Franklin.
You can also try addressing your child's fears directly. Ask them exactly what's making them nervous, then brainstorm solutions accordingly. For example, if they're worried about talking to other campers at lunch, come up with some go-to conversation topics beforehand. Also teach your child ways to self-soothe in case anxiety hits (such as deep breathing, visualization, etc.).
Although you want to protect your child, don't let them avoid their triggers altogether. Ordering their meal at a restaurant might not seem like a big deal in the short term, but it actually reinforces their fears. To overcome this worry, your child can try taking baby steps: They can start by saying "thank you" when the waitress drops off their meal. Then, after a few weeks, they can order their own drink. Eventually they might feel comfortable ordering their whole dinner.
Therapy and Medication
Children with social anxiety that doesn't go away or that interrupts daily life might need professional help. Ask your pediatrician or school guidance counselor for a referral to a licensed psychologist or child and adolescent psychiatrist. The professional will decide if your child needs treatment, which is usually in the form of cognitive behavior therapy (CBT).
CBT a type of talk therapy that "works with the kids on understanding how their thoughts play into their emotions," says Dr. Franklin. It allows them to "reframe their thoughts in a way that their emotions are less severe in the anxiety space." Kids will also learn deep breathing, mindfulness, meditation, and other relaxation exercises to cope with their symptoms.
If the child doesn't respond to talk therapy alone, your health care provider might recommend medications like selective serotonin reuptake inhibitors (SSRIs). Medications are often used in the short-term to make psychotherapy more effective. At the end of the day, "kids are very resilient, and social anxiety is not something that isn't to be overcome," Dr. Franklin says.