experiencing intense anxiety avoiding the situation exhibiting physical symptoms of anxiety, such as blushing, shaking, or vomiting
Normal anxiety includes the following: apprehensiveness before a public appearance, speaking or performance; shyness or awkwardness when meeting strangers; or unease when beginning a new conversation or social interaction. Social anxiety includes the following: extremely high anxiety and fear of failure, physical symptoms like sweating, trembling, and shortness of breath; negative thoughts regarding the performance; excessive and exaggerated feelings of fright and terror while facing new people; extreme anxiousness and a need to avoid them at any cost; and refusing a social gathering invitation because you are afraid you will be embarrassed or rejected. [4] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source
Bullying. Humiliation or childhood trauma such as being bullied can create social phobias and fears. Also, the feeling of not fitting in with peers may lead to social anxiety. Hereditary factors. Growing up with a parent who showed signs of social phobia as well. Often when a caregiver struggles in social situation in creates an environment that avoids social events leading to limited development of social skills and avoidant behaviors of their children. Shyness. Shyness is related to one’s personality and is not a disorder, but many people who have social anxiety are shy as well. But keep in mind that social anxiety is much more severe than “normal” shyness. People who are just shy do not suffer the way that people with social anxiety disorder do. [6] X Research source
SAD and Panic Disorder. Panic disorders refers a person that has a physical reaction to anxiety that can often feel like a heart attack. SAD is different from Panic Disorder but both disorders can coexist. One of the reasons the two disorders get confused is because people with panic disorder often avoid social situations to prevent having a panic attack around people who might see and judge them. People with SAD avoid social situations due fear. [8] X Research source SAD and Depression. Depression is a common coexisting diagnosis with SAD because people with SAD tend to limit their contact with other people. This creates a feeling of being alone and can cause or intensify depression. [9] X Research source SAD and Substance Abuse. There are higher rates of alcoholism and other substance abuse among people with SAD. Around 20% of people with SAD suffer from alcohol abuse. This could be due to the anxiety reducing effects of alcohol and drugs in social situations. [10] X Research source [11] X Research source
For example, if you have SAD, you may feel a sense of terror when a friend asks you a question in front of people you don’t know. You may worry that people will judge you for what you say and be too afraid to say anything as a result. [13] X Research source
For example, if you feel like you have nothing of value to say when you are discussing a subject that you are actually passionate about, you may have social anxiety. Instead of contributing your ideas and opinions, you may be obsessing over thoughts that the other people don’t like how you are dressed or that they don’t think you are intelligent.
For example, if you are invited to a party but you refuse to go because you are too nervous about hanging out with other people, you may have social anxiety.
For example, if you are in a discussion with others, do you voice your opinions or slowly shrink to the back, avoiding eye contact with others?
For example, if you have a speech coming up in two weeks and you’ve already written out what you’re going to say, you should feel pretty prepared. However, someone with SAD might be kept up at night worrying about the presentation for the whole two weeks before he actually has to give it.
For example, if you avoid raising your hand to ask a question in class, even if you don’t understand the material, this could be a sign of social anxiety.
For example, if you get called on in class and know the answer, but instead of answering you blush, begin to sweat, can’t seem to breathe, you may have social anxiety.
For example, imagine you are working on a group project and someone suggests an idea, but you have a better one. You may choose to go with the other person’s less efficient idea simply because you don’t want to be put on the spot and have to explain your idea.
In these instances, you may be thinking: what if I forget what I have prepared? What if I stop in the middle? What if my mind goes blank during the session? What will everybody think? Everybody will laugh at me. I will be making a fool of myself.
Children with SAD might also make statements that can indicate their fears. Common statements include “what if statements” such as, What if I look stupid? What if I say something wrong? What if I mess up?[22] X Research source
Children who have SAD suffer from an extreme fear of criticism by their peers as well as adults. This fear often interferes with day-to-day activities because children will do things to avoid the anxiety producing situation. Some children will cry, scream, hide, or do other things to avoid an anxiety producing situation. Some children also have physical reactions to anxiety such as shaking, sweating, and shortness of breath. These symptoms must last for more than six months to be considered SAD. Children who are just shy may sometimes try to avoid activities or have mild anxiety about certain situations, but the anxiety is not as extreme or as long lasting as it is with SAD children. Shyness will not interfere with a child’s happiness in the same way that SAD will. [24] X Research source For example, it might be hard for a child to give a book report, but a shy student can still do it when necessary. A child with SAD might refuse to do the assignment due to extreme fear or even skip school to avoid it. This might be misinterpreted as acting out or being a bad student, but the root cause is fear.
Your child may express fear of new people and be unwilling to meet new friends or go to social gatherings where there might be unfamiliar people. They may also refuse or try to get out of participating in events that involve other people, especially in large numbers, such as field trips, play dates, or after-school activities. In severe cases, your child may experience anxiety in seemingly simple social interactions, such as asking a peer to borrow a pencil or answering a question in a store. He may display symptoms of panic, such as heart palpitations, sweating, chest pain, shaking, nausea, shortness of breath, and dizziness.
Sometimes, SAD co-occurs with other disorders, such as attention deficit/hyperactivity disorder (ADHD), or learning disorders. It is important to get your child evaluated by a medical or mental health professional so that you know exactly what the problem is and how to address it.
Start by placing one hand on your cheek and one hand on your stomach. Take a deep breath in through your nose, counting to 7 as you breathe in. Then, exhale through your mouth, counting to 7, while tightening your stomach muscles to exhale all of the air. Repeat the process 5 times with an average of one breath per 10 seconds.
For example, a negative thought might be, “I am going to make a fool of myself in front of everyone when I give this presentation. ” If you find yourself thinking something like this, ask yourself, “Do I know that I will make a fool of myself?” and “If I mess up, does that mean that people will think I’m dumb?”[28] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source Your answers to these questions should be “No” and “No” because you cannot know what people will think or do. The more likely outcome is that you will do a good job and no one will think you are dumb. [29] X Trustworthy Source HelpGuide Nonprofit organization dedicated to providing free, evidence-based mental health and wellness resources. Go to source
Eat a balanced diet that include plenty of fresh fruits and vegetables, whole grains, and lean protein. Get between 7-9 hours of sleep per night. Exercise for 30 minutes three times a week. Limit caffeine and alcohol intake.
You might also consider attending a behavioral therapy group for people with social anxiety. These groups can help you to build your confidence and learn cognitive- behavioral techniques that can improve your ability to handle difficult situations. [32] X Research source
Common medications for SAD include: Benzodiazepines such as Xanax; Beta Blockers such as Inderal or tenormin; Monoamine Oxidase Inhibitors (MAOIS) such as Nardia; Selective Serotonin Reuptake Inhibitors (SSRI’s) such as Prozac, Luvox, Zoloft, Paxil, Lexapro; Serotonin-Norepinephrine Reuptake Inhibitors (SNRIS) such as Effexor, Effexor XR, and Cymbalta. [34] X Research source
The child’s therapist can also offer you advice on how to help your child. Another popular treatment is cognitive-behavioral therapy (CBT), which can help the child learn to identify and manage negative or unhelpful patterns of thinking. Your child’s therapist may even suggest group therapy. This can be helpful for your child, as he will see that he is not alone in his fears and that others struggle just like he does. A family therapist can help you communicate your support for your child and work with him to manage his anxiety. This type of therapy is especially helpful if the child’s anxiety is causing other family difficulties.
Make sure that you acknowledge your child’s feelings. Model confidence for your child, such as by being relaxed in social situations. Help your child learn social skills, such as by making friends, shaking hands, making complaints etc.
Teach your child to calm down by taking slow deep breaths. Show your child how to practice deep breathing and then instruct your child to use this technique any time he or she feels anxious. Help your child restructure his negative thoughts. For example, if your child says something like “I am going to mess up my book report tomorrow!” respond with something like, “If you practice really well, you will have a better idea of how you are going to give your book report and you will do a good job. ” Provide your child with a picture to act as a calming cue. For example, if your child is especially nervous about his book report, you can give your child a small picture of yourself and instruct him to hold it near the top of the page. That way, your child can pretend he is just reading the book report to you. Offer gentle encouragement rather than forcing your child to participate in activities that make him or her anxious. For example, if your child is not comfortable with participating in a game with some other children, don’t push him to participate. But if your child does choose to participate, offer some quiet praise and then shower your child with praise when you are away from other people. [39] X Research source
Instead, remind your child that he has successfully survived stressful situations in the past, and he can do it again.
Commonly prescribed SSRIs for childhood SAD include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), and paroxetine (Paxil). Venlafaxine HCI (Effexor) is another commonly prescribed anti-depressant, but it is an SNRI (serotonin and norepinephrine reuptake inhibitor). [40] X Research source
