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Social Anxiety in Children

A big part of growing up, especially during schooling years, is making friends, enduring peer pressure and sometimes being confronted with awkward or embarrassing social situations. Anxiety in children is common and it is normal for children find themselves uncomfortable with such situations such as speaking up in class, reading out loud, using public amenities, participating in extracurricular activities, speaking to people in authoritative positions and making new friends, particularly of the opposite sex.


anxiety in children

Social anxiety in children, also known as social phobia, is commonly recognized to most parents and observers as typical shyness, and, as the saying goes, children should be seen and not heard’, may be disguised as the case of the perfect student’. The thing is, social anxiety and shyness are two extremely different things

While shyness may cause a child to feel unease around others, the discomfort that comes with social anxiety is often so extreme that your child may not react to social situations at all, sometimes even prompting them to take overstressed avoidance tactics of their feared situations.

What Causes Social Anxiety in Children?

The cause of social anxiety disorder, according to doctors, is a combination of environmental factors and genetics.

GENETICS: Many children may suffer social anxiety if at least one of their parents has, or had, an anxiety disorder, though not essentially social anxiety. Doctors believe that this inheritance may partly be expressed via a condition known as behavioral inhibition, where children tend to react negatively to every new thing or situation. An estimated 15% of all children will be withdrawn, shy and irritable in the presence of new people, things or situations. Others are generally fearful; often irritable as infants, fearful and shy as toddlers, and quiet, introverted and cautious as at school age.

ENVIRONMENT: Environmental factors (anything other than genetics) that can cause social anxiety include: disfiguring physical disorders, language or speech problems, neglect, abuse, living with very nervous people and having experienced some extreme embarrassments, such as having diarrhea in class, vomiting in front of people, etc.

Mostly, social anxiety disorder is a combination of both environment and genetics. It takes a heavy genetic load (both parents bearing extreme anxiety) to bring about social anxiety in the absence of environmental issues. Likewise, only a huge environmental factor, i.e. massive neglect or abuse, can cause social anxiety when the family has no nervousness history.

Social Anxiety Symptoms in Children

Signs of anxiety in children differ by age group and gender. Some psychological, behavioral and emotional symptoms may however appear across age lines.

Physical Symptoms Include: shaky voice, difficulty in speaking, experiencing dizziness or feeling faint, nausea, shaking or trembling, hot flashes or sweating, racing heart and red face or blushing.

Behavioral and Emotional Symptoms Include: extreme fear of other people’s judgments, avoidance of social situations and fear of social activities, a compelling urge to stay hidden, quiet, or be invisible, dread of scheduled social events, which begins weeks or days in advance and overwhelming feeling during certain social situations.

The child may also experience fear of situations where they get exposed or introduced to unfamiliar people and doing things that may make them feel thought foolish by others. Some children may even have and express an understanding that their fear is excessive or unreasonable.

Additional signs of social anxiety among children may include: timidity in front of new people or in unfamiliar settings, elective mutism, and freezing, clinging to familiar people, tantrums, blaming others for perceived social failures, crying and misjudgments that strangers are looking at or talking about them.

Among adolescents, these exclusive symptoms may be perceptible: anti-social behavior, truancy, fighting, self-deprecation, too much concern with being talked about or being looked at, taking alcohol to calm anxiety before social events, irritability, sensitivity to criticism or judgment, low self-esteem and feelings of inferiority, extreme test anxiety, and personality rigidity or inflexibility.

Treatment for Social Anxiety Disorder in Children

Treatment may differ from child to child. Some may require one type of treatment while others may require more than one. Before suggesting medication, the pediatrician may start with a few self-help treatments and therapy. Treatment options include:

  1. Group Therapy, in which your child will learn social skills to help them interact with people in social settings.
  2. Exposure Therapy, which entails learning how to slowly confront social situations rather than avoiding them.
  3. Cognitive-Behavioral Therapy, which involves learning how to curb anxiety through breathing and relaxation and being taught how to replace negative thoughts with positive ones.

Home Treatments Include:

  1. Getting enough sleep (at least 8 hours a day) – lack of enough rest can worsen the symptoms of your child’s social phobia and anxiety.
  2. Avoid caffeine – your child’s symptoms might increase with stimulants such as chocolate, soda and coffee.

If your child’s condition doesn’t improve with any of the above treatments, the pediatrician may prescribe medications for depression and anxiety. These medications do not treat the condition; rather, they improve your child’s symptoms and help him/her function in daily life.

Though some drugs such as Paxil have been proven to ease anxiety in adults, there is no evidence they can work out for kids, and therefore should not be tried whatsoever without the doctor’s permission.

Helping Children With Anxiety

As a parent, you can use these four tips to reduce anxiety in your child:

1. Teach Calming Strategies…

Rapid breathing is the most common symptom of social anxiety in children. To control it, and consequently reduce muscle tension, dizziness and heart rate, have your child follow this routine every time they feel anxious:

  1. Sit in a comfortable position with their back straight, and one hand on the belly and the other on the chest.
  2. Slowly inhale through the nose for five seconds; they should feel the hand on the belly rise while the one on the chest stays still.
  3. Hold their breath for three seconds, and then slowly exhale through the mouth for five seconds.
  4. Repeat the procedure till they regain a steady calm breathing pattern.

2. Conquer Negative Thoughts…

Help your child recognize and identify negative thoughts for what they are: incorrect and unrealistic. Teach them to replace these thoughts with positive ones. Make them feel like no one really cares about what they do as much as they think. Make them say things like, “Yes I might be shaky with my voice, but the others are possibly too nervous about their speeches to even notice.” Or “I’m well prepared for this test, I’ll do just fine.” With practice, your child will learn to reduce their social anxiety triggers prior to appearing in social situations.

3. Teach Problem Solving…

When your child is anxious or expressing fear, show them that you have noticed: “You’re worried about reading in front of your class tomorrow”. Have them reading through the passage multiple times, let them read out loud at the dining table in front of everyone, and don’t tell them what they should do or provide all the answers for them. Let them come up with solutions by themselves. Just don’t forget to applaud them and correct them where necessary.

4. Facilitate Friendships…

Sure, you can’t make friends for your child but you can teach them how to do it themselves. Make them know how to approach unfamiliar children by role-playing. Be the other child’ and let your child approach you asking to know your name, and asking to play or study with you etc. Switch roles and practice till he/she learns to fight the fear and anxiety completely.

Praise their efforts, being specific on what they did right and pointing out areas they need to improve on.
With patience and practice, your child can learn to think more realistically about their fears and learn to confront stressful situations.

‘Scaredies Away’ is a helpful book for parents of anxious children; it is targeted to children in the 6 – 12 age groups, and was written by Barry McDonagh author of Panic Away and Stacy Fiorile a certified school psychologist.

The book is a kid’s guide to overcoming anxiety and worry, and as such is a good place for parents to start when trying to help their child cope with their fear and anxiety.

It is descriptive in a way that children understand, and it gives children the tools to help them overcome their fears and normalize their anxiety symptoms.


Children With Anxiety: Helping a Child with Anxiety Problems

Anxiety is one of the most common mental health problems in children and teenagers. According to the National Institute of Mental Health, around 1 in 8 children suffer from anxiety at some point in their lives. If untreated, this anxiety can lead to serious problems in life including depression, increased likelihood of substance abuse, missed opportunities in career and relationships, and a general decrease in the quality of life.

Fortunately, anxiety is relatively easy to treat – especially if detected early. The only problem is that most parents don’t detect it early enough. As such, it keeps festering slowly for years, and by the time it manifests, it is quite advanced. Therefore, it is imperative for a parent to pay keen attention to their child, so that they can notice any early manifestations of anxiety. The starting point is understanding what anxiety is. So, the ultimate question is:

Children with Anxiety

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What is Anxiety?

Anxiety is a normal, natural reaction to a stressful situation. We all experience anxiety from time to time. When we perceive something to be stressful, our body releases a hormone called adrenaline. This hormone prepares the body for a fight or flight response. Anxiety isn’t actually a bad thing. There are certain situations where it can actually be beneficial.

Anxiety about a forthcoming test can motivate you to work harder, and thus perform better. When crossing a busy street, a little anxiety can keep you focused, alert and decrease your chances of getting run over.

The problem arises when we fail to effectively cope with anxiety. As such, rather than becoming a positive influence, it can become debilitating. For children and teenagers, the effect can even be worse – since they are often not equipped with the life skills to positively handle their anxiety.

Basically, anxiety can broadly be divided into two types i.e. normal anxiety and abnormal anxiety. In children and teens, understanding these two types is critical if early potential anxiety problems are to be effectively dealt with. Let’s take time to consider the two types of anxiety.

Normal Anxiety in Children and Teens

Being anxious is part and parcel of growing up. As children begin to explore the world, they will encounter unfamiliar situations. The normal reaction to these situations is feeling anxious. The anxiety will typically manifest in three forms i.e. the physical, mental and behavioral.

Physical manifestations are bodily reactions to anxiety-inducing situations. These reactions are typically unpleasant, and arise from the effect of adrenaline on the body. They include heart palpitations, feeling tense, breathing difficulties, feeling shaky, stomach cramps, feeling sick, sweating, and feeling dizzy and breathing very fast.

The bodily reactions are designed to be normal. They are supposed to prepare the body for fight or flight responses. However, sometimes they trigger mental manifestations.

The mental manifestations are thoughts which accompany the feelings of anxiety, the mental state that results from insufficient coping skills when faced with a difficult challenge. They are typically fearful or worrisome thoughts. For instance, a child can see a dog and think “It is going to bite me”.

The behavioral manifestations are basically the actions which children take in reaction to anxious situations. There are two most common behaviors are avoiding the anxiety inducing situations, or seeking reassurance from their parents.

As children grow up, there a numerous things which they will be anxious about. For instance, things which children commonly worry about include darkness, dogs, being on their own, ghosts and monsters. With time, they either outgrow these anxieties or learn to cope with them.

However, not all children outgrow or cope with their anxiety. Some become incapacitated by the anxiety. This is when anxiety becomes a problem.

Anxiety in Teenagers

Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net

When Anxiety Becomes a Problem

There are some tell-tale signs which indicate that a child or teenager is having anxiety problems. The common anxiety symptoms are the following:

  • Somatic complaints such as constantly complaining about headaches or stomach aches – especially when they are about do something which they are uneasy about
  • Sleep difficulties including trouble sleeping alone, having nightmares or difficulty falling asleep
  • Constant worry and often needing reassurance
  • Being afraid of, and frequently avoiding certain situations, or overeating to a situation
  • Difficulty socializing with other children
  • Reluctance to ask for help
  • Occasional outbursts of anger
  • Crying or clinging to the parent (specifically for your children)
  • Experiencing sudden and frequent panic attacks.

Anxiety problems are often centered on specific situations. As such, the manifestations will usually be tied to specific situations. In children and teenagers, anxiety can be divided into the following categories.

Separation anxiety – this is anxiety which arises from being separated from their parental figure. In younger children, it arises from the fear of being away from their parents. In teens, it can manifest in the fear of something happening to their parents e.g. the fear of dread, accidents or imminent death.

School anxiety – this is anxiety which arises in relation to the school environment. Its causes can range from a fear that other kids will not like them, to a fear of being bullied or humiliated; or not being able to cope with school work, for example test anxiety, mathematical anxiety.

Social anxiety – this is anxiety which arises from social situations. It is typically manifested by stranger anxiety, nervousness when interacting with strangers, or reluctance to join other children in play.

Fears and Phobias – this is anxiety which arises out of debilitating fear of real or imaginary threats. However real fear is not the same as anxiety… Some real threats may be dogs, while imaginary threats may be loud noises, or ghost.

Generalized anxiety – this is being anxious about anything and everything. Children who have generalized anxiety are constantly feeling anxious. However, they cannot seem to put a finger on the thing which is causing them to be anxious.

Helping children with anxiety

Image courtesy of David Castillo Dominici at FreeDigitalPhotos.net

How to Help a Child with Anxiety Problems

Helping children with anxiety requires patience, tact and keenness. On the one hand, there is need to help the child to effectively deal with the anxiety-arousing situations. On the other hand, there is need to avoid the child becoming overly dependent on the parent. The following tips can help a child or teenager to effectively deal with anxiety.

1. Identify the anxiety trigger

Anxiety rarely occurs in a vacuum. There is often something which triggers it. As such, the first step towards helping the child is to identify the trigger. This can be done through either observation or asking the child.

2. Understand the child’s perception of threat

To an adult, feeling anxious about a ghost seems quite silly. However, some children think that ghosts are real. Therefore, for an adult to help a child such an anxiety, they have to empathize with the child. The same principle applies to any other trigger for anxiety. You need to understand the child’s perception – even if you know that it is erroneous. Encourage them to talk about how they feel; this is the only way you can get into their minds.

3. Provide reassurance

Once you understand the child’s perception, you can now address them by providing reassurances. Assure them that it is normal to feel the way they do. Then go ahead and provide them with positive encouragement. Inform them that everything will be alright.

4. Encourage the child to face to face their fears

The best way to empower the child is by teaching them how to cope with it. One way is through encouraging them to face their fears. This is the only way they can learn that anxious feelings can be effectively handled. Therefore, you shouldn’t avoid situations simply because it makes the child anxious. Take the child into anxiety-arousing situations, and provide reassurances, even as you help her to face them.

5. Model healthy ways of handling anxiety

Children learn mostly by imitation. As such, the best way a parent can do is to show children how to handle anxiety. The starting point is the parent’s own anxiety. A parent who, when faced with stressful situations, panics and loses her cool is likely to pass on that to the children. If a child observes a parent getting overwhelmed by anxiety, it will become difficult for her to effectively handle hers.

6. Don’t reinforce the child’s fears

Some parents use a child’s fears as motivation to make them do certain things. For instance, a parent who knows that a child is afraid of dogs may say things like “if you don’t go to bed, I’ll go outside and bring a dog.” Such things just worsen a child’s anxiety. Therefore, you should try to alleviate the child’s anxiety – not encourage them.

7. Seek professional help

The above 7 tips can be used for helping children with anxiety problems. These are tips to help a parent handle their child’s natural response to their environment and situations around them, and should in no way replace expert help if needed.

If the child’s anxiety levels are beyond normal, then the best course is to seek help from a counselor or psychologist.

In a nutshell, anxiety is a natural response to stressful situations. In children and teenagers, feeling anxious is a normal part of growing up. However, it is when anxiety interferes with the child’s development that it becomes problematic. In such cases, unless properly handled, it can lead to an anxiety disorder that can cause numerous problems later in life. So helping children with anxiety problems in a sympathetic and encouraging way is part and parcel of effective parenting.