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.
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 An estimated 15% of all children will be withdrawn, shy and irritable in the presence of new people, things or situations.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:
- Group Therapy, in which your child will learn social skills to help them interact with people in social settings.
- Exposure Therapy, which entails learning how to slowly confront social situations rather than avoiding them.
- 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:
- 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.
- 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:
- Sit in a comfortable position with their back straight, and one hand on the belly and the other on the chest.
- 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.
- Hold their breath for three seconds, and then slowly exhale through the mouth for five seconds.
- 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.
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.