How to Help Kids Deal with Social Anxiety

Does your child feel extremely uncomfortable in social settings? You might assume they're simply more reserved than other kids. But while it's understandably expected to feel self-conscious sometimes, like when speaking in front of the class, excessive shyness could indicate a social anxiety disorder.

What Is Social Anxiety?

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.

Social anxiety sometimes 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.

Keep reading to learn more about the causes and symptoms and 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: behavioral, emotional, and physical. She adds that parents know their children best, so pay attention to anything out of the ordinary. Here are some of the most common signs of social anxiety in kids.

Behavioral symptoms

• Avoids triggering situations like going to public restrooms, talking to teachers, or attending birthday parties.
• Regularly asking questions for reassurance ("What if I say the wrong thing in class?" "What do I do if something is embarrassing?")
• Difficulty making friends or talking to peers.
• Refusal to speak in certain situations.
• Speaking softly and avoiding eye contact.
• Refusal to go to school, in extreme cases.

Emotional symptoms

• Fear of meeting or talking to people. The distress can start days or weeks before an event.
• Constant worry about embarrassment or judgment by others, including worry about appearing anxious.
• Extreme self-consciousness in social or performance settings.
• Feeling helpless, sad, or angry in social settings.

Physical symptoms

• 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.
  

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. 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 might also experience symptoms of social anxiety, but what causes it?

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, specializing in childhood anxiety.

Genetics may also play a role; studies on twins have shown that there may be a genetic component to anxiety and depression expressed as hereditary traits. And while there needs to be more research done to better understand this phenomenon, another factor may be your child's environment. In other words, if one or both parents have an anxiety disorder, they could be modeling anxious behavior that a child could pick up.

Social Anxiety Treatment at Home

Kids with social anxiety may not show signs or symptoms at home, so parents might not realize anything is wrong. Teachers might also dismiss social anxiety as typical shyness. This may explain why some children can go for years without a diagnosis.

If your child displays signs of social anxiety, check out these at-home treatment options, and learn when to see a professional for therapy or medication.

Dr. Franklin recommends communication and preparation for social anxiety symptoms that appear mild or have a direct cause, like bullying, a death in the family, or other major life events.

Explain what to expect

For example, if your child is nervous about attending a new school, you can help by giving detailed descriptions. ("I will drive you there at 8 a.m. and pick you up at 1 p.m. You will meet your teacher and classmates. Our neighbor Logan will be there.") Knowing what to expect can make a huge difference, says Dr. Franklin.

Talk with your child

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 students 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.).

Practicing what to do

Although you want to protect your child, don't let them avoid their triggers altogether. Ordering their meal at a restaurant, for example, might not seem like a big deal in the short term, but it reinforces their fears. To overcome this worry, your child can try taking baby steps: They can start by saying "thank you" when the server drops off their meal. Then, after a few weeks, they can order their 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).

Talk therapy

CBT is 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.

Medication

If your 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.