Children and teenagers with social anxiety disorder (SAD) may live with symptoms into adulthood without ever being diagnosed. Although SAD is the third most common mental health disorder, many parents and teachers are not familiar with the signs and symptoms in children and teenagers.
Social anxiety disorder involves an intense fear or phobia of social and performance situations. Although most teenagers go through periods of normal anxiety related to the changes that go along with adolescence, those with SAD experience fear that is out of proportion to the situations that they face.
For some teenagers, social anxiety becomes chronic, affecting school performance, extracurricular activities, and the ability to make friends.
Types
Children and teenagers can be diagnosed with a more generalized form of social anxiety disorder or with the performance-only specifier (only performance situations cause anxiety).
General vs. Performance-Only SAD
Symptoms
Symptoms in children can vary by age.
As a parent or loved one, know that not all of these behaviors necessarily reflect SAD, but if you consistently recognize them and have cause for concern, consider seeking further evaluation with a psychotherapist.
Pre-School Children
- Fear of new things
- Irritability, crying, or whining
- Freezing or clinging
- Refusing to speak
School-Aged Children
- Fear of reading aloud or answering questions in class
- Fear of talking to other kids
- Fear of being in front of the class
- Fear of speaking to adults
- Fear of musical or athletic performance activities
- Fear of ordering food in a restaurant
- Fear of attending birthday parties
- Fear of having friends visit
- Worry about being judged by others
- Refusal to participate in activities or school
In addition, children with SAD are more likely than adults to experience physical symptoms like headaches, stomach aches, and nausea.
Teens
Temperament
Look for a teenager who...
- is quiet
- keeps to him/herself
- becomes more withdrawn if encouraged to talk
- is hesitant
- is passive
- is overly concerned about negative evaluation
- fears being embarrassed or humiliated
- crosses his/her arms
- keeps his/her head down
- displays few facial expressions
- has nervous habits such as hair twirling or fidgeting
School Behavior
- potentially does poorly in school
- doesn't raise his/her hand in class
- avoids classmates outside class
- fears performing in front of others/public speaking
- fears speaking up in class
- is uncomfortable in the spotlight
- sits alone in the library or cafeteria
- is afraid to ask the teacher for help
- is afraid to walk into class late
- may refuse to go to school or drop out
Behavior With Peers
- is uncomfortable in group settings
- has few friends
- is afraid to start or participate in conversations
- is afraid to ask others to get together
- is afraid to call others
- avoids eye contact
- speaks softly or mumbles
- appears to always be "on the fringes"
- reveals little about him/herself when talking to others
Teenagers with social anxiety disorder are at a disadvantage in all areas of life. They may perform poorly at school and may have trouble attending classes. Students with the disorder are also less likely to make friends and participate in extracurricular activities.
Those with severe SAD may drop out of school or refuse to leave home.
In addition, untreated social anxiety disorder in adolescence may lead to increased risk of other mental health problems later in life such as depression, eating disorders, substance abuse, and even suicidal ideation.
Causes
Just as with adults, social anxiety disorder in children and teenagers may be caused by genetic factors, environmental factors, societal factors, and brain/biological factors. Many parents may blame themselves, but know that it's usually a combination of things that cause the disorder. The most important thing you can do know is support the child and help them find help.
Understanding the Causes of Social Anxiety Disorder
Diagnosis
Diagnosis of social anxiety disorder in children and teenagers involves an evaluation of symptoms in several contexts. This evaluation will often include the perspective of parents and teachers and may involve the use of school records.
Children and teens with SAD can go undetected if parents and teachers interpret the student's behavior as shyness. However, SAD awareness is critical, and early detection and intervention are needed to prevent long-term impairment.
Potential underlying medical conditions are explored and other explanations for the behavior such as bullying are also considered. If the student is at risk of self-harm or suicide, these issues are addressed immediately.
If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
For more mental health resources, see our National Helpline Database.
The same diagnostic criteria used to diagnose adults also apply to children and teenagers. However, there are some additional caveats. Children and teenagers may not recognize that their fear is unreasonable and their anxiety must be present when interacting with their peers, not just adults.
How SAD Is Diagnosed
Treatment
Treatment of SAD in children and teenagers is aimed at helping to alleviate anxiety and allow the student to cope with school and day-to-day functioning. Effective treatments may include the following:
- Cognitive-behavioral therapy (CBT)
- Family therapy
- Medication such as selective serotonin reuptake inhibitors (SSRIs), for example: Zoloft and Prozac
In addition to standard treatments, there are a number of coping strategies that can be employed by teachers, parents,and students to manage social anxiety both in and out of school.
Schools can play an important role in this process, as it is the place where social anxiety disorder can often have the most negative effect on a teen's functioning. School-based interventions led by psychologists, social skills training, and academic skills training are all helpful ways that schools can intervene in cases of SAD.
As a parent, read about the disorder and increase your awareness of what your teen is experiencing. Be in touch with your school to coordinate efforts with teachers, school counselors, and other personnel. Together, you can work toward improving the situation for a child or teen with SAD.
The 7 Best Online Therapy Programs for Kids
Tips for Parents
As a parent of a socially anxious child, it can be hard to know how best to offer your support. It's important to manage your child's social anxiety in a constructive way.
Give your child or teen chances to expose him or herself to feared situations. Don't speak for your child or teen and offer praise when a feared situation is faced.
Choose realistic goals for your child or teen such as joining a club or making a new friend. Then, outline steps that can be taken to achieve this goal. Also, encourage activities that help your child or teen to relax such as arts and crafts, music, yoga, and writing.
Be a good listener and let your child or teen know that what he or she is experiencing can be overcome. Remind your child or teen of past successes and build his or her confidence.
Finally, seek help for your child or teen if anxiety becomes severe. Some problems are too big for you to handle on your own and require intervention such as medication or professional therapy.
How to Parent Teens With Social Anxiety
A Word From Verywell
If you have a child or teen who you believe is living with social anxiety, it is important to make an appointment for a diagnosis and potential treatment. The longer this disorder goes undiagnosed, the more impairment your child will experience. By the same token, if you are a teen living with social anxiety, reach out to a parent, teacher, or guidance counselor about the symptoms you are experiencing so that you can receive help.
6 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Schneier FR. Social anxiety disorder. BMJ. 2003;327(7414):515-6. doi:10.1136/bmj.327.7414.515
Hitchcock CA, Chavira DA, Stein MB. Recent findings in social phobia among children and adolescents. Isr J Psychiatry Relat Sci. 2009;46(1):34-44.
Jefferson JW. Social Anxiety Disorder: More Than Just a Little Shyness. Prim Care Companion J Clin Psychiatry. 2001;3(1):4-9.
Child Mind Institute. Social Anxiety Disorder Basics.
Masia-warner C, Klein RG, Dent HC, et al. School-based intervention for adolescents with social anxiety disorder: results of a controlled study. J Abnorm Child Psychol. 2005;33(6):707-22. doi:10.1007/s10802-005-7649-z
Anxiety and Depression Association of America.Tips for Parents and Caregivers.
Additional Reading
Kodish I, Rockhill C, Varley C. Pharmacotherapy for anxiety disorders in children and adolescents. Dialog Clin Neurosci. 2011;13(4):439-52.
Ryan JL, Warner CM. Treating adolescents with social anxiety disorder in schools. Child Adolesc Psychiatr Clin N Am. 2012;21(1):105-18, ix. doi:10.1016/j.chc.2011.08.011
:max_bytes(150000):strip_icc()/ArlinCuncic_1000-21af8749d2144aa0b0491c29319591c4.jpg "How to Recognize Children and Teenagers With Social Anxiety Disorder (1)")
By Arlin Cuncic, MA
Arlin Cuncic, MA, is the author of "Therapy in Focus: What to Expect from CBT for Social Anxiety Disorder" and "7 Weeks to Reduce Anxiety." She has a Master's degree in psychology.
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FAQs
How to Recognize Children and Teenagers With Social Anxiety Disorder? ›
For example, children with social anxiety worry about what will happen in social situations. They're often scared of what others will think of them. They might also fear being embarrassed, being separated from their parents or carers, or getting in trouble.
How do you know if your child has social anxiety? ›For example, children with social anxiety worry about what will happen in social situations. They're often scared of what others will think of them. They might also fear being embarrassed, being separated from their parents or carers, or getting in trouble.
What is social anxiety disorder in children and adolescents? ›Social anxiety disorder is a persistent fear of embarrassment, ridicule, or humiliation in social settings. Typically, affected children avoid situations that might provoke social scrutiny (eg, school). Diagnosis is by clinical criteria.
How can you tell if someone has social anxiety disorder? ›Intense fear of interacting or talking with strangers. Fear that others will notice that you look anxious. Fear of physical symptoms that may cause you embarrassment, such as blushing, sweating, trembling or having a shaky voice. Avoidance of doing things or speaking to people out of fear of embarrassment.
How do I know if my 12 year old has social anxiety? ›Children and teens with social anxiety disorder have an excessive and persistent fear of social and/or performance situations such as school, parties, athletic activities, and more. They are extremely worried that they may do something embarrassing, or others will think badly of them.
What are 5 symptoms of social anxiety? ›- Blushing, sweating, shaking or feeling your heart race in social situations.
- Feeling very nervous to the point of feeling nauseated in social situations.
- Not making much eye contact when interacting with others.
- A general fear of being judged by others.
- Concerns about being a burden to others.
- Frequent self-inflicted judgment and/or criticism after social interactions.
- Difficulty talking to peers or authority figures.
- Feeling uncomfortable or self-conscious when meeting new people.
Social anxiety may occur after a frightening or hurtful experience such as being bullied or abused. Being very self-critical can also be a factor.
What is an example of social anxiety in children? ›Examples. The kinds of situations that are anxiety-provoking can vary a lot depending on the person. Some kids with social anxiety mostly fear performing in front of people, while others are anxious in many situations—talking to a sales clerk, asking for help, eating or drinking in front of others.
What is the root cause of social anxiety? ›Environmental Influences and Stressful Life Experiences as a Cause of Social Anxiety. Stressful life events and trauma during childhood can influence the development of social anxiety problems. Some of the exposures known to have predictive value for severe social anxiety include: Physical, sexual, or emotional abuse.
What is the best therapy for social anxiety? ›
Cognitive behavioral therapy (CBT), a research-supported type of psychotherapy, is commonly used to treat social anxiety disorder. CBT teaches you different ways of thinking, behaving, and reacting to situations to help you feel less anxious and fearful.
Is social anxiety a red flag? ›Avoiding social situations or trying to blend into the background if you must attend a social event is a significant red flag signifying social anxiety disorder. This usually indicates that you're not comfortable in social settings and do what you can to avoid a healthy amount of interaction.
Is social anxiety a form of autism? ›There are plenty of similarities, including symptoms and services offered. That said, it's important to understand that social anxiety is not a form of autism and vice versa.
What is the average age of social anxiety disorder? ›Social anxiety disorder affects about 5.3 million people in the United States. The average age it begins is between age 11 and 19 -- the teenage years. It's one of the most common mental disorders, so if you have it, there's hope. The tough part is being able to ask for help.
Can a child outgrow social anxiety? ›Some tips to spot when social anxiety disorders in a child are serious. Shyness can make childhood difficult, but most grow up and out of it. However, for children with social anxiety disorder waiting to outgrow it will only make things worse.
What age does social anxiety start? ›Social anxiety disorder typically starts in childhood or adolescence. Among individuals who seek treatment as adults the median age of onset is in the early to mid-teens with most people having developed the condition before they reach their 20s.
What does social anxiety look like in kids? ›Students with social anxiety may: feel self-conscious and anxious in social or performance-based situations where they are observed by others, such as speaking in front of the class, raising their hand to answer a question, or eating in the presence of peers. avoid school or participating in class.
What is the earliest age of social anxiety disorder? ›Twenty-one percent of the overall sample reported social phobia onset during early childhood (i.e., onset at age 10 or younger), 10.0% during mid-childhood (onset between ages 10 and 13), 28.1% during adolescence (onset between ages 14 and 17), 19.5% during late adolescence/young adulthood (onset between ages 18 and 22 ...