Supporting children and young people with social anxiety disorder

What is Social Anxiety Disorder?

Social Anxiety Disorder, also known as social phobia, is a mental health condition and a type of anxiety disorder characterised by an overwhelming fear of social situations. People struggling with social anxiety have difficulty in engaging in social interactions, meeting new people and attending social gatherings. Being in social situations or thinking of being in social situations can lead to a lot of stress which can manifest in feelings of nausea, heart palpitations, sweating, trembling and panic attacks.  In children and young people, it can cause a fear of going to school or college, of engaging in activities and lead to self-isolation and low self-esteem.

Fear of being judged is very prominent in socially anxious individuals and, even when they are aware of the irrationality of their fear, they feel like they have no control over it.

It is not the same as being shy.  It can be a very isolating and emotionally taxing experience though there are many treatments and strategies that can help someone manage their social anxiety once someone is able to reach out for help or support.

Signs that a child or young person may be affected by Social Anxiety Disorder

The signs and symptoms for Social Anxiety Disorder may differ between individuals, however there are some common symptoms that you may become aware of.  These include anxiety induced by presence of strangers or potential situations where strangers could be present, missing school or work because of anxiety associated with the social interactions and situations involved, worrying way ahead of an event or situation and getting consumed by this worry, and suddenly cancelling plans with people without proper reasons and on short notice.  Additionally, your child may experience physical symptoms when faced with social situations including feeling sick, trembling or sweating, and having heart palpitations or panic attacks when in anxiety inducing situations.

Children and young people with Social Anxiety Disorder may also lack confidence in trying new things, experience negative thoughts that things could wrong, and exhibit clingy behaviour with family members.

These symptoms can overlap with many other health and mental health problems, and it is important that your child firstly be seen by their GP.  This will help rule out any other issues before a mental health referral is made to make a diagnosis.

Common issues faced by parents and carers

Self-esteem of children and young people with social anxiety is often low and can contribute to them avoiding social situations at all costs. This can also include avoiding any new experiences, going on family outings and vacations, and meeting with friends and family. This may be exhausting for family members particularly siblings whose own social development parents and carers should be mindful not to unintentionally restrict whilst supporting their child with social anxiety.  Since reasons for social anxiety are often changing and evolving, family members can also find it hard to keep track and feel frustrated.

Social anxiety can especially hinder the process of learning at school or college and frequent non-attendance can also be a challenge for parents and carers. Children and young people often find it hard to meet deadlines and might need extra time to finish their work. Their withdrawal from social situations can prove to be quite isolating and alienating which can further worsen the symptoms. Parents and carers need to practice patience especially if a child or young person does not recognise or accept that this anxiety exists or that their behaviour is different to that of their peers.

How to support a child or young person with Social Anxiety Disorder

To understand what is bothering your child, you need to have an open and honest conversation with them. But the pace of this conversation is decided by the child not by you. Your child might open up instantly or take time to trust you and then share with you.

One way to help is by being a good listener and addressing the things that cause them to worry so much one by one. Dismissing them as irrational or overthinking is not advisable as it will make them feel rejected and further worsen their anxiety.

With treatment, children and young people will hopefully open up more and share more with you. This means that they may begin sharing worries that might seem bizarre or irrational but, as a parent or carer, try to acknowledge and accept that these fears are real for your child and work with them to discuss strategies to help the child prepare or cope with certain situations.   For example, talking about potential situations with the child helps them play through the situation in their mind, recognising that they’ve been in similar situations before which might reduce the anxiety surrounding the situation. Researching and trying strategies including relaxation and breathing techniques may also help arm your child with some tools which they can use when they feel their anxiety and stress levels increasing and panic forming.  Our Self-care resource includes over 90 identified and written by young people to help other young people who may be feeling low or anxious.

What to say to schools and colleges

It is important for schools and colleges to recognise that Social Anxiety Disorder can harm a child’s emotional and mental wellbeing.  Therefore, it is helpful to try and lessen the anxiety surrounding the child or young person as much as possible. Good, open communication between parents and carers and schools is really important to helping your child manage anxiety when you are not around.

Teachers may find that children and young people with anxiety disorders have difficulty in completing their schoolwork. Finding strategies that work at home to also use in the classroom may help to ease some of the child’s anxiety. Providing children and young people with additional time to complete work or assignments and making sure that assignments are written down correctly before they are started, may also be helpful.  Reasonable adjustments, such as sitting exams in a quiet room, may also be helpful.

Supporting school attendance by implementing a daily schedule for children and young people may provide structure and lessen anxiety, although modifications to workloads and assignments may still be required. Inclusion of relaxation techniques and frequent breaks in the classroom may provide additional support. Lastly, it is important to be very aware of possible bullying amongst peers and to be aware of your school or college’s policy on bullying and how they will specifically support your child with both their anxiety and any instances of bullying that might occur.

What to say to siblings?

It is important for siblings to understand that the anxiety their brother or sister is experiencing is real, and that they are not simply seeking ‘extra’ attention. This may help to ease any feelings of jealousy towards a child or young person with Social Anxiety Disorder and will help siblings to understand the diagnosis a bit better.

It is also important that siblings are aware that they can, intentionally or unintentionally, worsen their brother or sister’s anxiety by teasing or bullying them. Although siblings do tend to tease and bully each other to a small degree, it may be necessary to explain to siblings that this may be very hurtful and discuss with them how their actions can impact on others. The lack of control and feeling of helplessness is a very real thing for individuals with social anxiety and the seriousness of that needs to be communicated to the siblings in order to avoid and rivalry or animosity between them.

What to say to extended family

Firstly, talk to your child about whether they are comfortable with extended family members knowing about their anxiety. It can be a very helpful exercise to sit with your child and decide what to say to extended family members, and to decide what they can do to help you and your child when visiting.

Extended family members should be aware that their presence can initially cause anxiety in children and young people with Social Anxiety Disorder. It is therefore important not to have too many expectations from the child or young person immediately. It may be helpful to allow your child to initiate interactions and conversations with extended family members when they feel comfortable enough to do so.

It is also important that extended family members not draw unnecessary attention to the anxiety of a child or young person. For example, rather than asking the child directly if they will be too anxious to go out shopping or to a meal, it may be best to ask the parents or carers first and decide how to discuss this with a child or young person after.

Lastly, it is important that extended family members understand the child is not being rude towards them or ignoring them for no reason. They should be made aware that Social Anxiety Disorder is a mental health disorder, and that certain arrangements may therefore be necessary to ease the anxiety of the child or young person. However, it is still possible to have lovely, positive interactions between extended family members and children and young people with Social Anxiety Disorder, given the right support and patience.

Additional support for parents and carers

• Anxiety UK – information and guidance