As parents, we aim to create a nurturing environment conducive to our children’s psychological growth, fostering emotional intelligence, social adeptness, and social-emotional learning. However, when a mental health condition or disorder emerges, it disrupts their psychological well-being and can lead to a confusing, frightening time.
Considering that almost half, or around 50%, of teenagers, have experienced a mental health disorder at some point in their lives, the importance of our role becomes even more apparent. This striking statistic underlines how common these issues can be, making our awareness, understanding, and support as parents essential.
We may feel unsettled or even overwhelmed, but it’s paramount to remember the instrumental role we play in our child’s mental health journey. Mental health in our young children and adolescents, integral to their cognitive development, emotional regulation, and behavioral health, is a crucial facet of their overall health and mustn’t be overlooked. Therefore, if you notice that your teen is struggles with social anxiety, it could be beneficial to seek adolescent anxiety treatment.
Signs of Social Anxiety in Teens
Parents that notice their teens struggling socially should understand that there may be a chance that they’re struggling with social anxiety disorder. Being able to spot the signs of this mental health condition is the initial step parents can take to help their teens obtain the necessary help.
Some signs parents should look out for that could indicate SAD include:
- Trouble having “normal” conversations with and/or talking to other people
- Anxiety about being around other individuals, particularly those they don’t know
- Fear of being embarrassed
- Feeling self-conscious or uncomfortable around other people
- Fear of being judged by other people
- Feeling embarrassment when interacting with others
- Self-criticism or judgment following social interactions
- Difficulty maintaining relationships or making friends
- Worry excessively for days or weeks prior to a public event
- Sweating, blushing, rapid heartbeat, or shaking when in social situations
- Avoidance of social situations and/or public places
- Nausea and stomach ache due to being around other individuals, or other physical symptoms like diarrhea, confusion, and muscle tension
Every teenager with SAD will experience these types of symptoms (or the same level of severity). While these symptoms are often very significant and can impair functioning in various ways, SAD is treatable. If you’re worried your child could have anxiety, take our parent quiz, an anxiety test for teens, to better understand your child’s behavior.
How Common is Social Anxiety in Teens?
It’s common for teens to feel some anxiety about how others think of them. Some teens experience so much anxiety that they develop a social anxiety disorder. They worry so much about what other individuals think about them that they stop doing things they want (or need) to do because they fear they will embarrass themselves.
SAD is the third most common mental health condition following substance abuse and depression. It has an approximate 12% lifetime prevalence rate.² Anxiety disorders are common and affect approximately one out of three adolescents between the ages of 13 and 18 years old.³
Teenagers can typically hide their emotions and feelings in the beginning, and teachers and parents might not notice that there is anything wrong. SAD means that even minor things, such as eating with friends in the cafeteria or answering questions in class, can feel extremely intimidating and scary. That’s because teens worry that they may do something accidentally that’s offensive or embarrassing, and it will change what other individuals think about them.
The types of situations that can lead to SAD in teens will differ for each individual. One teen may see their friends laughing and whispering, and they may believe their friends are laughing at them. Another teen may be too afraid to ask their teacher a question out of worry that they’ll sound stupid.
Teenagers with SAD often believe everyone notices their anxiety, and that’s another thing they are embarrassed and worried about. When they are very anxious, they might hide their emotions and feelings. Or some teens may lash out, appearing aggressive or angry.
What Causes Social Anxiety in Teens?
It’s natural for parents to hope their children grow up feeling comfortable and self-assured in their own skin since characteristics like these are some of the most important when it comes to teens achieving an overall sense of well-being and thriving socially. Sadly, there are many children who grow up and become socially anxious teens. This may occur for various reasons, and there are a number of factors that contribute to a teenager’s social anxiety.
As with most mental health conditions, SAD isn’t attributed to one cause. Even so, there are specific factors that can increase an individual’s chances of developing a social anxiety disorder, including:
- Brain chemistry
- Genetics
- Trauma
This means teens that have chemical brain imbalances, first-degree family history, or have experienced trauma or long-term stress might have a greater risk of receiving a social anxiety disorder diagnosis.
SAD tends to emerge in adolescence. Mental health specialists have explored other risk factors for the adolescent population because of this trend. Risk factors may include:
1. Demeanor
Children who are inherently withdrawn, shy, and/or apprehensive about trying new things might be at a higher risk for developing SAD as they grow into their teenage and adolescent years.
2. Physical or Health Problems
If a teenager has any type of physical or health issue that’s noticeable to other people, such as a large scar, a physical deformity, a birthmark, etc., they might be more susceptible to struggling with social anxiety.
3. Being Bullied
Unfortunately, bullying is extremely prevalent in schools and online. Teens that are being bullied can also be affected in other areas of their life, such as social relationships.
4. Speech Issues
It can be a big challenge to have a speech impediment for various reasons, and it can impact a person’s self-esteem and confidence negatively. This is particularly true with teens. Low self-esteem frequently affects teenagers’ willingness to place themselves in social situations. Sadly, the more times a teenager spends isolated and alone, the more difficult it becomes to re-engage with other people.
5. Parenting Style
Some mental and medical health specialists attribute the development of social anxiety disorder to parenting styles. A lot of research shows a strong link between SAD in children and overprotective parenting styles. This may be due to overprotective parenting styles, potentially keeping kids from experiencing healthy levels of social interaction and, thereby, lacking the chance to learn essential social skills.⁴
How to Help Your Child With Social Anxiety
Social anxiety in teens can make it hard for them to function properly in regular social settings. Parents can have a hard time watching their teens struggle, but there are a number of options that can help them manage the symptoms their teens experience. Social anxiety may reach a point where some adolescents refuse to attend school. To alleviate your teenager’s discomfort and facilitate school attendance, explore school refusal interventions here.
Some ways parents can help their teens with social anxiety include:
1. Understand and Discuss their Teen’s Problems
Parents should talk with their teens to gain a better understanding of what they’re truly feeling and experiencing. Parents should also explain anxiety to their teens and why they might be feeling it. Parents should provide their teens with a safe space for them to talk and communicate openly with them about the fear and anxiety they might be experiencing.
2. Practice and Teach Relaxation Methods
Relaxation methods are used for various things. For instance, relaxation techniques can help to lower blood pressure, reduce heart rate, and slow rapid breathing.
This brings an individual’s body to a relaxed state rather than the individual being in the anxious and stressed state that their body was currently in. There are a number of relaxation methods teens can try, including:
- Progressive relaxation
- Breathing exercises
- Guided imagery
- Autogenic training
Parents should work with their teens to identify different relaxation methods that seem to help. The NIH website lists several relaxation techniques that parents can try out with their teens to see which ones are most effective.⁵
3. Teach Cognitive Reframing
This is a method that involves identifying and changing the way individuals observe certainly:
- Emotions
- Ideas
- Situations
- Experiences
4. Expose Teens to Social Situations
While it can be tempting for parents to shelter or overprotect their teens, it’s essential they provide their teens with experiences that will build their confidence and not allow their teens to avoid anxiety-provoking situations. Slow exposure to new social experiences can help teens feel more confident in their abilities and build their social skills. This generally involves a little bit of pushing teenagers out of their comfort zones but doing so in a measured approach. A mental health professional or therapist can help guide this, and parents’ involvement is important.
5. Model Social Behavior
It’s essential for parents to be aware of how they’re interacting with others when their children are watching. If a parent has a shy child and they’re overprotective of them, their child will not be able to get used to new situations and people, and this can cause social anxiety. Also, parents with shy temperaments can end up setting the example accidentally of avoiding certain social situations. Parents should model good social behavior to help their kids learn how to interact socially and how to overcome their social anxiety.
6. Work on Friendship Skills
SAD can make it hard for certain teenagers to make friends since they often aren’t sure how to feel safe while in social situations. Parents can help their teens learn these essential skills. They can encourage their teens to join groups or clubs that involve their interests.
7. Get Professional Help
Obtaining professional help is an essential way for parents to help their teens work through and overcome their social anxiety. Having a professional SAD diagnosis can provide teachers and other professionals with better ideas for helping teens. Professionals can also provide teenagers with the proper tools to help them deal with social situations better.
Living with social anxiety can frequently be debilitating for teens, but parents can help. Parents should let their teens know that they support them and will be there to help them manage their SAD symptoms. This is a crucial part of their healing.
Diagnosing Social Anxiety in Teens
To receive a social anxiety diagnosis, the symptoms of anxiety must show up when the teen is not just around adults but also around their peers. Their symptoms must also last for a minimum of six months.
When making a SAD diagnosis, mental health professionals frequently talk with teachers, parents, and other adults in the teen’s life.
A social anxiety disorder diagnosis in children is based on symptoms like:
- Tantrums
- Crying
- Clinging
- Freezing
- Refusing to speak in social situations
Teens may show avoidant behaviors such as not going to parties, refusing to go to school, or not eating in front of other people.⁶
Treatment Options for Social Anxiety
Social anxiety treatment, similar to any anxiety treatment, often involves medication, psychotherapy, or a combination of both. A SAD treatment plan is usually based on the frequency and severity of symptoms.
1. Medications
Medication is frequently prescribed to teens who struggle with SAD, particularly if SAD is affecting their functioning significantly. Overall, medication for anxiety targets the emotional control center of the brain and helps with circuits functioning more efficiently. Various medications, in combination with therapy, might be prescribed to teens with SAD, which include:
Selective Serotonin Reuptake Inhibitors (SSRIs)
Generally, SSRIs like escitalopram (Lexapro), sertraline (Celexa, Zoloft), and fluoxetine (Prozac) are prescribed for people with depression. They work for anxiety as well since they help slow down the brain’s re-absorption of serotonin. This is a neurotransmitter that helps regulate overall mood and anxiety.
Benzodiazepines
These fall under the “sedative” class of medication, and while they’re not the usual first line of treatment for teenagers with social anxiety (because of their addictive nature), they’re sometimes prescribed by doctors to help treat the symptoms of SAD. Benzodiazepines like alprazolam (Xanax), clonazepam (Klonopin), lorazepam (Ativan), or diazepam (Valium) work by affecting the brain’s neurotransmitter GABA activity. This leads to a more calming effect on the brain areas that become excitable.
2. Physical or Health Problems
The most common treatment approach for social anxiety in teens is Cognitive behavioral therapy (CBT) which is actually common for most anxiety disorders in general. CBT is usually goal-oriented and short-term. For teenagers with SAD, this approach of psychotherapy targets the teen’s unhealthy behaviors and thinking patterns that drive their social anxiety and offers the skills and tools for them to choose healthier behaviors and manage their thoughts. CBT also helps teenagers with social anxiety disorder to understand the connection between their feelings, behaviors, and thoughts.
3. Exposure Therapy
While exposure therapy isn’t as common as CBT, it can still be an effective approach for teenagers with SAD. This treatment approach gradually exposes teens to their fears (while it keeps them safe) and, at the same time, teaches them helpful strategies to manage their fears. It’s based on the belief that the more teens encounter their fears, the less scary their fears become. Exposure therapy also teaches teens that they can still fear something but are able to do it anyway.
4. Dialectical Behavior Therapy
This therapy is designed to stop teens from acting on distressing feelings or from trying to hurt themselves by teaching them healthy coping skills. It’s a technique that teaches teens safe and better ways to manage their emotions. The whole family is included in the treatment process, making dialectical behavior therapy a comprehensive treatment approach.
DBT combines CBT and mindfulness treatments. Mental health specialists use this treatment approach to manage a teen’s strong emotions that could result in a lack of stability. Dialectical behavior therapy is an evidence-based treatment option to manage an individual’s emotional dysregulation and mental health.
Learn More About Treatment for Social Anxiety in Teens at MCAW
Mental health conditions can be debilitating for teenagers and impact day-to-day functioning. Anxiety, including social anxiety in teens, is a common mental health condition that frequently develops in childhood or adolescence. A mental health professional can develop a customized treatment plan for a teen’s social anxiety to help them with long-term recovery. This treatment plan can help reduce their symptoms of anxiety and provide them with tools to cope with their anxiety.
If your teen is struggling with social anxiety, contact Massachusetts Center for Adolescent Wellness (MCAW) for help. MCAW is an outpatient program for mental health that provides support and therapy to teens between the ages of 13 years old and 17 years old. We provide treatment options for an array of different mental health conditions, including social anxiety disorder. Evidence-based treatment options are combined with holistic techniques that allow us to offer adolescents and their families the best care possible. Contact us today to schedule a consultation to discuss your teen’s social anxiety and see which customized treatment approach is right for them.
References
- National Library of Medicine. DSM-IV to DSM-5 Social Phobia/Social Anxiety Disorder Comparison. Retrieved on 3-22-23 from:
https://www.ncbi.nlm.nih.gov/books/NBK519712/table/ch3.t12/ - National Library of Medicine. Understanding Social Anxiety Disorder in Adolescents and Improving Treatment Outcomes: Applying the Cognitive Model of Clark and Wells (1995)
Eleanor Leigh, and David M. Clark. Clin Child Fam Psychol Rev. 2018; 21(3): 388–414.
Published online 2018 Apr 13. doi: 10.1007/s10567-018-0258-5
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6447508/ - National Institute of Mental Health. Any Anxiety Disorder. Retrieved on 3/22/23 from:
https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder - National Library of Medicine. Social Anxiety Disorder: Recognition, Assessment and Treatment. Retrieved on 3/22/23 from:
https://www.ncbi.nlm.nih.gov/books/NBK327674/ - National Center for Complementary and Integrative Health. Relaxation Techniques: What You Need To Know. Retrieved on 3/22/23 from:
https://www.nccih.nih.gov/health/relaxation-techniques-what-you-need-to-know - Merck Manual. SOCIAL ANXIETY DISORDER IN CHILDREN AND ADOLESCENTS. Retrieved on 3/22/23 from:
https://www.merckmanuals.com/home/children-s-health-issues/mental-health-disorders-in-children-and-adolescents/social-anxiety-disorder-in-children-and-adolescents#v12819166
