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Author: Dr Sabina DosaniConsultant Child & Adolescent Psychiatrist

Social anxiety or social phobia are terms used to describe an intense self-consciousness or fear of embarrassment triggered by being in social settings.

What is social anxiety?

We all might worry sometimes about what other people think of us, teenagers and children are no different. These worries can mean we get nervous before a party or social event and are quite natural. Social anxiety is different. It is a diagnosable anxiety disorder that can leave sufferers with an immense and limiting fear that they may do something to humiliate themselves in public settings. It can mean that the child or teenager with social anxiety does not take part in activities, becomes socially withdrawn, develops school refusal and may lead to depression developing.

Social anxiety is common amongst teenagers, perhaps due to the changes that are happening to their brain which lead to teens being more socially aware and sensitive.

Social anxiety peaks in adolescence and is associated with depression later on in life.


What are the symptoms of social anxiety?

It is absolutely normal for children and teenagers to feel worried before a presentation or performance at school or even feel a bit nervous before going to a party. We all do, and it is a natural, and to some degree, helpful reaction and can help prepare us.

However, if your child regularly feels or shows distress when faced with social situations, or if they experience the symptoms of anxiety in social situations then it may be useful to seek professional help.

As with many anxiety disorders, the symptoms of anxiety can be hugely unpleasant and distressing and for a child who is acutely worried about embarrassing themselves in front of others, their uncontrollable symptoms can make things even worse.

Signs you child may have social anxiety include:

  • Making excuses not to go out
  • Not socializing as much
  • Tearfulness or tantrums before an event
  • Sleeping badly the night before
  • Trembling
  • Dizziness
  • Feeling sick on route to an event

The whole process was excellent, from the speed of being seen, to the level of detail the report goes into, to seeing such an experienced clinician.

Anna, London


How can I help my child with social anxiety?

The first step in helping your child is to make sure they receive a thorough diagnosis, as often social anxiety can accompany another condition, such as autism or depression.

CBT (cognitive behavioural therapy) and other talking therapies are some of the most useful ways of helping children and teenagers overcome their social anxiety. Working with a therapist, who has an understanding of social anxiety, can allow the child to understand their fears more and work on successful coping strategies they can apply in everyday life.

For some children and teenagers, their anxiety is so severe that medication is needed to help keep the symptoms in control and allow them to engage with the therapy. The first step is to receive a diagnosis by a child and adolescent psychiatrist, as the symptoms of social anxiety can be found in other disorders such as Autism.

Parents are sometimes surprised that their children have such severe anxiety. It can be really hard for parents to know if there is a problem, as often children and teenagers with social anxiety are so concerned with what other people think of them that they play down their symptoms or internalise their anxiety for fear of criticism. It is usual for an older child or teenager to conceal many of their symptoms.
MBBS, MSc, MRCPsych

Consultant Child & Adolescent Psychiatrist
London

Dr Sabina Dosani is a highly experienced Consultant Psychiatrist currently working for the Anna Freud Centre looking after Children and Adolescents. She has a Bachelor of Medicine and Bachelor of Surgery as well as being a member of the Royal College...

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