Parents worry about whether their child’s shyness is part of their personality later, allowing them to navigate the world more as happy viewers, or whether the problem lies in their Anxiety. Social anxiety causes many children social development problems that can lead to issues with school and friends. But how do you compare being shy vs. anxiety?

Social anxiety is a mental health condition characterized by the fear of interacting with others. Social anxiety symptoms include feeling nervous or uncomfortable in social situations. 

For some, their anxiety can be so great that they struggle to speak with others and make friendships. They are very concerned that they will do or say something embarrassing or humiliating or that others will think badly of them, so they often avoid others.

People with social anxiety typically know their anxiety is irrational and not based on fact. Nevertheless, thoughts and feelings of anxiety persist, are chronic, and can greatly impact their ability to interact with others.

Social phobia differs from this type of anxiety, where one fears conversations or similar social interactions. Social phobia encompasses fears and insecurities associated with public speaking or performance.

How Common is Social Anxiety?

Social anxiety is extremely common and is the third-largest mental health issue in the US. According to the Anxiety and Depression Association of America, social anxiety affects 15 million adults, or 6.8% of the U.S. population (Bener et al., 2011). 

Even though social anxiety is common, most parents and teachers don't know the signs and symptoms. Social Anxiety is equally common among men and women, with the most common age of onset being age 13. According to a 2007 American Depression Association of America survey, 36% of people with Social Anxiety Disorder report experiencing symptoms for ten or more years before seeking professional support (American Psychiatric Association, 2018). Since depression and anxiety are often comorbid, parents may miss the social avoidance and attribute it to solely depression.

Shy vs. Anxiety: What is the Difference Between Shyness and Social Anxiety?

Shyness is a personality trait, not a clinical issue, so we shouldn’t pathologize it. A child who doesn’t want to be the center of attention and is more comfortable viewing the world from the sidelines does not automatically mean they have a problem. 

Several considerable symptoms distinguish being shy from being socially anxious at a clinical level. Shy people may not always feel comfortable around people they don’t know and are more reserved, but they live a normal life and can connect with others.

On the other hand, children with social anxiety struggle due to irrational fears and worries that they might say or do something to embarrass themselves. Social Anxiety Disorder has accompanying negative emotions and feelings that limit and interfere with a person’s life which isn’t the case with a shy person. 

The key difference between social anxiety disorder and shyness is the pervasive negative feelings and emotions that limit interactions with others. But can shyness turn into social anxiety? Possibly. The onset of social anxiety disorder typically occurs in teens with social inhibitions or shyness during adolescence.

Can Social Anxiety Cause a Panic Attack?

For some children and teens, the fear and anxiety created by social interactions can be so overwhelming that they can have a panic attack. A panic attack is a sudden episode of intense fear that triggers severe physical reactions (heart palpitations, sweating, shortness of breath, chest pain, dizziness, etc.) when there is no real danger or apparent cause. 

For those living with Social Anxiety Disorder, the irrational fear of saying or doing something wrong can throw one into a panic attack, which can be frightening and cause one to avoid social interactions.

Can ADHD Cause Social Anxiety?

Many children and teens with ADHD or attention problems also have anxiety because of the shame they feel with having difficulty regulating their focus and behaviors. However, not all kids with ADHD and anxiety have social anxiety. 

Children with ADHD are more prone to social skills and friendship issues if they are impulsive and may have social anxiety. Working on their difficulties putting the breaks on, underlying shame, and anxiety are important for these kids to be successful in all areas of their life. People often ask if ADHD medication can help anxiety, and most report that ADHD medication aggravates anxiety. It is important to calm the nervous system, and stimulants can cause a serious exacerbation of anxiety of symptoms.   We use PEMF for anxiety and neurofeedback to calm anxiety.

What are the Signs of Anxiety in Children and Teens?

People with social anxiety display behaviors beyond shyness, they avoid social interactions and situations altogether. When interacting with most people, they worry about what they might say or do (or have said and done). Many people with social anxiety scrutinize all interactions, even with family members, and review them repeatedly, fueling their avoidance behaviors.

Signs and Symptoms of Social Anxiety

• Anticipatory anxiety in most social interactions
• Fear of situations in which you believe you are judged
• Worrying about embarrassing or humiliating yourself
• Intense, irrational fear of interacting or talking with
  strangers or superiors
• Fear of physical symptoms that may cause you embarrassment, such
  as sweating, having a red face, or trembling
• Fear that others will notice that you look anxious
• Overanalyzing your comments or actions and then misidentifying
  errors in your interactions with others
• Expecting the worst possible outcomes from social interactions
• Avoiding social communications
• Avoiding new interactions with others
• Avoiding large group activities
• Avoiding public speaking
• Avoiding Interpersonal relationships, whether friendships or romantic

Physical Signs of Social Anxiety

• Muscle tension    
• Difficulty relaxing   
• Dry throat or mouth
• Headaches
• Stomach aches
• Nervous bowels
• Red face or blushing
• Hives or skin conditions (unexplained)
• Panic Attacks
• Difficulty swallowing
• Vomiting or nausea
• Excessive sweating
• Muscle twitching or facial tics
• Sleep problems

How is Social Anxiety Different From Generalized Anxiety?

It is important to note that generalized anxiety in children differs from social anxiety. The signs and symptoms can overlap, but a child or teen with social anxiety worries very specifically about social interactions.

How Does Social Anxiety Look Like in Young Children?

While young children’s anxiety about social interactions looks different than adults, they both avoid others. Behaviorally, social interactions may cause young children to cry more, have temper tantrums, display separation anxiety, or refuse to speak. Ultimately, children’s fear of speaking with others may be more outwardly behavioral and, therefore, more noticeable.

What Does Social Anxiety Look Like in Teens?

As the child with social grows into a teen, some differences in avoidant or fearful behaviors become more obvious. Although most teenagers experience periods of normal anxiety, those with social anxiety experience disproportionate fear and worry. 

Typically, a teen may avoid social interactions or speak very little in groups or with unfamiliar people. Physical signs of anxiety, such as headaches and stomachaches, may become more prevalent.

Some teenagers learn to throw themselves into schoolwork to mask their intense anxiety. Most experience waxing and waning periods of situationally dependent intense anxiety. Parents often think their teen is shy, saying, “Their grades are so good, and they spend so much time studying that they don’t have time for friends.” 

Teenagers with social anxiety can be masterful at hiding just how intense their worries and irrational thinking are. In more extreme or long-term cases, social anxiety can be a chronic issue impacting attendance, school performance, sports, and the ability to make and keep friends. As the behaviors become more observable, the teen is more distressed, making parents more likely to seek help.

What Does Social Anxiety Look Like in College Kids?

College students with social anxiety experience many of the same issues as high school students, but the social demands often intensify their problems. College is equal parts academic and social learning causing those with social anxiety to fall apart with the intensity of increased interpersonal demands. Some college students' heightened anxiety propels them to seek support while others leave school.

What is Selective Mutism?

Selective Mutism is a more extreme, complex version of Social Anxiety Disorder where children cannot speak or communicate effectively in select social settings. For example, they may not speak at school or out in public, but they speak and communicate in settings where they are comfortable, secure, and relaxed (such as at home). While not as common as Social Anxiety Disorder, it is an increasing problem, especially with young children. We are social anxiety and selective mutism specialists, and with our trademarked BrainBehaviorReset Program, kids can gain control of their brains, bodies, and thoughts.

When Should I Worry That My Child or Teen Has an Anxiety Disorder?

Parents often know their child or teen struggles but become perplexed by their functionality (e.g., good grades or pleasant at home). Professionals classify persistent anxiety (typically six or more months) that interferes with one’s daily functioning (school performance, home life, social functioning, etc.) as a disorder. Thus, parents must observe behaviors (social avoidance, physical signs) and listen for negative self-talk and worry talk.

How To Help a Kid With Social Anxiety

As with any clinical issue, addressing social anxiety early is critical to prevent the habituation of avoidant behaviors and irrational or negative thinking. Learning how to deal with anxiety in one’s child is important. Trying to force a child or teen into social situations isn’t help and may fuel the fire. Instead, they need to be taught tools and how to break their cycle of negative thinking.

Before medicating a child, children should begin a course of anxiety treatment therapies. Although anxiety pills may temporarily help with anxiety relief, they usually don’t address the root cause. 

Moreover, they may negatively reinforce avoidant behaviors instead of learning how to deal with stress and uncomfortable feelings, and learning coping skills is the key to lifelong mental health. 

Working with a therapist to address the causes of anxious feelings and how to manage them is more effective than medication. Moreover, medication is not best for young children and is too often recommended before clinical and natural therapies are tried. 

Additionally, several effective natural remedies for anxiety are changes in diet (anti-inflammatory), exercise, improving sleep, homeopathy, supplements, and working with a naturopathic physician to look at nutrient deficiencies, genetic issues, and irritants in the system.

To prevent social anxiety from becoming a clinical condition, parents can learn how to deal with anxiety by recognizing emotional and behavioral signs. Children and parents benefit from psychotherapy and parent coaching, particularly Cognitive Behavioral Therapy or CBT (DiMauro et al., 2013). CBT practitioners believe individuals’ perceptions of a situation closely connect to their reaction and work through those misperceptions to bring relief. 

Helping children and teens address their faulty perceptions and negative thinking about social interactions can mitigate the effect of anxiety and give them lifelong tools to manage stress. Building stress tolerance for uncomfortable emotions and teaching kids to talk back about anxiety is paramount in tackling social anxiety or any form of anxiety.

Types of Clinical Therapies That Treat Anxiety

We treat social anxiety with a combination of neurofeedback and psychotherapy. With our BrainBehaviorReset Program. The central nervous system must be calmed, so a child or teen with social anxiety can be calm enough to do the work in psychotherapy to address their anxieties and worries.

• Neurofeedback
• Biofeedback
• Advanced Bio-Regulation Therapy (BRT)
• Psychotherapy
• Cognitive Behavioral Therapy (CBT)
• Somatic Therapy
• Meditation
• Play and Expressive Arts Therapy
• EFT/Tapping
• PEMF 
• Magnesium Supplements

Parent Action Steps

Citations

American Psychiatric Association. (2018, May 8). Survey Finds Youth Diagnosed With Anxiety Rose From 2007 to 2012. Psychiatric News.
https://alert.psychnews.org/2018/05/survey-finds-youth-diagnosed-with.html

Bener, A., Ghuloum, S., & Dafeeah, E. (2011). Prevalence of common phobias and their socio-demographic correlates in children and adolescents in a traditional developing society. African Journal of Psychiatry, 14(2).
https://doi.org/10.4314/ajpsy.v14i2.6

DiMauro, J., Domingues, J., Fernandez, G., & Tolin, D. F. (2013). Long-term effectiveness of CBT for anxiety disorders in an adult outpatient clinic sample: A follow-up study. Behaviour Research and Therapy, 51(2), 82–86.
https://doi.org/10.1016/j.brat.2012.10.003

Always remember… “Calm Brain, Happy Family”

Disclaimer: This article is not intended to give health advice and it is recommended to consult with a physician before beginning any new wellness regime. *The effectiveness of diagnosis and treatment vary by patient and condition. Dr. Roseann Capanna-Hodge, LLC does not guarantee certain results.

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