Social Anxiety In Children
Social anxiety can also affect children.
Signs of social anxiety in a child include:
- crying more than usual
- frequently complaining of feeling unwell – nausea, headaches, dizziness
- having frequent tantrums before a social event or activity
- avoiding interaction and eye contact with other children and adults
- fear of going to school or taking part in classroom activities or events
- not asking for help at school
- being very reliant on their parents or carer
Speak to your GP if you’re worried about your child. Your GP will ask you about your child’s problems and talk to them about how they feel.
Treatments for social anxiety in children are like those for teenagers and adults. The use of medication depends on the age of the child and the severity of their experience of social anxiety.
Therapy will depend on your child’s age and will often involve help from you. You may get training and self-help materials to use between sessions. It may also take place in a small group.
Content supplied by the NHS and adapted for Ireland by the HSE.
Diagnostic Criteria And Symptoms Of Anxiety
- The individual fears that he or she will act in a way or show anxiety symptoms that will be negatively evaluated.
- The social situations almost always provoke fear or anxiety.
- The social situations are avoided or endured with intense fear or anxiety.
- The fear or anxiety is out of proportion to the actual threat posed by the social situation and to the sociocultural context.
- The fear, anxiety, or avoidance is persistent, typically lasting for six months or more.
- The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
- The fear, anxiety, or avoidance is not attributable to the physiological effects of a substance or another medical condition.
- The fear, anxiety, or avoidance is not better explained by the symptoms of another mental disorder, such as panic disorder, body dysmorphic disorder, or autism spectrum disorder.
- If another medical condition is present, the fear, anxiety, or avoidance is clearly unrelated or is excessive.
Social Anxiety Disorder In Children
Theres nothing abnormal about a child being shy, but children with social anxiety disorder experience extreme distress over everyday situations such as playing with other kids, reading in class, speaking to adults, or taking tests. Often, children with social phobia dont even want to go to school.
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The Worst General Advice: Face Your Fears
Equally annoying and discouraging to people with social anxiety is the oft-mentioned “face your fears” and you will become anxiety-free. Several books on the market have this terminology in their title and it is not only a wrong course of action to take with social anxiety, it is an action that leads to doubt, depression, questioning, and even more anxiety.
Some of the worst advice given to people with social anxiety is to “buck up and face your fears”. This will not work. It will backfire, cause more anxiety and depression, and damages lives.
The term “systematic desensitization” is also used as a behavioral technique for social anxiety. This is actually a strategy that will work, given that the therapist knows how to adequately and to appropriately implement it.
The “systematic” part of systematic desensitization is highly important. In behavioral therapy for social anxiety, the progress must be systematic, step-by-step, hierarchical, and repetitious. If it moves too fast, or if it is too much, this therapy will backfire. It is very important that any process of desensitization be gradual and systematic.
However, we tend to shy away from this terminology as well, because not everyone means the same thing when they use it, and it can easily be misunderstood and misused.
Cognitive Behavioural Therapy For Social Anxiety
Cognitive Behavioural Therapy or CBT is considered to be one of the leading psychological treatments for social anxiety. All of our online courses use CBT strategies to help ease symptoms of anxiety and depression. Click below to see if CBT can help you tackle your symptoms to improve the way you feel.
Strategies for Managing Symptoms of Social Anxiety
Cognitive Strategies
People with social anxiety disorder tend to overestimate the likelihood of being judged by other people and underestimate their own worth. Theyre often self-critical, can fixate on their own flaws, and constantly compare themselves to other people. They can also be hyperaware of and embarrassed by the physical symptoms of anxiety, like blushing, sweating, or trembling.
Cognitive strategies help people identify and challenge these kinds of thoughts, and learn new, more helpful ways of thinking. In doing so, these strategies help can people become more confident and self-compassionate.
Behavioural Strategies
Two key features of social anxiety are avoidance and safety behaviours. Avoidance is when you miss out on fun or important experiences because of anxiety, for example, skipping a friends birthday party or an important presentation at work because youre afraid of being judged. Safety behaviours are things you do that help you cope with anxiety, like having a few drinks before you get to a party.
Coping With Symptoms of Social Anxiety
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Proven Ways To Cure Social Anxiety
For as long as I can remember, I have been scared.
Growing up, I didnt know what the words social anxiety disorder meant. It wasnt until many years later Id find out I had it.
- It was why I couldnt make or hold eye contact with most people.
- It was why I felt constantly tense and worn out if I wasnt alone by myself.
- It was why my voice was so quiet, shaky and insecure.
- It was what made me so nervous, awkward and withdrawn around people.
- To the point that I couldnt even hold a regular conversation or have friends like a normal person.
Social anxiety stole over 20 years of my life away.
Years of nervous sweat dripping down my armpits every time I spoke up in class. Years of weirdly avoiding people every day and staying in every weekend night. Not because I wanted to, but because I was afraid. Years of believing that I would never get a girlfriend and spend my life alone and unwanted.
This page is written for people who want to cure their severe social anxiety, like I did.
If you feel like your social anxiety has sent you into a downward spiral of self shame, depression and loneliness
If you feel bitter and even angry sometimes when you see how most people in the world are born knowing how to easily socialize, make friends and get a relationship
If you feel like the best years of your life are slipping through your fingers day by day, year by year
Then I feel for you. I really do.
You Really Need To Pull Yourself Together
A colleague said this to me when she found me crying in the staff toilets at an event. She thought the tough love approach would help me snap out of it. However, not only did it not help, it made me feel more embarrassed and exposed. It confirmed that I was a freak and therefore needed to hide my condition.
When faced with anxiety, the natural response from observers seems to be to encourage the person to calm down. Ironically, this only makes it worse. The sufferer is desperate to calm down, but is unable to do so.
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Unresponsiveness To Standard Treatments
Before considering a patient to be treatment unresponsive, it should be ascertained that the diagnosis was correct, adherence to the treatment plan was sufficient, the dose prescribed had covered the full range, and there had been a trial period of adequate duration. When patients report previous treatment failures, it often turns out that a drug was only prescribed in the lowest dose or was stopped within the first 2 weeks due to side effects that occurred in the initial phase before the patient could experience improvement.
Elderly patients may take longer to show a response. Table III contains options in case of drug inefficacy or intolerance. In patients who are unresponsive to psychotropic drugs, the addition of CBT is generally recommended.
A combination of antidepressants and benzodiazepines is sometimes used in treatment-refractory cases.
When all standard treatments have failed, the off-label use of drugs may be considered, for example, drugs licensed for another anxiety disorder or that are not licensed but have shown efficacy in clinical studies. Such drugs include quetiapine and agomelatine.
Therapy Time And A Relaxed Group Makes Overcoming Social Anxiety Easier
At the beginning of 1999, we began using Saturday as the cognitive therapy day for new people and the behavioral therapy group for new and returning people . By taking this approach, we found we could lengthen the behavioral therapy time by an hour and have a group of people who were more rested and relaxed, relative to a weeknight group. Thus, while still providing individual appointments for cognitive therapy, and maintaining an evening behavioral therapy group, we launched an all-day Saturday CBT group.
In general, we believe the Saturday approach works better, is easier for patients, and most likely shortens therapy. In our initial assessment, the behavioral therapy group on Saturday afternoon has proven to be a more effective approach to group therapy relative to a weeknight group.
The behavioral therapy group must be individualized to allow for each person to work on their own specific anxiety hierarchy. While many of the behavioral activities will be the same for people with social anxiety, some of the behavioral experiments necessary will be different from person to person, due to specific fears.
For example, the vast majority of people with social anxiety list “presentations/speeches” and “making introductions” as part of their anxiety hierarchy. “Mingling” or making small talk, especially with strangers, usually makes the anxiety hierarchy as well. Everyone in the group works on these anxiety problems and we do most of these activities together.
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Tip : Learn To Control Your Breathing
Many changes happen in your body when you become anxious. One of the first changes is that you begin to breathe quickly. Overbreathing throws off the balance of oxygen and carbon dioxide in your bodyleading to more physical symptoms of anxiety, such as dizziness, a feeling of suffocation, increased heart rate, and muscle tension.
Learning to slow your breathing down can help bring your physical symptoms of anxiety back under control. Practicing the following breathing exercise will help you stay calm:
- Sit comfortably with your back straight and your shoulders relaxed. Put one hand on your chest and the other on your stomach.
- Inhale slowly and deeply through your nose for 4 seconds. The hand on your stomach should rise, while the hand on your chest should move very little.
- Hold the breath for 2 seconds.
- Exhale slowly through your mouth for 6 seconds, pushing out at much air as you can. The hand on your stomach should move in as you exhale, but your other hand should move very little.
- Continue to breathe in through your nose and out through your mouth. Focus on keeping a slow and steady breathing pattern of 4-in, 2-hold, and 6-out.
Can Social Anxiety Disorder Be Cured
Depending on the conditions severity and the treatment that people receive, social anxiety disorder may affect people differently. For some, social anxiety may be short and brief, while others may experience a more chronic condition with symptom relapses.
Studies suggest that over 50% of people with social anxiety disorder achieve remission and no longer experience symptoms. Regardless of how long people experience symptoms, social anxiety disorder can be treated with cognitive behavioral therapy , certain medications, or a combination of both.
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Serotonin Modulators And Stimulators
, sometimes referred to more simply as “serotonin modulators”, are a type of with a multimodal action specific to the system. To be precise, SMSs simultaneously modulate one or more and inhibit the of serotonin. The term was coined in reference to the of the serotonergic antidepressant , which acts as a , of the , and of the and . However, it can also technically be applied to , which is an antidepressant as well and acts as an SRI and 5-HT1A receptor partial agonist.
An alternative term is serotonin partial agonist/reuptake inhibitor , which can be applied only to vilazodone.
How To Overcome Social Anxiety Disorder Tip : Challenge Negative Thoughts
While it may seem like theres nothing you can do about the symptoms of social anxiety disorder or social phobia, in reality, there are many things that can help. The first step is challenging your mentality.
Social anxiety sufferers have negative thoughts and beliefs that contribute to their fears and anxiety. These can include thoughts such as:
- I know Ill end up looking like a fool.
- My voice will start shaking and Ill humiliate myself.
- People will think Im stupid
- I wont have anything to say. Ill seem boring.
Challenging these negative thoughts is an effective way to reduce the symptoms of social anxiety.
Step 1: Identify the automatic negative thoughts that underlie your fear of social situations. For example, if youre worried about an upcoming work presentation, the underlying negative thought might be: Im going to blow it. Everyone will think Im completely incompetent.
Step 2: Analyze and challenge these thoughts. It helps to ask yourself questions about the negative thoughts: Do I know for sure that Im going to blow the presentation? or Even if Im nervous, will people necessarily think Im incompetent? Through this logical evaluation of your negative thoughts, you can gradually replace them with more realistic and positive ways of looking at social situations that trigger your anxiety.
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How Effective Are Treatments
- Pure self-help, using books without a therapist, seems to help some people a bit, but it doesn’t reduce the impact of the social phobia on their life. This may be a good choice if your anxiety about social situations is troublesome, but doesn’t stop you from doing too many things
- Self-help with group meetings seems to work better, but is relatively new.
- Graded self-exposure seems to work for about half the people who finish the course – but quite a few people don’t complete it.
- CBT seems to be better than SSRI medication and should be provided before medication is tried.
If you want to find out more about social phobia, here is a list of self-help organisations, books, websites and other materials that you may find useful:
How To Practice Deep Breathing
When in social situations, make sure that you are breathing the way that you practiced. In time, this way of breathing will become automatic.
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