Helping all children become happy learners

Social ANxiety Disorder

Introduction

Probably everyone has experienced shyness and some degree of social phobia at some point in their lives. This is particularly likely to have occurred when going into unfamiliar social contexts like a new school or workplace; and/or having to perform socially with new people or for people with perceived greater importance or social standing. For those with Social Anxiety Disorder they experience these feelings when trying to engage with everyday activities. This leads them to retreat from other people and avoid situations where any expectations can be placed on them to interact.

Social Anxiety Disorders in adults and children

Situations that can be stressful include:

meeting new people 

initiating conversations and talking in front of others

being watched particularly when doing something

speaking on the telephone

talking to people in authority

going to school or a work place

eating or drinking in front of anyone other than close family

going to shops

eye-to-eye contact

social gatherings and parties

using public toilets

complaining about a poor service or faulty goods

Adults are also likely to:

have low self-esteem

feel insecure about their relationships

fear being criticised

misuse drugs or alcohol to try to reduce their anxiety

Social Anxiety Disorder in young children 

Young children may:

frequently cry when new adults or children appear

freeze becoming immobilised

be wary of other children and tend to play alone

cling to parent and avoid socialising

not talk in social situations - selective mutism

have temper tantrums when faced with new social situations or these are suggested

be risk avoidant - needs lots of encouragement to use playground equipment

show continuing separation anxiety when taken to nursery or school

Physical Symptoms

Social Anxiety Disorder can cause a range of physical symptoms that can include:

skin flushing or blushing

sweating

feeling short of breath

feeling sick (nausea)

churning feeling in stomach (butterflies)

fast thumping heartbeat

feeling faint

difficulty talking and shaky voice

trembling or shaking 

Confusion or feeling 'out of body'

Diarrhea

Muscle tension

Emotional Symptoms

Emotional symptoms of social anxiety disorder include:

feeling intensely self-conscious and easily embarrassed

obsessively worrying about social events for days, weeks or months before they occur

fear that others are judging them - paranoia that everyone is talking negatively about them

fear of doing something wrong and being humilated - predicting the worst possible outcome from any social situation

fear that others are aware that they are feeling anxious and notice physical symptoms such as blushing or stress in the voice.

Bullet Point
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Bullet Point

Treatment

The extent to which each individual with Social Anxiety Disorder is able to cope with their condition determines the impact on their everyday functioning. Treatments focus on helping individuals with their symptoms and supporting them to overcome their anxieties. There are two approaches that have been found to effective for both adults and children:

Cognitive Behaviour Therapy. This approach involves attending sessions with a therapist who helps the patient replace negative cycles of thoughts and feelings with more positive interpretations of the situations that cause them distress. 

Medication. Drugs are prescribed that work by reducing the excitability of the amygdala, part of the brain concerned with processing fear responses. The behaviours of Social Anxiety Disorder can be described as flight or freeze responses to stress and the amygdala is involved in this. Inhibiting these responses reduces the physical symptoms of anxiety enabling the individual to cope better when faced with difficult and stressful situations.

Five-Minute Guide to Social Anxiety

Five Minute Guide to Social Anxiety
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