At every party or large family gathering there are always the children who go immediately to play with the other kids and those who might need to hang back for a bit before joining in, or who would rather sit on their own and read a book or just hang out at the grownup table.
At parent-teacher conferences some children are described as being excited to share their knowledge with the class while others need much more encouragement to participate in class discussions so that they can share the knowledge and understanding of the materials that their teachers know they have.
Some parents may have experience with a child who, though seemingly popular, has to be pushed to go out and socialize with her friends or who is constantly worried that she has done something to embarrass herself in front of her friends. Parents who have a child that fits into the second category may sometimes wonder if their child’s behavior is normal or if there is something more going on. There are many possible explanations as to why some children are less likely to join in and play with a group, why they may not participate in class even when they know the information, or why they may not want to socialize with others even though they seem to have many friends. This post will discuss social anxiety disorder (SAD) and provide information explaining common myths and misperceptions regarding the diagnosis as well as treatment options for children who are struggling with social anxiety disorder.
One of the most common misconceptions about social anxiety disorder is that it is the same thing as shyness. And while it is true that someone can have both shyness and social anxiety, they are not the same thing. According to the American Psychological Association, shyness is “the tendency to feel awkward, worried or tense during social encounters, especially with unfamiliar people.” Social anxiety disorder, on the other hand, has a number of diagnostic criteria which include:
- A marked fear or anxiety regarding social situations where one will likely interact with or be observed by other people such as during recess time at school, giving a presentation in front of the class or eating lunch in the cafeteria at school.
- A fear of acting in such a way or of showing symptoms of anxiety such as sweating or shaking that will lead people to judge her negatively. Someone with social anxiety disorder is afraid that she will forget the answer if a teacher calls on her or that someone will notice her palms are sweaty if they shake her hand and that she will be embarrassed or rejected because of it.
- Avoiding social situations or enduring them with a great amount of fear or anxiety. Someone with social anxiety disorder may either avoid going to birthday parties or eating lunch in front of other children or she will do so but will be experiencing a high level of fear or anxiety throughout the time that she is engaged in the social setting.
- The fear, anxiety, or avoidance causes clinically significant distress or impairment in social, occupational or other important areas of functioning. Someone with social anxiety may avoid playing with other children during recess and will choose to go to the library or hide out in the bathroom instead, she may avoid raising her hand in class to ask a question or going up to the teacher to ask questions when she is unclear about the material.
One of the most important differences between shyness and social anxiety disorder is that whereas someone who is shy may act less shy as she gets more comfortable, someone with SAD will feel anxious even around people that they know well and should feel comfortable with. Other common misconceptions about social anxiety disorder are that it only relates to performance, and while there is a subgroup of people with SAD that only suffer from performance anxiety, many people with the disorder have anxiety during multiple kinds of social interactions, not only ones that involve performing in front of a group of people. In addition, people sometimes believe that someone with SAD must have suffered from a traumatic event that led to their fear and anxiety regarding social interactions. Although someone with post-traumatic stress disorder may be more susceptible to social anxiety disorder, most people with SAD have not experienced trauma.
Treatment for social anxiety disorder involves both cognitive and behavioral components. With CBT (cognitive behavioral therapy), children will learn coping skills for dealing with their anxiety in stressful situations along with ways to challenge and change their anxious thought patterns that will lead to decreased anxiety in social situations. Social skills groups are also a helpful treatment option for children who may lack some social skills or could benefit from a small and supportive group environment in which to practice and become more comfortable being more social.
Written by Joshua Rosenthal, PsyD