Social Anxiety in Teens: Signs, Symptoms, and How to Help

Social phobia, also known as social anxiety disorder (SAD), is an intense and debilitating fear of social situations.

It is a recognized mental health condition, detailed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

With this disorder, individuals may fear that they will embarrass themselves or believe that they will be judged negatively and criticized by others in social situations.

Individuals with SAD may only fear one or two social situations, while others may get severely anxious in multiple or all social situations.

SAD often peaks in adolescence, with a study from the National Institute of Mental Health (NIMH) finding that around the age of 13, SAD emerges in approximately 12% of teenagers who identify as shy.

Although most teenagers go through periods of normal anxiety related to changes that go along with adolescence, those with SAD experience fear and anxiety that is out of proportion to the situations they face.

SAD may be common in teens, perhaps due to the changes that are occurring in their brains which lead them to be more socially aware at a time when the peer group becomes increasingly important.

Causes of SAD in teens

It is not thought there is a specific causing factor for SAD; rather, it is thought to be attributed to a number of influencing factors such as genetics, brain chemistry, and environmental factors.

Below are some of the common factors which can cause SAD in teens:

• Personality – a child with a naturally quiet temperament, withdrawn or unwilling to try new things, may be at an increased risk of developing SAD as they enter adolescence.

• Parenting style – there may be an association between parenting styles and a teen developing SAD. This can be especially relevant if the parent is overprotective of their child.

  An overprotective parent may keep their child from experiencing a healthy level of social interaction or from taking new risks. Thus, the child may lack the opportunity to learn the necessary skills to cope in certain situations.

• Bullying – unfortunately, many children and teens experience bullying from their peers in school and online. Bullying can affect many areas of a person’s life, including making them fearful of social situations.

• Speech problems – if a teen has a speech impediment, this can be challenging for many reasons and can negatively affect their confidence in speaking to others.

SAD vs. shyness

It is natural for teens to feel self-conscious or shy in front of others at times. Shy people usually feel uncomfortable around strangers and hesitate to open up in social situations.

For some people, the anxiety that goes with feeling shy or self-conscious can be extreme.

When teens feel so self-conscious and anxious that it prevents them from speaking up or socializing most of the time, it is probably more than shyness, and they may have a social phobia.

In this way, SAD is more than shyness. It is a persistent fear that can affect everyday activities, self-confidence, relationships, and work or school life.

Teens with SAD may go undetected in many cases if parents and teachers interpret their behavior as shyness.

Signs of SAD in teens

Although SAD is a very common mental health disorder, many parents and teachers are unfamiliar with the signs and symptoms in teens.

It is important to consider the following symptoms if you suspect a teen may have social anxiety:

• Difficulty talking to others.

• Anxiety about being with other people, especially strangers.

• Feeling embarrassed when interacting with others.

• Criticizing themselves after social interaction.

• Having few friends and having difficulty making or maintaining friendships.

• Reveals little about themselves when talking to others.

• Afraid to ask others to meet up.

• Speaks softly, mumbles, or stutters over their words.

• Not wanting to go to social events such as parties.

• Worrying for days or weeks before a public event.

Pay attention to the physical appearance of the teen, as this may give insight into how they may feel in social situations:

• They may talk with their head down, or arms crossed and slouched posture.

• They may engage in nervous habits such as nail biting, hair twirling, or constantly fidgeting.

• Blushing

• Sweating

• Trembling, such as their hands or legs shaking.

• Few facial expressions.

• Lack of eye contact and looking away from the social group.

It may become obvious that a teen has SAD by noticing their school behavior. Their teacher may report that the teen:

• Is afraid to speak up in class or contribute to class discussions.

• Does not ask their teacher for help even when they are struggling.

• May be visibly uncomfortable in the spotlight, such as when giving presentations to the class.

• Avoid their classmates outside of class, perhaps eating and playing alone.

• They may do poorly in school compared to their peers.

How do teens express that they have social anxiety?

It can be important to also pay attention to what the teen is saying, as this can indicate that they are feeling socially anxious.

They may express they think that no one likes them or that they are a ‘loser’ or start saying that they do not want to attend school or do not enjoy school.

They may not explicitly say that they are feeling anxious. Still, they may complain of physical symptoms in social situations, such as having headaches, feeling sick, feeling dizzy, and complaining of the room being hot.

How can SAD get worse?

Those with SAD may prefer to alleviate their anxiety by avoiding social situations which make them anxious.

For instance, a teen with SAD may choose to avoid attending parties with their peers so that they are avoiding being anxious. Some with SAD may use safety behaviors to utilize when in social situations.

Safety behaviors can include excessively checking their phone, wearing headphones, rehearsing what to say to others, and drinking alcohol. All these behaviors can be used to make the social situation more tolerable for someone with SAD.

While avoidance and safety behaviors can provide instant relief from anxiety, they can make these individuals more anxious in the long term.

Even if they are not avoiding the situation, the safety behaviors prevent them from fully testing their fears of social settings.

These behaviors can make it harder for those with SAD to face social situations in the future that are unavoidable and where safety behaviors are not possible.

They may be more likely to have negative thoughts about themselves and strongly believe that a ‘social catastrophe’ will occur since they have not fully tested these beliefs previously.

How can SAD Affect Teens?

Missing out

Teens with SAD may feel disappointed over missed opportunities they were too fearful of trying.

They may have missed out on attending parties, partaking in extracurricular activities, or talking to potential new friends.

They may also miss the chance to share their talents, such as not getting involved in school talent shows, plays, or trying a team sport.

Feeling lonely

Since teens with SAD may struggle with initiating and maintaining friendships, they can become very lonely.

They may also be too fearful of going on dates or even talking to someone they have a romantic interest in, meaning they may find it hard to date.

School problems

Issues in academic performance may arise for teens with SAD. They may do less well than their peers on group projects and presentations due to their fear of speaking in front of others.

They may be less likely to ask for help in class and may even have trouble attending classes, resulting in lower school performance.

Low self-esteem

Due to all the associated problems teens with SAD may experience, they may develop low self-esteem and a lack of self-confidence.

This can be in combination with negative self-talk, such as being overly critical about themselves and feeling worthless.

Risk of other mental health disorders

Untreated SAD may increase the risk of developing other mental health conditions, especially as they get older.

They may be at a higher risk of developing depression, eating disorders, substance use disorders, other anxiety disorders, and even suicidal ideation.

How to help your teen

Embrace discomfort

Anxiety is not likely to be stopped completely as it is natural to experience some discomfort in many situations.

In order to manage their fears and develop confidence, teens with SAD should learn to stop avoiding things that make them anxious.

They should accept that it is not an easy process and that overcoming social phobia means having the strength to go beyond what is comfortable.

Break the avoidance cycle

Since avoidance and safety behaviors can keep the anxiety going and even worsen it, one of the best things to do for a teen with SAD is to break the cycle of avoidance.

This can be done by encouraging your teen to approach situations that make them anxious.

In the short term, this can elevate anxiety, but in the long term, it will give opportunities to test their fears and build their confidence in being able to cope.

Set realistic goals

Start off small and choose realistic and achievable goals for your teen. This could include goals such as joining a club or making a new friend.

Outline the small, manageable steps that can be taken to reach this goal.

Challenge beliefs

After encouraging your teen to approach anxiety-inducing situations, you can help them to challenge their beliefs about the situation, reflecting on what happened.

You could ask them, ‘Were the negative beliefs about the situation accurate?’, ‘Did something go wrong?’ and ‘What went well?’.

You could also encourage them to rate their anxiety before the anxious situation and then again after it is over to help them reflect on how they feel.

Relaxation techniques

Work with your teen to find relaxation exercises that work for them. This could include activities such as drawing, listening to music, yoga, or meditation.

You could experiment together to find the most effective technique for calming anxiety.

Relaxation exercises such as deep breathing can also be utilized when the teen is challenging themselves to break the avoidance cycle.

Educate your teen

It can be helpful to teach the teen about why they feel anxiety, so they have an understanding of the physical changes during these periods of stress.

They could be taught about the fight-or-flight response and the stress hormones involved during heightened anxiety.

This can be helpful for normalizing the responses and understanding that what they are feeling is normal.

Expect setbacks

It is important to expect some setbacks when learning to manage SAD. For instance, there may be times when someone may actually criticize or give judgment to your teen.

It is essential that they try not to focus on the setbacks too much and instead focus on what they can do to get back on track.

They can also use these setbacks to build resilience and have more of an understanding of what to do if they find themselves in a similar situation again.

Role of school

Getting schools on board can play a vital role in your teen overcoming their social anxiety.

This is because school is likely a place where someone with SAD is likely to be the most anxious. School-based interventions led by psychologists, social skills training, and academic skills training can all be helpful ways that schools can intervene in teens with SAD.

Therapy

If a teen’s social anxiety is getting to a stage where it is becoming unmanageable, or they may need some extra help, talking therapies such as cognitive behavioral therapy ( CBT ) may be considered.

CBT is used to identify and challenge negative thinking patterns and behaviors and restructure these into healthier ones.

Working with a therapist who understands SAD can allow your teen to understand their fears and work on successful coping strategies.

References

Bank, S., Burgess, M., Sng, A., Summers, M., Campbell, B., & McEvoy, P. (2020). Stepping Out of Social Anxiety. Perth, Western Australia: Centre for Clinical Interventions.

National Institute of Mental Health (2016). ANXIETY DISORDERS. https://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml

Scott, H. (2018, June 18). GUIDANCE FOR PARENTS OF TEENAGERS: DOES YOUR SHY TEEN HAVE SOCIAL ANXIETY DISORDER? National Social Anxiety Center. https://nationalsocialanxietycenter.com/2018/06/18/guidance-parents-teenagers-shy-teen-social-anxiety-disorder/