What is SAD?
Anxiety is usually related to fear of being criticized, embarrassed, or being judged by others. Diagnostic criteria include the following: persistent and intense fear about specific social situations, avoiding these situations, excessive anxiety that interferes with daily living and is out of proportion to the social situation, not explained by medical condition/medication/substance. ( See https://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/diagnosis-treatment/drc-20353567)
How to Recognize SAD
The following potential symptoms of a SAD are outlined by the National Social Anxiety Center (https://nationalsocialanxietycenter.com/2018/06/18/guidance-parents-teenagers-shy-teen-social-anxiety-disorder/)
Possible Behavioral and Emotional Symptoms
- Intense fear of situations where the teen may be judged by others
- Feeling overwhelming anxiety when around unfamiliar people
- Excessive fear of being embarrassed or humiliated by their own actions
- Fear and avoidance of social situations
- Extreme fear of being thought foolish by others, even with an understanding that the fear is unreasonable
- Dread of social events that begins days or weeks in advance
- Severe test anxiety
- Irritability or anger before a social event
- Hyper-sensitivity to criticism
- Poor school performance
Possible Physical Symptoms
- Trembling or shaking when around others
- Blushing, flushed skin
- Difficulty speaking, shaky voice
- Rapid heart beat
- Nausea / stomachache
- Feeling dizzy or faint
- Muscle tension
“Children and teens with social anxiety disorder have an excessive and persistent fear of social and/or performance situations such as school, parties, athletic activities, and more.” (https://www.anxietycanada.com/disorders/social-anxiety/)
Social anxiety disorder often begins in early adolescence, but it can occur in children. A stressful or particularly embarrassing situation might be the start. The percentage of teens is about 7% (equal for males and females). Problems might include low confidence socially, poor academic achievement, trouble making and maintaining friends, depression or substance use.
Anxiety Canada website (https://www.anxietycanada.com) lists examples of thoughts (e.g., “they won’t like me”) emotions (e.g., anxiety, shame, sadness) and behaviors (e.g., school refusal, not talking in class, mumbling or poor eye contact). Teens might have particularly negative and critical thoughts about themselves and inaccurate or more extreme negative interpretation of other people’s actions. Misreading other people might also contribute to more intense SAD.
The aim of treatment of SAD is to reduce anxiety and improve daily functioning, allowing children to better cope with school and social situations. Cognitive behavioral therapy (CBT) is effective in treating a social anxiety disorder. CBT teaches how to recognize thoughts, emotions, and reasons for behaviors. It helps teens learn how thinking, feeling, behaving, and reacting to situations is connected and focuses on helping teens learn strategies that can help reduce and better manage anxiety and build social skills. If you notice several of the behaviors listed above and think that social anxiety has reached a level that is significantly interfering with your child or teens functioning please reach out to your pediatrician or a qualified therapist. Additional websites with resources for parents are listed below.
References and Resources: