My phone rings and the parent on the other end is asking for support for her “very shy” daughter. She describes her 13-year-old to frequently turn down birthday party invites, doesn’t participate in class and usually spends lunch in the library. The mother describes both herself and her spouse as very outgoing, so she doesn’t know how her daughter became so “shy.” Within a few sessions and after gaining a clear understanding of the client’s social experience, I am able explain to both the parent and teenager the difference between just being “shy” and being “socially anxious.”
According to the Anxiety and Depression Association of America, 6.8% of the American adult population have Social Anxiety Disorder and symptoms typically begin around the age of 13. A person who describes themselves as shy but does not have social anxiety is usually comfortable and accepting of their shyness. It doesn’t interfere with their daily functioning.
Difference Between Shyness and Social Anxiety
Many of us can relate to feeling shy from time to time and the presence of this feeling is attributed to the social circumstances given to us at a particular moment in time. Eating lunch with new co-workers on your first day at a new job, being set up on a blind date or taking a hip-hop dance class for the first time can make many people feel timid, but it doesn’t mean they are socially anxious. Someone who is socially anxious is unhappy with feeling shy and feels anxious in all social situations on a persistent daily basis. They long for more connections with others but become frozen or stuck when trying to start a conversation or attention is put onto them.
Middle school is time of many social, emotional and academic changes and symptoms of social anxiety start to show up in disguise. Some parents and teachers assume that the student is having difficulty adjusting to the new demands of middle school and requires some support with acclimating to the new environment. This may be true, but a particular kind of support is needed if the teen has social anxiety. You can’t just force her into the school dance with 300 other students on the list. Imagine someone told you that you have to go the local zoo and feed the lion. They also told you that you have no choice in the matter, you just simply just have to do it. This is what it feels like for teens with social anxiety when they are forced into social situations without equipping them with the tools they need to effectively and safely do it. Just like you would need to go feed that lion. You’d require a lot of help from the experienced zoo keeper and some training and practice to give you the right mindset to get yourself into that cage.
Many teens I have treated with social anxiety describe themselves as feeling so overwhelmed with social interaction that they avoid it at all costs throughout their school day. They take alternate routes in the hallways between classes, they eat lunch with their teacher instead of walking into the cafeteria and literally vomit the day of their best friend’s Bat Mitzvah celebration. Some parents feel as though their teen might feign illness to avoid the social event, but anxiety can trigger the presence of very real physiological symptoms like headaches, nausea and stomach aches. These teens don’t feel good about what is happening within themselves and really want to be able to have a “normal” day and not feel anxious amongst their peers.
If you are wondering if your teen may have social anxiety, talking with a psychotherapist can help you clarify what your child may be going through. Here is the current DSM-5 criteria for social anxiety:
- A persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The individual fears that he or she will act in a way (or show anxiety symptoms) that will be embarrassing and humiliating.
- Exposure to the feared situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally pre-disposed Panic Attack.
- The person recognizes that this fear is unreasonable or excessive.
- The feared situations are avoided or else are endured with intense anxiety and distress.
- The avoidance, anxious anticipation, or distress in the feared social or performance situation(s) interferes significantly with the person’s normal routine, occupational (academic) functioning, or social activities or relationships, or there is marked distress about having the phobia.
- The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months.
- The fear or avoidance is not due to direct physiological effects of a substance (e.g., drugs, medications) or a general medical condition not better accounted for by another mental disorder.
Treatment for Social Anxiety
There are a wide range of options for helping people with social anxiety. For example a variety of psychotherapeutic methods have been shown to be effective. One popular method of psychotherapy that has proven beneficial is Cognitive Based Therapy (CBT). CBT techniques help clients recognize irrational thought patterns that lead to feelings of anxiety, which prevents them from being able to socialize. For example I ask my clients list all possible feared situations and rank them in a hierarchy. They are then slowly exposed to weekly situations listed in the hierarchy and are taught to use certain coping skills that are discussed in weekly sessions to help them accomplish these exposures and start to socialize in the way that they desire. Along with psychotherapy, there are many other remedies that have proven effective in helping with social anxiety. For example practicing gratitude, making an effort to overcome social isolation, and practicing kindness, are but a few options.
