- How to Help a Teen With Extreme Social Anxiety
- Anxiety Disorders: Know the Symptoms
- DSM-5/SAI Diagnostic Criteria for SAD
- Steps You Can Take
- What Kind of Treatment Should I Expect?
- Your Teen Can Heal
- Anxiety disorders: pre-teens and teenagers
- Signs of anxiety disorders in teenagers
- Getting professional help for anxiety disorders in teenagers
- Supporting teenagers with anxiety disorders at home
- Teenagers recovering from anxiety disorders
- Types of anxiety disorders in teenagers
- 7 Tips for Teens with Social Anxiety
- 1. Remember You’re Not Alone
- 2. Practice Breathing Exercises
- 3. Face Your Fears Head On
- 4. Fight Negative Self-Talk
- 5. Encourage Your Teen to Find a Support Group
- 6. Embrace Discomfort
- 7. Practice Makes Perfect
- Hope for Teens with Social Anxiety
- Book An Appointment
How to Help a Teen With Extreme Social Anxiety
We recently posed a question on social media:
“Hey Parents of Teens! What Do You Want to Know? What topic would be the most helpful for you? If you’ve ever thought, ‘I wish I had a guide to deal with this problem!’ Now is your chance to ask for that guide.”
Members of our community replied with their most pressing questions. One concerned mother commented,
“Following. I have a 17-year-old son. His social anxiety is debilitating.”
This post is for her, her son, and any parent with a teen struggling with social anxiety. The first thing we want you to know is this:
You are not alone.
The most recent information from the National Institute of Mental Health (NIMH) shows that in the U.S. as of 2014, 9.1% of adolescents had Social Anxiety Disorder (SAD – not to be confused with Seasonal Affective Disorder) and about 1.3% had severe impairment as a result. In raw numbers, that’s about 2.
5 million teens with SAD and about 250,000 with SAD symptoms that cause severe problems in their daily functioning. Which means there are literally thousands, if not millions, of families out there who can relate to what you’re going through.
Many of the links in this article will take you to websites with a wealth of resources for you and your child.
The second thing we want you to know is possibly the most important thing:
Anxiety – even debilitating social anxiety – is treatable.
Before we discuss the best practices for treating SAD, we want to make sure we’re on the same page about exactly what it is and what the symptoms are.
Anxiety Disorders: Know the Symptoms
According the National Association on Mental Illness (NAMI), all anxiety disorders share this common trait:
“Persistent, excessive fear or worry in situations that are not threatening.”
NAMI advises parents to keep an eye out for the following symptoms:
- Heightened fear of regular daily situations
- Extreme irritability and/or restlessness
- Always assuming the most negative outcome for any future event
- Extreme agitation or nervousness
- Increased heart rate and/or hyperventilating
- Insomnia, fatigue, headaches
- Twitching, sweating, or tremors
- Frequent trips to the bathroom
Those are the symptoms common to all anxiety disorders. But what about the symptoms specific to SAD? The Social Anxiety Institute (SAI) streamline the clinical definition of SAD, The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the reference manual mental health professionals use to diagnose mental health disorders.
DSM-5/SAI Diagnostic Criteria for SAD
- 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.
In children, there must be evidence of the capacity for age-appropriate social relationships and the anxiety must appear in peer settings, not just interactions with adults.
- 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 drugs, medications, or a general medical condition not better accounted for by another mental disorder.
If your teen meets these criteria, you can do an informal check. Ask your teen to take one of these online questionnaires, which were developed by mental health professionals:
Please understand that while professionals created these tests, they cannot replace an in-person assessment conducted by a fully licensed and certified mental health provider. So, if your teen meets these criteria, what next?
Steps You Can Take
Your next step is to consider seeking professional help. There are many resources you can utilize.
Start with the three sites above: The Social Anxiety Institute, Psychology Today, and the Anxiety and Depression Association of America.
To find a psychiatrist near you, you can use this Online Child and Adolescent Psychiatrist Finder maintained by the American Academy of Child and Adolescent Psychiatry.
If you seek professional help, make an appointment, and the psychiatrist advises a course of treatment for your teen, then you should take their advice. Because, as we mentioned above, anxiety is treatable and even people with extreme anxiety can successfully manage their symptoms.
What Kind of Treatment Should I Expect?
Research shows the best way to treat SAD is through a combination of medication and therapy:
- Medications typically include:
- Anxiolytics, a.k.a. anti-anxiety medications
- Common therapeutic approaches to SAD include:
- Cognitive-Behavioral Therapy (CBT)
- Dialectical Behavior Therapy (DBT)
- Exposure Response Prevention Therapy.
In addition to traditional therapy and medication, many complementary therapies are effective approaches manage anxiety.
Note: in this context, complementary means in addition to and not in place of.
While the following approaches may help on their own, our best advice is to use them under the guidance of a mental health professional, in conjunction with their recommended course of treatment:
- Mindfulness-Based Stress Reduction (MBSR) techniques
- Breathing exercises
- Walking meditation
- Seated meditation
- Power Yoga
- Hatha Yoga
- Hot Yoga
- General Exercise
- Group exercise: aerobics, etc.
- Weight training
Your Teen Can Heal
Sometimes anxiety is its own worst enemy. It creates a vicious cycle that’s hard to break. Your teen may worry about an upcoming social situation, then try the coping mechanisms they have at hand to deal with their anxiety.
Then, if they don’t work, that failure to manage their anxiety causes more anxiety – and this situation can repeat itself over and over again, gaining energy all the while, and a snowball rolling down a hill, increase in size and scope until it’s out-of-control and virtually unmanageable.
You can help your teen avoid this – with the professional interventions we discuss above – but also with your compassion and understanding.
The best thing you can do, before you get professional help, is to validate their feelings and let them know you’re there for them, you love them, you support them, and you’ll help them get through this difficult period.
With a caring support system behind them, the chances of successful treatment increase dramatically.
Your teen can turn their symptoms from debilitating to manageable, which can make all the difference and lead to a balanced life and improved sense of happiness and overall well-being.
Angus is a writer from Atlanta, GA who writes about behavioral health, adolescent development, education, and mindfulness practices yoga, tai chi, and meditation.
Anxiety disorders: pre-teens and teenagers
Most normal feelings of anxiety last for only a short time – a few hours or a day.
An anxiety disorder is when anxious feelings:
- are consistently very intense and severe
- go on for weeks, months or even longer
- interfere with young people’s learning, socialising and everyday activities.
Anxiety disorders can be treated very effectively. And the earlier they’re treated, the less ly they are to affect young people’s mental health and development in the longer term.
Everybody feels anxious sometimes. In fact, some anxiety can even be a good thing. You can read more about normal anxiety in pre-teens and teenagers.
Signs of anxiety disorders in teenagers
Talk with your child and see a health professional if, over a period of more than two weeks, your child shows these thinking, emotional, behavioural and physical symptoms. Not all the symptoms have to be present for there to be an anxiety disorder.
Your child might:
- have trouble concentrating
- say their mind is racing and they can’t think straight
- often seem forgetful or distracted
- put things off – for example, have trouble starting or completing schoolwork.
Emotional and behavioural symptoms
Your child might:
- feel constantly agitated, tense, restless or unable to stop or control worrying – your child might seem unable to relax
- seem very sensitive to criticism or extremely self-conscious or uncomfortable in social situations
- always expect the worst to happen or seem to worry too much or in a way that’s proportion to problems or situations
- avoid difficult or new situations, or have difficulty facing new challenges
- be withdrawn or very shy, or become isolated by avoiding social activities
- feel that they must do a particular action, touch things in a particular order
- have obsessive thoughts or images that they can’t get their head.
Your child might:
- have tense or sore muscles
- go to the toilet more than usual
- have a racing heart, chest pain, sweating, headaches, dry mouth, stomach aches, nausea, vomiting or diarrhoea
- have sleeping problems, trouble falling asleep, staying asleep or waking early
- feel short of breath.
A teenage anxiety disorder might be hard to spot. Many teenagers are good at hiding their feelings and thoughts. They might even mask their feelings with aggressive behaviour or withdrawal. There are also several different types of anxiety disorders in teenagers, and not every child will have the same symptoms.
Getting professional help for anxiety disorders in teenagers
An anxiety disorder is unly to go away on its own, but most anxiety disorders improve with treatment. Seeking professional help early for your child is the best thing you can do. Also, getting treatment for your child shows your child that you care and sends the message that your child isn’t alone.
Options for professional help include:
- your GP, who can guide you to the most appropriate services for your family if you don’t know where to go
- psychologists – you don’t need a referral, but your GP might be able to recommend someone
- school counsellors or counsellors
- telephone parenting hotlines or Lifeline – 131 114
- your local community health centre or local mental health services.
Psychological treatment usually focuses on strategies to help teenagers cope with anxiety. This means that teenagers learn to manage anxiety rather than avoid it. Teenagers don’t usually need medication, but health professionals might prescribe it under certain circumstances.
You can read more about mental health treatment options and get more mental health links and resources.
Your child might not want to talk with you about how they’re feeling. Your child might even say there’s nothing wrong. If so, you could suggest a confidential telephone counselling service for young people, Kids Helpline for teens – 1800 551 800. Your child could also go to Kids Helpline – Teens.
Supporting teenagers with anxiety disorders at home
There are many ways you can support your child with an anxiety disorder and look after your child’s mental health at home.
Here are some ideas:
- Acknowledge your child’s fear – don’t dismiss or ignore it. Let your child know you’re there to support and care for them.
- Gently encourage your child to do the things that they’re anxious about. But don’t force them to face situations they don’t want to face.
- Wait until your child actually gets anxious before you step in to help.
- Praise your child for doing something they feel anxious about.
- Avoid labelling your child as ‘shy’ or ‘anxious’. Try to refer to your child as ‘brave’ or another positive term. After all, your child is trying to overcome their difficulties.
- Try to be a good role model by managing your own stress and dealing with your own anxiety.
If your child is being treated for anxiety by a professional, you should discuss these strategies with the professional first. You can also ask the professional for suggestions about how to help your child use the strategies they’ve learned in therapy sessions.
Strong parent-teenager relationships are good for young people’s mental health. A sense of belonging to family and friends can help protect teenagers from mental health problems anxiety disorders. Your support can have a direct and positive influence on your child’s mental health.
Teenagers recovering from anxiety disorders
Your child’s recovery from an anxiety disorder will probably have some ups and downs. Many young people who experience an episode of anxiety will have another episode, or go through some symptoms again in the future.
No-one is to blame for a setback. Go back to your health professional to help your child find new ways to manage anxious feelings and thoughts.
You play an important role in helping your child to develop confidence in their ability to overcome anxieties. You can also be on the lookout for warning signs that might indicate your child is relapsing.
Types of anxiety disorders in teenagers
There are several different types of anxiety problems that health professionals classify as disorders:
- Social phobia or social anxiety disorder is an intense fear of social situations or of being judged or embarrassed in public.
- Generalised anxiety disorder is excessive worry about many everyday situations.
- Specific phobias are intense fears of situations or objects – for example, dogs or heights.
- Panic disorder is repeated, unexpected panic attacks. A panic attack is an overwhelming feeling of fear or panic in a situation where most people wouldn’t be afraid.
- Agoraphobia is a fear of being in situations where it might be hard to escape or get help if things go wrong.
- Separation anxiety disorder is an excessive fear of being separated from home or a loved one.
Young people might be diagnosed with more than one type of anxiety disorder. They might also experience anxiety along with other physical or mental health problems depression.
7 Tips for Teens with Social Anxiety
For teens with social anxiety, the high school years can feel particularly challenging.
Trying to cope with expectations, changing bodies, and meet their school demands places a lot of pressure on students. Fortunately, there are ways to fight social anxiety and enjoy being a teenager.
Successfully managing social anxiety doesn’t happen overnight. The first step is being willing to do something about it and not just accept it as reality.
Once your teen has made the commitment to overcome their social anxiety, these 7 tips to help them get there.
1. Remember You’re Not Alone
It’s easy for teens with social anxiety to feel they are suffering by themselves. But the reality is there are a lot of people who have similar fears.
Feelings of anxiety are normal. It’s a natural response to fear and discomfort embedded in our DNA for as long as we’ve been here. In fact, more than half of Ontario’s youth has admitted to missing school because of anxiety disorder. And while there are many different reasons triggering this epidemic, struggling teens can take some comfort in knowing that they’re not alone.
The next time they encounter a tough social situation and feel those familiar anxieties creeping in, remind your teen that those feelings are natural and common. Other teens with social anxiety have conquered their fears, and they can too.
2. Practice Breathing Exercises
Stressful situations can affect breathing which, in turn, adds more stress and triggers a chain reaction of physical problems. Anxiety can lead to dizziness, lightheadedness, feeling disoriented, and even fainting. In fact, your teen’s social discomfort can easily become a medical issue.
For teens with social anxiety, it’s important to face fears head-on or there’s a strong risk of becoming adults with social anxiety.
Simple breathing exercises will help your child stay calm and reduce the anxiety they’re feeling at the moment. When stress creeps in, that’s the moment to pause, breathe, and get centered.
Encourage your teen to close her eyes and slowly take a deep breath. Count to 10 on the exhale and visualize all the tension evaporating with the breath.
Techniques mindfulness meditation benefit those who prefer a guided meditation. In a few minutes, they’ll feel calmer and ready to handle whatever situation they’re facing.
3. Face Your Fears Head On
Avoiding a difficult situation isn’t always the best solution. Sometimes it’s not even an option at all.
Desensitization is a tactic many cognitive therapists have used with strong results. Teens with social anxiety learn coping tools by being exposed to difficult, triggering situations. Through repetition, with patience, the impact these triggers have can be greatly reduced.
Facing your fears head-on doesn’t mean that they go away completely. But it gives you a way to fight them and the confidence in knowing that you survived them before and can do it again.
4. Fight Negative Self-Talk
Help your teenager learn to check their interior monologue. The more they tell themselves that they aren’t good in social situations, the truer it will be.
There is a lot of power in the words we speak. And for teens with social anxiety, it can be natural to recall past experiences through a negative lens.
But there are documented medical benefits to positive thinking. People who regularly engage in being optimistic have lower stress and depression levels, healthier hearts, and longer lifespans.
Dwelling on the negative could literally be making people sick. If you want to help reduce social anxiety, it will take practice and diligence.
Be your teen’s biggest cheerleader. They may not be able to resist the urge to beat themselves up over something that didn’t quite work out. But you can champion them and help them develop an alternate self-image through positive reinforcement.
5. Encourage Your Teen to Find a Support Group
Being surrounded by allies and supporters will lower your teen’s social anxiety as much as possible. If the voices that have the greatest influence on you are supportive, you will be better equipped to drown out the negative ones that arise.
Be aware of who your child’s friends are. Encourage them to hang out with people who reinforce the positive things they about themselves.
Help fight against non-supportive tendencies within their group and keep an eye out for if and when your teen is really struggling with feelings of isolation.
If they need someone to talk to who can listen without judgment, consider making an appointment with a therapist. They’ll be able to help them process their feelings in a safe space and give them tools to cope with anxiety.
A therapist can also help you support your teen better by providing you with a welcoming environment to share your own frustrations and fears.
Click here to learn more about our group for teens with social anxiety.
6. Embrace Discomfort
When you’re suffering from social anxiety, stepping into a new situation can feel staring into the deep end of a pool. The temptation is to tiptoe into it and run back at the first sign of discomfort.
Sometimes it’s better to just jump right in. After the initial shock wears off, the water feels refreshing and your fear of being too cold is no longer relevant.
Your teen won’t be able to avoid every triggering situation, and there will be some initial discomfort. However, embracing it can help them recover quickly and realize that most of it was self-created.
Help your child get used to being uncomfortable and not being able to control everything around you. It’s important they learn to go with the flow. Know that you can’t protect them from every uncomfortable situation, but you can help them embrace it.
7. Practice Makes Perfect
The more often you expose yourself to a situation, the more routine it will become. Though your teen’s instinct may be to avoid social stress at all costs, resisting the urge to flee will make them stronger and better equipped for future stress.
Practicing their response to your triggers can help them feel more comfortable in the moment. Help your teen think through all the possible triggering scenarios they might face and formulate a game plan that ends in success.
It will build their tolerance to anxiety, much a vaccine.
With practice, they’ll begin to realize that the worst of their fears are largely impractical and, even when things don’t go perfectly, it’s not the end of the world.
Hope for Teens with Social Anxiety
No one has to be a slave to social anxiety. Your teen can enjoy life to the fullest and connect with others if they practice these tips and give themselves permission to grow.
We’re here to support you however we can. From helpful tips on our blog to our well-trained team of caring therapists, our goal is to be there when you need us.
Read how our child psychologists team can help your child’s anxiety.
Book An Appointment
If you are interested in therapy for social anxiety in Vaughan, Thornhill, Markham, or the GTA, please call 905.597.4404 or fill out the form below and you will be contacted within 24 business hours.