• Mar 07, 2017

When Kids Are More Than Shy

Lucas (not his real name) moved to Cambridge from Brazil in middle school.

By Lauren Marchette, PhD, Child Psychologist and Harvard Medical School Instructor in Psychology.

He loved playing soccer and was involved with his church, but going to school was hard. By the time Lucas started high school, he had no friends at school, had a difficult time talking with people he did not know well, and avoided joining any school clubs, groups or organizations – including the soccer team. He was lonely and miserable, longing for more friends and to feel a sense of belonging.

It may take time for kids to figure out social settings. They may stand on the sidelines before joining in with other children to play a game or talk in class. We often call these kids “shy” but this label may not capture how uncomfortable some children feel in social situations. While many kids are eventually able to find their place in social settings, some remain on the sidelines. These kids may be struggling with more than just shyness. They may have social anxiety disorder (also known as social phobia).

When and Why?
Anxiety is normal and can be helpful. It keeps us safe by letting us know when there is danger nearby. However, some kids feel anxiety when there is no real danger. Kids with social anxiety, like Lucas, often have trouble managing everyday situations. They may be terrified about making a mistake or accidentally doing something embarrassing and being judged or rejected. This can keep them from answering a question in class, eating in front of friends in the cafeteria, or even making a phone call.

This may eventually result in missed school, poor performance in class, not spending time with peers, or just not enjoying being a kid. They may spend weeks worrying about an upcoming event or avoid places or activities because it is hard to be around people they think might make fun of them.

About seven percent of youths in the United States have social anxiety disorder. People usually start experiencing it around age 13, but it can start earlier or later. The cause is not exactly clear but research suggests it comes from a combination of genetics and the environment.

The Important Role of Families
Parents may notice that their child seems nervous or anxious around others, or is avoiding places where people will be. Parents may fear that talking with their child about how he or she is feeling could make things worse. But parents can play an important role in helping their child bravely overcome social anxiety.

Tips for parents:

1. Tell your child it’s normal to feel anxious (or nervous, or scared or whatever word your child uses to describe this feeling), and that we all feel this way sometimes. Explain that anxiety helps keep us safe by warning us about danger. But sometimes we feel anxious in a situation that isn’t actually dangerous.
2. Tell your child there are tools that can help manage how he or she is feeling. Learn deep breathing and muscle relaxation exercises with your child and practice them together.
3. Help your child think more positively and realistically about the situation causing anxiety. This is especially useful for older children and teenagers. It may not work with younger children who aren’t yet able to change their thinking. To guide this thought reframing you can ask your child or teenager:
   
   • What are you afraid could happen?
   • How likely is that to happen?
   • If it did happen, how could you handle it?
4. Share one of your own experiences about a mistake or embarrassing thing you have done and explain how you got through it.
   
5. If you still have concerns about your child, please contact a mental health professional for additional support. Overcoming social anxiety in therapy requires hard work but it can be very rewarding. Cognitive Behavioral Therapy (CBT) is a well-known and effective treatment for social anxiety. CBT teaches kids different ways of behaving and thinking to feel better. Exposure therapy is a type of CBT in which kids gradually face fears, ultimately learning how to handle stressful social situations. With your support and the expertise of a mental health professional, your child can learn to take control of his or her social anxiety and enjoy being around other people more.

Other Tools
The Anxiety and Depression Association of America is a good resource.

A Success Story
Lucas entered therapy with the goals of meeting more friends and feeling more comfortable at school and around other people. Using CBT, I worked with Lucas to gradually help him face his social fears and accomplish his goals.

One of the first steps was to have him simply wave at someone he didn’t know. This progressed to saying “hi,” then asking a question to start a conversation, and then holding brief conversations. Lucas also learned deep breathing exercises to calm his body and reduce his heart rate. We also worked to change his worried thoughts to more positive, realistic ones.

Now a senior in high school, Lucas plays on his school’s soccer team, is part of the debate club, and has many friends. He occasionally emails me or stops by my office to let me know how well he is doing. He’s looking forward to going to college and continuing to make new friends.

Disclaimer
This articles provide general information for educational purposes only. The information provided in this article, or through linkages to other sites, is not a substitute for medical or professional care, and you should not use the information in place of a visit, call consultation or the advice of your physician or other healthcare provider.