How to Recognize Teenagers With Social Anxiety Disorder

Coping with social anxiety as a teen can be stressful.
Socially anxious teens need extra help from parents. Getty / Vicky Kasala

Teenagers with social anxiety disorder (SAD) often live with the problem through adulthood without ever being diagnosed. Although SAD is the third most common mental health disorder, many parents and teachers are not familiar with the signs and symptoms in children and teenagers.

Social anxiety disorder involves an intense fear or phobia of social and performance situations. Although most teenagers go through periods of normal anxiety related to the changes that go along with adolescence, those with SAD experience fear that is out of proportion to the situations that they face.

For some teenagers, social anxiety becomes chronic, affecting school performance, extracurricular activities and the ability to make friends.

How Does a Teen With Social Anxiety Disorder Act?

Do you know a teenager who appears to be socially anxious? If so, review the list below and see if it describes the teenager about whom you are thinking.

Not all of these behaviors necessarily reflect SAD. If you recognize someone when reading this list, consider helping them seek further evaluation.

Temperament

Look for a teenager who...

  • is quiet
  • keeps to him/herself
  • becomes more withdrawn if encouraged to talk
  • is hesitant
  • is passive
  • is overly concerned about negative evaluation
  • fears being embarrassed or humiliated
  • crosses his/her arms
  • keeps his/her head down
  • displays few facial expressions
  • has nervous habits such as hair twirling or fidgeting

School Behavior

In school, a teenager with social anxiety disorder may display the following behaviors:

  • potentially does poorly in school
  • doesn't raise his/her hand in class
  • avoids classmates outside class
  • fears performing in front of others/public speaking
  • fears speaking up in class
  • is uncomfortable in the spotlight
  • sits alone in the library or cafeteria
  • is afraid to ask the teacher for help
  • is afraid to walk into class late
  • may refuse to go to school or drop out

Behavior With Peers

Look for the following behaviors:  

  • is uncomfortable in group settings
  • has few friends
  • is afraid to start or participate in conversations
  • is afraid to ask others to get together
  • is afraid to call others
  • avoids eye contact
  • speaks softly or mumbles
  • appears to always be "on the fringes"
  • reveals little about him/herself when talking to others

Impact of SAD on Teens

Teenagers with social anxiety disorder are at a disadvantage in all areas of life. They may perform poorly at school and may have trouble attending classes. Students with the disorder are also less likely to make friends and participate in extracurricular activities.

Those with severe SAD may drop out of school or refuse to leave home. In addition, untreated social anxiety disorder in adolescence may lead to increased risk of other mental health problems later in life such as depression, eating disorders, substance abuse, and even suicidal ideation.

Diagnosis and Treatment

Often teenage SAD will go undetected because parents and teachers believe that the adolescent is just shy. However, early detection and intervention are crucial in the prevention of long-term impairment.

Diagnosis of social anxiety disorder in teenagers involves an evaluation of symptoms in the family context.

This evaluation will often include the perspective of parents and teachers and may involve the use of school records.

Potential underlying medical conditions are explored and other explanations for the behavior such as bullying are also considered. If the student is at risk of self-harm or suicide, these issues are addressed immediately.

Treatment of SAD in teenagers is aimed at helping to alleviate anxiety and allow the student to cope with school. Effective treatments may include

In addition to standard treatments, there are a number of coping strategies that can be employed by teachers, parents and students to manage social anxiety both in and out of school.

Schools can play an important role in this process, as it is the place where social anxiety disorder can often have the most negative effect on a teen's functioning. School-based interventions led by psychologists, social skills training, and academic skills training are all helpful ways that schools can intervene in cases of SAD.

As a parent, read about the disorder and increase your awareness of what your teen is experiencing. Be in touch with your school to coordinate efforts with teachers, school counselors, and  other personnel. Together, you can work toward improving the situation for a teen with SAD.

Sources:

Akron Children's Hospital. Social phobia

Pruitt, D. Your Adolescent: Emotional, Behavioral, and Cognitive Development from Early Adolescence Through the Teen Years. New York: Harper; 2000.

Ryan JL, Warner CM. Treating Adolescents with Social Anxiety Disorder in Schools. Child Adolesc Psychiatr Clin N Am. 2012;21(1):105-ix. doi:10.1016/j.chc.2011.08.011.

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