Social anxiety disorder is described as:

• Fear and anxiety in social situations
• Extreme shyness
• Being very timid
• Concerns about being judged by others

This affects up to 5% of children. It is the third most common psychiatric disorder in children.

Some things that trigger anxiety and are often hard for children with social anxiety are:

• Speaking in front of the class
• Talking with children they don’t know
• Performing in front of others
• Starting conversations
• Taking tests
• Interacting with strangers

Children with social anxiety are often lonely, have fewer friends than other children their age, and report symptoms of depression.

Children who develop social anxiety before the age of 12 are not likely to outgrow it. Left untreated, many grow up to be socially anxious adults. They may continue to have problems in interpersonal situations.

What Are the Symptoms?

Children with social anxiety disorder may:

• Avoid eye contact
• Speak softly
• Tremble
• Fidget
• Be nervous
• Have shortness of breath
• Have headaches and stomach aches
• Miss school because of their fears
• Throw tantrums, cry or refuse to speak (young children)

How Is Social Anxiety Different from Being Shy?

Shyness is very common. Some children with social anxiety may be so shy that they avoid everyday things, like playing sports, reading in class, music and athletic events, playing with other kids, speaking to adults, or ordering food in restaurants.

They may have thoughts such as:

• "I hope the teacher doesn't call on me."
• "I'm going to make a mistake."
• "They are staring at me."
• "Nobody likes me."
• “What if I do something stupid?”

They may feel:

• Light-headed, dizzy, have a headache
• Sick, have butterflies in the stomach
• Sweaty or clammy

How Is Social Anxiety Disorder Treated?

Children with social fears and anxiety may benefit from several treatments.

One approach is using medicines to reduce children's anxious and depressed feelings.

A second approach targets the child's anxiety and teaches ways to cope with overwhelming fear and anxiety.

Both approaches have been used with success in adults with social anxiety and have shown significant promise with young children.