The curtains part. The audience stills. You step up to the microphone with your carefully prepared lines. You’ve worked for this performance all year. Carefully, you clear your throat and open your mouth to speak.
And your mind goes horribly blank.
Ever been there? Maybe you’ve never had that exact experience, but you can imagine the terror of that moment. Your throat might tighten or your palms might sweat, and you would probably rather be anywhere than on that stage.
Believe it or not, there are people for whom that scenario happens every day, only it doesn’t necessarily happen on a stage or in front of a huge audience. It might happen in a classroom or in the lunch room. It happens in one-on-one conversations on the playground or in social settings that shouldn’t be the least bit intimidating to anyone.
Children and adults alike battle something called social phobia, also known as social anxiety.
What is it?
Social phobia is a chronic mental health condition, and is actually a common disorder.
It is important at the outset to understand that this disorder is not simply a personality problem or a dislike of people (the way someone might dislike a color or a food). Social phobia is characterized by extreme self-consciousness that terrorizes a person and impairs him or her from engaging in normal activities and conversations. A person with social anxiety might panic in a restaurant when asked to place an order, for instance.
Social phobia most commonly begins in the early teen years and, if left undiagnosed or untreated, can follow a person into adulthood where the consequences are extensive.
What causes it?
According to the Mayo Clinic, social phobia can result from several factors including:
- Genetics. Anxiety disorders are often genetically traced.
- Chemicals in the brain. Specifically, sensitivity to serotonin may be responsible
- An overactive brain structure. Heightened responses to fear may be due to an overactive amygdala (the part of the brain that processes emotions).
- Negative social experiences. Humiliation, rejection, and other harmful events in childhood can shape a person’s fear of people.
It is no surprise that children who have been excessively teased, bullied, or humiliated are at a higher risk of experiencing social phobia. (Makes sense, right?) These behaviors have, in essence, shaped the child’s expectations of personal interactions. Until the child experiences a series of positive personal interactions, his expectation will not change.
What are the symptoms?
Social phobia is, at its core, a phobia. And what is a phobia by definition?–an irrational fear that is disproportionate to the risk.
Back to the original example of speaking in front of an audience. Most people, including seasoned public speakers, experience heightened nerves at the prospect of performing in front of a crowd. So the tight throat and sweaty palms are completely normal. Someone who struggles with social phobia is excessively anxious about any social situation, including the following:
- meeting someone for the first time
- entering a room full of people
- making eye contact
- using a public bathroom
- responding to a question in a classroom
This person may experience any of the following:
- visible trembling
- frequent blushing
- rapid heartbeat
- upset stomach
- sudden dizziness
Young children may throw a fit or get particularly clingy in a social context that doesn’t merit it.
Children who struggle with social phobia may fear going to school, restaurants, church, or any setting in which crowds gather or in which he or she may be expected to participate.
Doesn’t every child experience social anxiety?
Yes, many children do experience some degree of social phobia as a normal part of growth and development. Children may be (and to some degree should be) uncomfortable around strangers or in new environments or situations. A child who doesn’t want to go to school or throws a fit in a restaurant isn’t necessarily someone who will experience severe social anxiety disorder for the whole of his life. Often a child simply needs to adjust to a new situation or person.
Children who experience social phobia will consistently demonstrate anxiety in a familiar setting long after he or she should feel comfortable before adults recognize that the fear isn’t going away.
How is it diagnosed?
A medical professional asks the child (or adult) a series of questions to see whether or not physical triggers are responsible for the anxiety. Unlike diabetes or high blood pressure, social phobia can’t be diagnosed with a lab test. Instead, the doctor may ask for a detailed list of instances when the anxiety was at its worst. The child or parent may need to complete a questionnaire.
Prior to talking to a doctor, the parent should consider journaling instances when the anxiety flared.
- What triggered it?
- Who triggered it?
- How did the child respond?
- How was the response handled?
- What eventually caused the child to relax?
Knowing the answers to some of these questions may save time and effort in the doctor’s office.
Why treat it?
Sometimes it’s easy to believe a child will simply outgrow a disorder. Specifically as it relates to phobias, parents might be tempted to hope that time and maturity will provide the cure.
This is not necessarily true with social anxiety.
Untreated over time, social phobia works like a wildfire. What begins as a stray spark can eventually engulf an entire forest, leaving a trail of devastation. Anxiety has the power to control a person from the inside out, making school, work, and home life impossible.
Consider the following consequences of social anxiety if left untreated into adulthood:
- alcohol and substance abuse
- missed work days
- failed relationships
The child that once had social phobia becomes an adult who can’t do life at all.
The truth is, a person who is anxious around people doesn’t need to suffer silently. A century ago, parents who didn’t understand social anxiety simply assumed their child was being inconsiderate or uncivilized and punished him or her until things changed. Now parents and professionals have a better understanding of the phobia as well as the treatment plan and can confidently help the child become a healthy participant in previously difficult settings.
The prognosis for overcoming social phobia is good if treated correctly in a timely manner.
How is it treated?
The good news is that social phobia can be treated with therapy and does have a good history of success. Therapists essentially work with the child to help him or her control the anxiety and overcome the negative thinking in order to modify the unwanted behavior. Some therapists choose to introduce the child to controlled situations in which the social phobia is heightened so that the child can face it in a successful environment where the outcome can provide the child with confidence and success.
In some cases professionals choose to treat the phobia with medication. This choice is made on a per-child basis and does not mean medication will be a long-term treatment plan.
How can I support my child with social phobia?
It is important to understand that your child’s phobia is not necessarily a reflection of your parenting. The fact that you want to help your child in the best possible way speaks volumes about your care. In addition to talking to your child’s doctor or seeking the advice of a licensed therapist, you can do the following:
- Avoid forcing your child into situations where he or she is truly afraid. Sometimes, in a genuine effort to help a child overcome a fear, parents force too much too soon. This may actually backfire as the child may lose trust in his caregiver.
- Be as patient as possible. Phobias require a lot of energy and attention. One of the reasons phobias are difficult to handle is because, by definition, they don’t respond well to reason and logic. This can be frustrating. Remember, your child can get better. The more he feels your love and support, the more likely he is to overcome his fears.
- Remind your child to use the things he has learned. Various breathing techniques and thought processes are helpful in stressful situations. Ask your child’s doctor to give you things you can do to help your child feel comfortable when he is afraid.
Can you see it now?
The curtains part. The audience stills. Your child steps up to the microphone with his carefully prepared lines. He’s worked for this performance his entire life. Carefully, he clears his throat and opens his mouth to speak.
And what comes out is confidence and fearlessness.
Social phobia doesn’t need to have the last word.