Is My Teen Just Shy, or Do They Have Social Anxiety Disorder?

Figuring out The Shy Kid

Anyone who spends time with children knows they come in all shapes, sizes, and personality types. One of the most important and most difficult jobs as a parent, teacher, or caregiver is figuring out what kind of child it is you’re dealing with.

A free spirit? A loose cannon? A happy-go-lucky goofball? A quiet and reserved sit-on-the-side observer? An even-keeled kid with an understated dry wit? A shy kid?

Granted – none of those types are mutually exclusive. A child can be quiet in the morning and goofy in the afternoon. A child can be totally social at lunch or on the playground, yet keep to themselves in the classroom or in other more formal situations. But spend enough time with any young person, and before long you figure out then general parameters of who they are and how they see and experience the world.

Introvert, Extrovert, or In-Between?

Many teachers and parents think extroverts – though often challenging – are easier to deal with, because everything is out in the open. They wear their hearts on their sleeve and voice their opinions without reservation. You almost always know what they’re feeling, because they tell you. Sometimes indelicately, and sometimes adorably. Either way, you know. And by easier to deal with we don’t mean your job as a parent or teacher is any easier, really – what we mean is that with extroverts you know what their strengths and weaknesses are, because they lay them bare for you and the whole world to see.

So what we mean is they may not be easier to teach, support, and manage, per se, but it’s generally a simpler process to identify what their issues are, if they have any. And therefore, deciding how to help them at home or in the classroom is straightforward because they give you a lot to work with.

But What About The Shy Kids?

What about the ones who don’t volunteer a lot of free information?

The ones who hold back, avoid jumping into social situations, and for the most part, keep to themselves?

Teachers tend to know how to handle these kids. At first, give them space. Next, draw them out. Third, find their strengths. Finally, engage them at the level they’re comfortable engaging. Parents of shy kids, however, have a different job. Teachers only have the time, energy, and resources to do so much, and they have scores of kids to concern themselves with. They can’t take everything on. Parents, however, are responsible for more than their child’s academic development: they’re responsible for the development of the whole child. They’re obliged to take everything on. When their child’s shyness has an anxious feel to it, and persists through grade school, middle school, and high school, they start to wonder if there’s something deeper going on. Especially if the shyness increases over time, rather than decreases.

If that describes your child, then it may be difficult to tell if they’re simply a shy, reserved, hold-it-all-close-to-the-vest type person, or if there’s a psychological issue at play. You may ask yourself these two questions:

How can I tell if my child has some type of anxiety disorder?

More specifically, how can I tell if my child has Social Anxiety Disorder (SAD)?

We’ll start with the first question.

Anxiety Disorders: How Can You Tell?

Anxiety disorders are not all identical. The salient characteristics differ from type to type. Common anxiety disorders include Generalized Anxiety Disorder (GAD), Social Anxiety Disorder (SAD), Obsessive-Compulsive Disorder (OCD), Post-Traumatic Stress Disorder (PTSD), Panic Disorder, and various Phobias. According the National Association on Mental Illness (NAMI), all anxiety disorders share one unifying trait:

“Persistent, excessive fear or worry in situations that are not threatening.”

NAMI describes specific symptoms to watch for:

Emotional

• Apprehension and/or dread of typical, day-to-day situations
• Constant restlessness and/or irritability
• Always anticipation or predicting the worst outcome in any situation
• Excessive tension or jumpiness

Physical

• Racing heart and/or shortness of breath
• Headaches, insomnia, fatigue
• Twitching, sweating, or tremors
• Nausea
• Frequent trips to the bathroom (diarrhea or frequent urination)

About Anxiety Symptoms

There’s a general rule of thumb to follow with regards most mental health issues, anxiety and depression in particular. We discussed this rule in a previous article geared toward teens: Is My Anxiety Normal? How Can I Tell?, but it applies here, too – even though this article is geared toward parents and focuses on Social Anxiety Disorder. You can apply this rule to yourself, your teenager, or anyone you know, for that matter. The rule has two parts:

1. When anxiety asts for more than a few days – up to two consecutive weeks – it may be an indication there’s an anxiety disorder at play, rather than typical anxiety.
2. If the anxiety disrupts the daily flow of life – meaning it prevents your teenager from doing things they like to do, makes them perform poorly on tests, keeps them up at night, or disrupts their relationships with family or friends – then they may be experiencing an anxiety disorder, rather than typical anxiety.

If your teenager meets these criteria, don’t freak out.

Anxiety is a common and treatable mental health disorder. It’s the most common mental health disorder in the United States. Statistics show about 40 million adults and about 7.5 million adolescents struggle some type of anxiety disorder. Only about 36% of people diagnosed with an anxiety disorder get the help they need, but those that do are able to manage their anxiety and lead fulfilling, successful lives.

We’ll talk about how to find professional help in just a moment.

Now that you know the basics about anxiety disorders – particularly the fact that they’re treatable – we’ll move on to the second question:

How can you tell if your child has social anxiety disorder?

Social Anxiety Disorder: The Symptoms

The Social Anxiety Institute (SAI) offers a concise and helpful definition of SAD, based on the most recent edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is the go-to, authoritative bible mental health professionals use to identify and diagnose mental disorders in children, adolescents, and adults.

DSM-5/SAI Diagnostic Criteria for SAD

1. 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 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.
2. Exposure to the feared situation almost invariably provokes anxiety, which may take the form of a situationally bound or situationally pre-disposed Panic Attack.  
3. The person recognizes that this fear is unreasonable or excessive.
4. The feared situations are avoided or else are endured with intense anxiety and distress.
5. 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.
6. The fear, anxiety, or avoidance is persistent, typically lasting 6 or more months.
7. 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 you see your child or teenager in these criteria, we’ll repeat what we said above: don’t freak out. Even if the symptoms are extreme, and last more than six months, please remember this crucial fact:

Anxiety is treatable.

Gather your emotions, and rather than worry yourself half-to-death over what you can do, read on: there are specifics steps you can take to help your child deal with their anxiety.

What You Can Do

First, choose one of the three following online tests. All three were developed by mental health professionals to assess the level of social anxiety in an individual, and ask your teen to take it:

• The Test for Social Anxiety Disorder provided by the Social Anxiety Institute. This test takes about five minutes and can give a preliminary assessment about the severity of your child’s anxiety.
• The Psychology Today Social Anxiety Test. This one stakes ten minutes and give you a basic idea of the severity of your anxiety.
• The Anxiety and Depression Association of America (AADA) Screening for Social Anxiety Disorder. This test is more formal. It’s similar to an assessment you’d take if you went to a therapist, psychiatrist, or other qualified mental health practitioner.

It’s important to understand that although professionals created these tests, they cannot replace an in-person assessment conducted by a fully licensed and certified mental health provider. That’s your next step. When these preliminary, informal screens indicate your teenager’s social anxiety exceeds the shyness and/or anxiety often typical for youth, it’s time to consider seeking professional help.

How to Find Help

To find a qualified professional in your area, use the Online Child and Adolescent Psychiatrist Finder provided by the American Academy of Child and Adolescent Psychiatry. If they screen your teen and recommend treatment – which, by the way, did we mention? is often successful – then here’s what to expect:

• The most effective way to treat anxiety of any type is through a combination of medication and therapy.
  • Medications may include anti-anxiety medications or anti-depressants.
  • Therapy may include Cognitive-Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), or Exposure Response Prevention Therapy.
• Complementary Therapies. Over the past twenty years, approaches that were once considered alternative are now – almost – mainstream. Don’t be surprised if a mental health practitioner recommends any of the following:
  • Stress management and relaxation techniques.
  • Meditation
  • Yoga, tai chi, and qigong.
  • Typical exercise such as walking, running, lifting weights, or old-school calisthenics
  • Yoga
  • Acupuncture

You and Your Child Are Not Alone

Removing stigma from mental health disorders is critical for society as a whole and for individuals suffering from SAD in particular. Data from the National Institute of Mental Health (NIMH) show that as of 2014, 9.1% of adolescents had SAD – that’s about 2.5 million – and about 1.3% had sever impairment as a result – roughly 250,000. 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 website with a wealth of resources for you and your child.

In addition to researching all the information on those sites, following the recommendations of mental health professionals, and supporting your child with unconditional empathy, love, and compassion, we also recommend seeking help. Ask friends and other family members for support. You may be both surprised and relieved when you find wise and sympathetic listeners closer at hand than you ever imagined. Nothing can replace professional treatment, but one thing you’ll learn from the professionals you consult is the importance of a solid and loving social support network for a teen struggling with emotional issues. It can make all the difference in the world. Bottom line: don’t be shy. Don’t be embarrassed. Asking for help is the opposite of weakness. It’s a sign of strength.