Question 1

Is being shy the same as having social anxiety?

Jennifer Shannon · Accepted Answer

There are similarities, but they are not the same. Shyness is is much more common and does not interfere with functioning the way social anxiety does. Most people would say that they have felt shy at some point in their lives, but only around 7% of people actually have social anxiety disorder. Both have to do with feeling uncomfortable in social situations, but in the case of social anxiety this this discomfort is severe and leads to avoidance that can severely impact one's life.

Question 2

Is social anxiety linked to low self-esteem?

Jennifer Shannon · Accepted Answer

Social anxiety is based on what I call social perfectionism. This is the belief that you must sound smart, interesting, funny.  That there should never be awkward silences in conversations. You should not stumble over words or forget peoples names. When the socially anxious person is unable to meet this perfectionistic standard, they feel they have failed and this leads to low self-esteem.  The truth is none of us can live up to this perfectionistic standard. When we start to accept this, we feel better about ourselves and have less social anxiety.

Question 3

How do I help my teen not care what other people think of her?

Jennifer Shannon · Accepted Answer

We are in a sense pack animals, meaning we survive and thrive in groups. It is part of our nature to care about what people think of us. The problem with socially anxious teens is that they catastrophize what might happen if someone judges them. For example if someone does not like their outfit, the socially anxious teen is afraid this would lead to being rejected, not just by that person, but possibly by a whole group of people.  Helping your teen identify catastrophic thinking can decrease their anxiety about the possibility of being judged by others.

Question 4

Is social anxiety a treatable condition?

Jennifer Shannon · Accepted Answer

Most definitely! In fact the treatment for social anxiety not only helps  you get your life back, but the skills you learn in treatment will help in all areas of your life. Like the treatment for all types of anxiety, the goal is not to banish anxiety from your life, but to tame it so that you can do everything you want to, like make friends, go to parties, get a job, date, give oral presentations.

Question 5

What are the key components of treatment for social anxiety disorder?

Jennifer Shannon · Accepted Answer

There are two key components. One is to recognize that the anxious thoughts you are having are not 100% true. Socially anxious teens have thought distortions for example mind-reading, assuming that you know what others are thinking about you. Or social perfectionism, setting a standard for yourself that doesn't allow for mistakes. Or spotlighting, thinking everybody is watching you and/or how you feel inside shows on the outside. The second component is exposing rather than avoiding people and situations that make you anxious. This part of the treatment is scary, but you do it one step at a time and gain more and more confidence with each step you take.

Question 6

How can I tell if my teen is simply introverted or if they might have social anxiety?

Jennifer Shannon · Accepted Answer

This can be a little tricky. As an introvert myself, I know that it is important that I have down time away from other people to recharge. Whereas  with social anxiety, this same behavior can be a form of avoidance. In other words, taking time away from people is an attempt to manage their anxiety, not to recharge.  I have attached a social anxiety quiz that can help teens identify if they may be suffering from social anxiety as opposed to simply being introverted.

Question 7

Why do you think that the social anxiety often starts in early adolescence?

Jennifer Shannon · Accepted Answer

Anxiety disorders, including social anxiety, are partially genetic. If you have a first degree relative who suffers from anxiety, for example  a parent or sibling, you are  more likely to suffer from anxiety as well. The age of onset during adolescence  is at least impart due to genetic pre-disposition. Also it is during adolescence that  we begin to care more what our peers think of us than our parents, this too contributes to social anxiety.

Question 8

How does social anxiety develop into a chronic issue?

Jennifer Shannon · Accepted Answer

The anxiety cycle starts with a thought like, "What if I say something stupid and everyone thinks I'm weird." This thought leads to a feelings of anxiety and panic. In order to decrease the anxiety, I avoid saying something so one will think I am a fool. This anxiety cycle reinforces the anxious thoughts and avoidant behavior that can lead to a chronic problem. The good news is that this cycle can be broken by changing our thoughts and behaviors using cognitive behavioral therapy interventions.

Question 9

I work in a secondary school setting. Many students present to the front office with stomach aches and wanting to go home. How should we assess and address if this is social anxiety?

Jennifer Shannon · Accepted Answer

Stomach aches and wanting to go home can be signs of a number of different types of anxiety, the most common being social anxiety, panic attacks, separation anxiety, generalized anxiety and certain phobias like emetophobia, the fear of vomiting. I have attached a quiz I developed that can help identify if the student is experiencing anxiety, and what type. Having a team meeting that includes the parents, teachers, counselors and the student to develop a plan of how to deal with ongoing anxiety is important. Creating accommodations that allow the student to leave the classroom and take a break in the office are helpful. It is not advisable to send the student home, as this type of avoidance makes the problem worse in the long run.

Question 10

Why do so many people drop out of therapy for social anxiety disorder?

Jennifer Shannon · Accepted Answer

The active ingredient in social anxiety treatment is exposure to people and situations that cause anxiety. Often times people are doing exposures, but their social anxiety is not decreasing. The reason for this is that they are applying social perfectionism to the exposure itself. For example, a common exposure is to initiate a conversation with someone. After doing this, they may think they failed because they blushed and sounded nervous, their perfectionistic expectation of themselves was they should not show signs of anxiety. If you have social anxiety, it is not realistic to think you won't show signs of anxiety when doing something anxiety producing. A realistic goal for this exposure is that even though they may blush or sound anxious, they can smile, make eye contact, and ask the other person a question. If they did do this they did great. It is all about hitting the target, you don't have to hit a bullseye. Here is a link to an article I wrote on social perfectionism.  https://overcomingteenanxiety.com/blog/

Question 11

What treatment strategies would you recommend for youth that refuse gradual exposure therapy?

Jennifer Shannon · Accepted Answer

I find an ACT strategy of having the teen identify what is important to them, what they truly value and what they are missing out on in life to be helpful when they are resistant to exposures. This can give more purpose to the exposure and motivate them. It is also important to validate avoidance as a behavioral strategy, the truth is it is effective in reducing anxiety. The problem is the cost of this avoidance and this is where values fit in.  Another strategy, which you may have already tried, is to start out really really gradual. A very common exposure I do with teens is to have therm engage in small talk with me for two minutes. This can be a rich practice in identifying anxious thoughts and cognitive distortions that contribute to their anxiety.

Question 12

What makes it important to address social anxiety during teen years?

Jennifer Shannon · Accepted Answer

Early intervention is so important with social anxiety because it can disrupt normal adolescent development. One of the tasks of adolescence is to individuate from one's family and develop a sense of self. We develop this sense of self through social, academic and extracurricular engagement. Socially anxious teens often avoid these activities and retreat back to their home. This gets in the way of important milestones. Also, I truly believe that the treatment for social anxiety teaches life long skills that help teens develop self-compassion, confidence and the courage to move towards rather than a way from what scares us in life.

Question 13

What is the best way for parents to help their teen if they are struggling with social anxiety?

Jennifer Shannon · Accepted Answer

My daughter Rose developed crippling social anxiety when she was thirteen. It was so bad that she soon began to refuse to go to school. I knew as a therapist who specialized in anxiety that if she continued to avoid school, her social anxiety would get much worse. Together with the school we put together a plan to help get her back in classes with support. She was able to go to the office when needed, and she was paired with another student to sit with during lunch. I did send her to a therapist, but it was hard to find one trained in CBT which was frustrating. It is why I wrote my first book, She Shyness and Social Anxiety Workbook, for Rose and so many other teens like her.  Here is a link to how she explained this painful time and who she got through it. It outlines many of the things I did as her parent to help her. 
https://www.youtube.com/watch?time_continue=8&v=tq4klkup4mk&feature=emb_title

Question 14

Is social anxiety in teens genetic or learned?

Jennifer Shannon · Accepted Answer

Most everyone has some degree of social anxiety. Jerry Seinfeld, the comedian, once said that the number one fear for the average people is public speaking, the number two fear is death. This means that if the average person had to be an a funeral, they would rather be in the casket than giving the eulogy. This is funny because most of us can relate to it. So some degree of social anxiety is written into our DNA. Regarding anxiety disorders, if you have a first degree relative with an anxiety disorder, you are four times more likely to suffer from anxiety as well. This is not to say that our environment, from parent modeling to traumatic events can also contribute to the development of social anxiety disorder.

Question 15

Can parents alone cause social anxiety?

Jennifer Shannon · Accepted Answer

I believe that one of the reasons mental health has a stigma attached to it is that we tend to blame parents for mental health disorders. In the 1940's a psychologist studying autism coined phrase "refrigerator moms" suggesting that it was the lack of warmth on the parent's part (usually the mother) that caused autism. We now know that genetics and possibly environmental factors cause this disorder. I do not believe that parents alone cause social anxiety. I do think parents can hinder their child or teen getting over social anxiety if they reinforce avoidance of social engagement. In my experience, it is necessary to educate parents and teens about how the cycle of avoidance creates a chronic problem and how to break this cycle. I have a link to one of my YouTube videos on the CBT model of anxiety. https://www.youtube.com/watch?v=mlBaKewAmqo&feature=emb_title

Question 16

Does social media encourage social anxiety in teens?

Jennifer Shannon · Accepted Answer

I think that social media can cause anxiety in both teens and adults! One of the reasons for this is that people tend to post idealized images of themselves doing fun things with other people. This can trigger negative comparisons making us feel that we are not measuring up. Another reason is that people may be more judgmental saying things that would not say to someone in person.  At the same time, social media can help build social connections, and during Covid, this is especially important. We can use the anxiety social media causes as an opportunity to learn coping strategies. One of my favorite tools is something Christine Padesky developed called Assertive Defense of the Self. I have included a YouTube link where Padesky describes this as well as a handout that I use with my clients. https://www.youtube.com/watch?v=YbCSgon47UM

Social Anxiety in Teens

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