Children suffer from social anxiety, but if not dealt with correctly in time, the disorder can have repercussions even in adulthood, compromising the quality of life
- Social anxiety: what are the symptoms
- Causes of social anxiety
- How to overcome social anxiety
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The ‘ social anxiety , also called ” social phobia “, is a form of psychological distress that comes under the group of anxiety disorders , which includes also the anxiety disorder generalized panic attacks. Unlike the latter, which are often worse when alone, those suffering from social anxiety find themselves in difficulty only in situations related to interaction with other people , especially if the attention of these people is focused on what you are doing. or saying (or if you perceive it as such) and you feel exposed to the judgment of others.
Children who suffer from social phobia are especially children in the first years of life and in particular in the first years of school, when they have to deal with peers, to speak in public and to establish their first interpersonal relationships outside the home environment. , well known and reassuring, and out of sight of parents.
Social anxiety has a tendency to spontaneously fade over time , as the child grows and becomes familiar with the outside world, with the other children he or she gradually meets, with the teachers and, therefore, gradually also with the “strangers. “adults with whom he has the opportunity to interact in various situations and in any context.
In some cases, however, it is important for parents and teachers to pay a little more attention to children’s behavior and manifestations of fear and concern, because this process does not always happen spontaneously.
If the child’s shyness is objectively excessive and prevents him from interacting with peers, attending school with good results, participating in sports or other collective situations, this can result in a serious impairment of the quality of life and the possibility of serene psychological development, to the point of remaining as social unease even in adulthood.
But how to understand if shyness and embarrassment are a normal expression of personality, common to many children, or if you are facing a real problem of social anxiety to be subjected to the evaluation of a psychotherapist and to be faced with specific therapies? Here are some factors to consider in guiding the diagnosis of the disorder.
Social anxiety: what are the symptoms
The general criterion that must guide the recognition of social anxiety as a form of psychic distress is the level of interference that its presence has in the life of the subject who suffers from it.
If a person is shy , has a low tendency to show themselves and express their thoughts in public, take a worried and anxious attitude when having to undergo an exam or present a project to co-workers, but can manage and overcome the stress that lives, then it is not a question of social phobia, but only of insecurity due to low self-esteem and lack of confidence in one’s abilities.
Conversely, it is very likely that a social anxiety disorder is present when a strong fear and excessive worry occur in situations that do not justify them and take on an intensity such as to prevent the “functioning” of the subject (ie his ability to face the task that must be performed), causing a real psychological and physical block and an irresistible desire to avoid and escape. As if he were faced with a danger or an undertaking absolutely beyond his strength.
In children, social phobia can express itself through the repeated and inexplicable refusal to go to school or even to leave the house; or it can be suspected when a child does not achieve academic results in line with their abilities, despite adequate study commitment (for example, because they cannot answer questions when questioned, even though they know the answers). Serious and persistent difficulty in approaching other children, alone or in groups, and making new friends is also a sign of social anxiety, as well as refusal to play or play an instrument in public, participate in individual or individual sports training and competitions. as a team, while desiring it.
In adults , the persistence of social phobia can seriously compromise not only interpersonal relationships and the ability to lead a peaceful life, but also professional success and personal fulfillment. In fact, this form of psychological distress leads to the exclusion of all work activities that require showing oneself and exposing oneself to the judgment of others: from holding reports and conferences to singing, playing or dancing in front of other people, from teaching to conducting work groups, to carry out activities in contact with the public.
In cases where the discomfort in social interaction is more marked, even attending a business dinner or a conversation with people who do not know each other very little, expressing one’s opinion on a topic (especially if in contrast with that of the interlocutor) simply eating a sandwich or drinking a beer in a bar (especially alone) or feeling observed while attending a party or traveling by train becomes a pain that is difficult to bear .
The psychological malaise generated by social anxiety and the anticipatory anxiety that precedes situations considered difficult to deal with leads to avoiding a large number of activities and opportunities for confrontation with others, resulting in even an extreme social withdrawal , which can facilitate the worsening of the disorders anxiety, promote a negative attitude and increase the risk of developing other psychiatric problems, such as depression .
In addition to mental and behavioral symptoms, social anxiety causes characteristic physical signs , such as:
- increased heart rateand changes in the beat ( tachycardia , palpitations, etc.)
- tremors (especially in the hands and legs)
- hot flashes, redness ofthe face and neck
- excessive sweating and / or chills
- feeling of dry mouth
- difficulty speaking (up to stuttering) and temporary change in tone of voice
- throat discomfort, coughand difficulty in breathing
- stomach cramps, nausea , abdominal pain and intestinal disturbances (bouts of colitis, diarrhea , bloating and flatulence)
- muscle tension and contractures
- drop in pressureand mental confusion
- difficulty falling asleep and insomnia, even in the face of considerable psychophysical fatigue.
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In children , physical signs of social phobia are also desperate and seemingly unmotivated crying, agitation and physical restlessness or, conversely, refusal to move, stiffness and apathy in the face of an invitation to participate in activities. and situations that are perceived as dangerous and unpleasant and cause significant anticipatory anxiety and discomfort.
Regardless of age, in order to be able to diagnose social anxiety, the symptoms mentioned must be present continuously (almost every day) for more than six months and must not depend on the intake of drugs or substances active on the central nervous system ( alcohol, drugs, etc.), nor be attributable to another psychiatric disorder already present, to an organic pathology (such as, for example, Parkinson’s or Alzheimer ‘s disease ) or to recent traumatic experiences (a road or work accident, an assault etc.).
The symptoms experienced, their intensity and combination can change over time, in relation to the activities carried out, the living environment and, in children, the psychoemotional and cognitive growth and development process.
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Causes of social anxiety
The exact causes of social anxiety are not known, but in all likelihood the origin of the disorder is multifactorial and determined by the interaction between individual predisposition to anxiety disorders, unfavorable environmental factors and life experiences that led to develop a negative approach to social situations and interaction with other people, especially if they are strangers.
To date, there are no known specific alterations or genetic variants capable of justifying a greater likelihood of developing social anxiety, but the disease shows a certain familial recurrence . On the other hand, this association could also depend on behavioral elements acquired by parents in the first years of life, or on the type of relationship that is established between parents and children.
In particular, a domestic climate characterized by excessive control over children , with punishment or blame in case of failure to achieve the desired goals by family members, can generate a strong sense of inadequacy , low self-esteem and difficulty in dealing with the judgment of others, as well as conviction of not being up to par and of not being accepted and loved by others as imperfect.
Even a loving and not particularly demanding, but definitely too anxious parent or grandparent who transfers their excessive concern for every activity and circumstance to their children / grandchildren can favor the onset of social phobia even in children who might not have developed it to a child. pathological level if they had found themselves in a more serene and relaxed environment.
In childhood, negative experiences lived in public , between adults or peers, perceived as frustrating and humiliating by the subject who lives them, can have a negative impact on subsequent psychosocial development and, if not addressed and managed in a timely and correct manner, can affect the behavior of that person even in adulthood. This can happen to victims of bullying , physical abuse, domestic violence (even if only psychological), but also to children who make too early and intense use of social networks, without parental guidance.
Research conducted in the field of neuro-psychology has also shown that the structure and functioning of specific areas of the brain may also contribute to making the development of social anxiety more likely . In particular, it has been observed that people with social phobia tend to have neuronal hyperactivity in the amygdala , the brain region that controls emotions, fear and escape behavior.
How to overcome social anxiety
As with all physical and mental illnesses, the rule also applies to social anxiety that prevention is the best “cure” and that you face the situation promptly, as soon as you realize that there is some problem in the behavior or in the reactions of the person. child, it is preferable to waiting to see how the picture evolves.
In particular, when the symptoms of a possible social phobia are recognized, it is important to seek the help of a specialist in anxiety disorders and evaluate together with him if it is appropriate to start psychotherapy , possibly associated with pharmacological treatment in the most cases. compromises, or if it is a transient discomfort that does not require the intervention of a psychotherapist.
In the case of children , first of all it is good that the parents (preferably both) undergo an interview to present and evaluate the problem. This will allow the psychotherapist to also get an idea of the psychological profile of the couple , the relational dynamics and the family context. Only later will the child also be evaluated.
In the case of an adult person with social anxiety, the search for help can be more complex and delayed, since it must arise from a specific need of the subject who suffers from it, who must also find the strength to expose himself to the “judgment” of the psychotherapist. Generally, the stimulus to do so comes from the presence of a strong malaise , often endured for years, or from the presence of performance anxiety that limits success and professional growth.
In all cases, the most used approach to deal with social phobia is based on cognitive-behavioral therapy , individual or in groups: it is a type of psychotherapy aimed at making the patient learn a series of techniques and strategies to manage the stress and overcoming the fear associated with situations of public exposure and social interaction that create difficulties.
Specific times and methods of cognitive-behavioral therapy are defined case by case, based on the needs of the individual person and intermediate “tests” can be envisaged, in which the subject is asked to voluntarily expose himself to gradually more “challenging” situations , in which will have to apply the techniques gradually learned.
Since fear and anxiety are primary reactions that are difficult to control even by people who do not suffer from them in a pathological way, at least in a first phase and especially in adults, antidepressant drugs may be prescribed to support the psychotherapy path , not only useful. against depression, but also for the treatment of anxiety disorders in their many variants, including social anxiety.
