Social Anxiety in Adolescence: Social Phobia & Mental Health
Social anxiety disorder, which can be defined as excessive worry about being judged or scrutinized by others that leads to extreme discomfort in or avoidance of social situations and social interactions, triggering intense fear and hindering social performance, can be difficult at any age. However, those who live with social anxiety symptoms in early adolescence may find that the condition significantly impairs their functional ability and social skills, and negatively impacts their quality of life and mental health during a critical stage. Left unaddressed, social anxiety and social phobia often persist into adulthood as one of the most pervasive mental health disorders, continuing to affect an individual’s well-being. It can be vital to support your child as they navigate this difficult phase, addressing risk factors, and online therapy can offer a convenient treatment program with professional support and guidance.
What is social anxiety and social phobia?
In general, anxiety, including social anxiety and other anxiety disorders, is a common mental health disorder that can affect people of all ages in various social situations for socially anxious individuals. When someone is often anxious about how others might perceive them, they may be diagnosed with social anxiety disorder.
According to National Library of Medicine researchers, social anxiety is typically defined as a mental health condition characterized by an overwhelming, persistent social anxiety symptoms with fear of humiliation, ridicule, or judgment from others. The acceptance and approval of peers often become increasingly important during adolescence, and studies show that teenagers with untreated social anxiety often experience interpersonal impairment in social skills that persists into adulthood. Social anxiety in children and adolescents typically presents between the ages of eight and 15 and can co‑occur with other anxiety disorders as part of broader mental health conditions.
Understanding the effects, symptoms, and fear of social anxiety disorder
Social anxiety can affect people in many ways, from extreme discomfort around unknown persons to the avoidance of social situations. Researchers have compiled a list of common mental health disorder symptoms typically experienced by people with social anxiety disorder. This includes muscle tension, trembling, and sweating that often accompany intense anxiety-provoking situations.
Signs and symptoms of social anxiety, social phobia, and fear in adolescents
If you're worried that your child could have social anxiety, here are some common signs and symptoms to look for in adolescents experiencing mental health needs, strained social relationships, or perceived social threat during everyday life:
- A general fear of being ridiculed or judged by others in most or all aspects of their lives, which can involve negative evaluation and social fears
- Spending a lot of time worrying about social or public events
- Persistent concern about being a burden to family and friends
- Avoiding social situations or public places so they won’t have to interact with people
- Judging or criticizing themselves after social and peer interactions
- Ongoing challenges in making and maintaining friendships and relationships
- Frequently having trouble speaking to peers or authority figures
- Physical symptoms like sweating, shaking, stomachaches, rapid heartbeat, headache, and other unpleasant sensations related to social events
- Overwhelming feelings of being uncomfortable or self-conscious when meeting new people
How does social anxiety disorder affect the mental health of adolescents?
Social anxiety in adolescence can present differently than it does in adults, as anxiety and frequent social situations shape each individual’s experience. While most teenagers occasionally feel anxious or worried about what others think of them, some can become so occupied with those feelings that they develop maladaptive patterns associated with anxiety disorders.
According to a 2022 study, “Lifetime prevalence of social anxiety disorder (SAD) is estimated at around 7% with high incidence rates in childhood and early adolescence. In addition, a substantial proportion of many adolescents, socially anxious individuals, and young adults do not meet the diagnostic criteria of threshold SAD, but nevertheless report ever having had a strong fear of a social situation and/or the desire to avoid it.” This demonstrates how mental health disorders persist over time.
Young people tend to be more likely to be socially anxious
Recent United States Census Bureau data indicates that young people are usually more likely to experience social anxiety symptoms than older adults. Despite this, few receive exposure therapy or follow the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The study found that approximately 50% of people aged 18 to 24 (late adolescence and early adulthood) reported symptoms related to anxiety and depression in 2023, compared to roughly one-third of adults overall, illustrating how reduced social activities during the teenage years can exacerbate anxiety. The data also shows that young adults tend to be the most likely age group to experience mental health symptoms.
Teens normally establish social patterns during adolescence
Many people establish lifelong patterns of behavior during adolescence, and if they are consumed with a social phobia, social threat, or socially anxious adolescents tendencies, those patterns and negative aspects may be unhealthy. While these patterns can often be changed later with substantial psychotherapy and dedicated effort, setting healthy habits for social interaction, and peer and romantic relationships, early in life can lead to a happier, more well-adjusted, functional adulthood supported by a positive social environment.
Adolescents may try to hide their anxious feelings due to shame
You may not notice that your child has social anxiety for a while. Teenagers may feel ashamed that they aren’t comfortable in public or worry they will be judged for their fears. They may engage in risk-taking to mask discomfort. You may notice group differences in how teens cope and observe lapses in attention control. Pay attention to your child’s mental health needs and how your teenager behaves in social situations, in public, and when meeting new people. This may give you some insight into their comfort level with interpersonal interactions.
The social anxiety of adolescence is usually more than simple shyness
Adolescent shyness differs from social anxiety disorder: Socially anxious individuals tend to withdraw, and adolescent social anxiety disorder can impair social skills.
Being shy might cause teenagers to avoid auditioning for the school play or make it difficult to speak up for themselves. Social anxiety is usually something more. When someone is socially anxious, they typically experience a significant impairment to their functional ability in one or more areas of their life. Their persistent fear of judgment and embarrassment may make even small things—like giving a report at school or eating lunch in the cafeteria—overwhelmingly scary.
Social anxiety disorder can present in numerous ways
Social anxiety in adolescents doesn’t always look like a shy and quiet kid. Many children show sudden anger or aggression, reflecting underlying mental health challenges. Some children and teens may try hiding their feelings, but others may lash out with aggression or anger to disguise their embarrassment.
Adolescent social anxiety disorder can present in numerous ways, sometimes manifesting more like social phobia than mere shyness. Physical symptoms or sudden aggression may emerge, reflecting an overlap with other anxiety disorders and complicating underlying mental health conditions. Some teens find support through group CBT sessions that teach effective coping strategies.
How is social anxiety treated in adolescence?
According to the National Social Anxiety Center, this disorder can be treated in the following ways:
Cognitive behavioral therapy (CBT)
Exposure therapy
Anti-anxiety medication (must be prescribed by a doctor or psychiatrist)
Interpersonal approach
Social skills training
Situations that can cause social anxiety in adolescence
While every teenager with social anxiety may be different, there are usually some common triggers, risk factors, and group differences that shape how socially anxious adolescents respond. As a parent, you can pay extra attention to the psychological processes behind your child’s reactions and offer them the emotional support they need in those situations.
- Social events like parties, dances, and school functions: Teens with social anxiety are likely to be incredibly self-conscious and may develop increased anxiety before and during social events. Before they leave, try building up their confidence, practicing social skills, or reminding them to challenge negative self-talk because their anxiety may lie to them.
- A wide range of social interactions: From early adolescence into adulthood, your child may develop anxiety symptoms related to a wide range of social interactions. This may present as an extreme fear of embarrassment or judgment when having conversations with strangers, working in groups, making telephone calls, being observed by others, and in other types of social situations.
- Public speaking or performing for an audience: Social anxiety can make required social events, like public speaking in a class project or school recital, extremely uncomfortable, often leading to difficulty performing and embarrassment about how others see them.
Tips to help adolescents cope with social anxiety disorder
If your child struggles with social anxiety, consider offering the following advice to them and helping them follow it:
- Establish a healthy lifestyle with active, robust self-care to support physical, emotional, and mental well-being.
- Challenge negative and self-conscious thoughts with positive thinking through exposure therapy.
- Ask yourself if what you’re afraid of is likely to occur, whether you would care about it in five to 10 years if it did happen, and whether something positive could happen instead.
- Shift your focus toward the task you need to accomplish rather than your feelings about it. This may be an approach that helps young adults manage anxiety.
- Examine and evaluate the facts of the situation and whether your anxiety amplifies your feelings.
- Be afraid—and do the thing anyway. Start small and gradually expose yourself to situations you're scared of to build tolerance and overcome your fears.
Consider offering mental health support, helping them recognize social fears, guiding them through understanding risk factors, and connecting them with a suitable treatment program.
Social anxiety is a common mental health disorder that often triggers muscle tension, leads to avoidance of social situations, and can evolve into persistent social phobia, affecting daily functioning if left unaddressed.
How therapy can help support social anxiety in adolescence
Adolescence often comes with many unique obstacles, and parenting tends to be challenging no matter who you are. Many parents utilize a mental health professional's emotional support and guidance to help them find healthy ways to relate to and communicate with their children.
Benefits of online therapy to improve mental health
If you're worried about supporting your teenager with social anxiety, consider working with a licensed therapist online through a virtual platform like BetterHelp. Online therapy can help you learn healthier, more effective ways to parent and support your teenager through the turbulent adolescent years. Your therapist can teach you about productive communication, how to work through conflict together, and how to establish clear parent-child roles and expectations.
Parents or guardians looking for additional emotional support for their child can find online therapy for kids ages 13 to 19 at TeenCounseling. Therapists from online therapy can help your teenagers with an evidence-based approach to reduce symptoms of SAD and improve their mental health.
Effectiveness of online cognitive behavioral therapy (CBT) for social anxiety disorder
Therapists frequently use cognitive behavioral therapy to help patients with social anxiety. CBT generally allows individuals to explore the connection between how they think and the way they feel, identifying and reshaping harmful thought and behavior patterns. One study found that an online CBT intervention could be effective in treating symptoms of social anxiety disorder. In fact, by the completion of the program, 73% of the participants no longer met the diagnostic criteria for SAD.
Takeaway
What is the cognitive behavioral therapy approach for social anxiety?
The effectiveness of cognitive behavioral therapy (CBT) as a treatment for social anxiety, sometimes called social phobia, is well-recognized. Therapists help clients identify their negative thoughts and behaviors and replace them with healthier thought patterns. Exposure therapy, a form of CBT, allows clients to face their fears gradually, resulting in a decrease in anxiety symptoms as they become more confident.
CBT also teaches clients with social anxiety disorders to recognize negative interpretations that fuel their anxiety. Clients build social skills and confidence in various social situations by practicing guided role-playing. Homework exercises help them monitor physical symptoms like sweating or trembling during feared tasks. Interventions focus on reducing excessive self-consciousness and shifting attention outward to improve performance. Many programs use a structured treatment program that incorporates peer feedback in a supportive social environment. In fact, the same principles that address social phobia are applied to many mental health disorders within CBT protocols.
What is the treatment for socially anxious adolescents?
Treatments for social anxiety disorder in adolescents can include family therapy or cognitive behavioral therapy. In addition to therapy, the healthcare provider may recommend medication if symptoms are severe.
Family involvement in CBT sessions can address social anxiety disorder by creating a safe home context. Clinicians often use the term social phobia when assessing adolescents whose symptoms interfere with daily life. Many youth with social anxiety also meet criteria for other mental health disorders, underscoring the need for comprehensive care. Including peers in a treatment program helps socially anxious adolescents practice new behaviors.
School‑based interventions teach social interactions to reduce muscle tension during group activities. Addressing risk factors, such as avoidance, can prevent negative outcomes in youth. Psychoeducation on psychological processes gives young people insight into how thoughts trigger anxiety.
What is the best therapy for social anxiety?
According to the National Institute of Mental Health, CBT is the gold standard of treatment for social anxiety. This approach to treatment teaches people how to identify and change negative beliefs, thoughts, reactions, and behavior. In CBT, people with social anxiety can also develop confidence by learning social skills and practicing relaxation techniques, and other coping skills to help them manage their symptoms. CBT can also be delivered in a group environment, which can also be beneficial for people with social anxiety.
There are various types of CBT. One that may be used to treat social anxiety is exposure therapy, which focuses on helping people confront their fears and stop avoiding things in a progressive manner in a controlled environment.
Much research shows that combining CBT with mindfulness can enhance outcomes. Analyses anchored in the statistical manual framework confirm CBT’s status for treating social anxiety. In many trials, clinicians observe that contextual exposures yield most evidence of lasting change. For young adults, booster sessions encourage them to spend time practicing new skills. Addressing inherent risk factors, such as persistent fear, can improve social relationships and reduce relapse rates.
What is the root cause of social anxiety disorder?
Experts are not sure what causes social anxiety disorder. Like other anxiety disorders, it can run in families, but researchers have not identified why some family members develop it and others don’t. Experts also believe that some environmental factors can contribute to whether someone develops social anxiety disorder, including early childhood trauma, harsh discipline, or growing up with a parent who has social anxiety disorder.
Genetic studies show that a common mental health disorder pattern can run in families, suggesting inherited risk. Children who experience frequent criticism in childhood often have increased vulnerability to feelings of social rejection. Neuroimaging research into mental health disorders reveals that atypical processing in fear circuits may underlie these fears. Automatic negative interpretations of neutral faces can trigger a cycle of worry in socially anxious individuals. Difficulties navigating peer interactions during the teenage years can reinforce avoidance and heighten long‑term distress.
How do you deal with social anxiety in high school?
Social anxiety is not uncommon in high school students. According to the National Comorbidity Survey Replication Adolescent Supplement, an estimated 9.1% of adolescents surveyed had social anxiety disorder, with 1.3% experiencing severe impairment. Research into the age of onset distributions of psychiatric disorders has found that social phobia has a mean onset before age 15. In other words, many people with this condition may experience symptoms in high school.
Dealing with social anxiety in high school can not only help improve the teen’s quality of life, but it can also help avoid some of the comorbidities and complications of this condition. For example, anxiety disorders are highly comorbid with eating disorders. As much as 83% of people with an eating disorder also meet the criteria for an anxiety disorder, with social anxiety disorder being the most prevalent. Studies have also found that about 20% of people with social anxiety disorder also meet the diagnostic criteria for an eating disorder.
High school students may deal with social anxiety by skipping school, but avoiding the situation is a short-term solution and can ultimately exacerbate the symptoms of social anxiety disorder. An effective way to deal with social anxiety in high school is to seek treatment from a mental health professional. In clinical psychology, CBT is a well-studied approach to treating a variety of mental health conditions, including social anxiety. In CBT, a trained therapist helps someone with social anxiety disorder learn how to stop the avoidance cycle, overcome functional impairment, and learn how to face social situations, growing confidence and self-esteem over time.
Recognizing early symptoms helps students address social anxiety disorder before it takes hold. Using gradual exposure therapy builds confidence for larger audiences. Cultivating steady eye contact during discussions strengthens both self‑assurance and connections with classmates. Participating in clubs or team activities fosters genuine peer acceptance and offers real‑world social practice. And by meeting each student’s unique mental health needs—through counselors, support groups, or online tools—they gain the tailored support required to succeed.
Is it normal for a 12-year-old to have social anxiety?
Yes. Social anxiety in children often starts between eight and 15. Any child in this age range may feel self-conscious or stressed about what people in their peer group think of them, but kids with social anxiety feel uncomfortable enough in various social settings that they may stop doing the things they want or need to do to avoid these feelings.
Many young people exhibit the emergence of symptoms like avoidance and worry around age 12. Identifying risk factors, such as a family history of anxiety disorders, helps educators and clinicians intervene early. If left unchecked, social anxiety disorder in socially anxious individuals can hinder the development of key social skills. Often, support services for mental health conditions address this issue, reflecting how social anxiety has become a common mental health disorder among youths.
Recognizing social phobia early allows for targeted exposure therapy in a safe social environment. Exploring positive and negative aspects of peer feedback helps reduce reliance on social approval. Building strong social relationships in supportive settings fosters resilience against future anxiety.
Can kids outgrow social anxiety?
Children with social anxiety who had symptoms before age 12 are unlikely to outgrow them. If left untreated, they may continue to have problems with social performance in adulthood.
Many young people and socially anxious youths struggle with persistent symptoms even after adolescence. Studies of anxiety disorders show that only a minority of untreated cases remit naturally. Integrated interventions for mental health disorders in young people yield better outcomes than waiting for spontaneous recovery. Addressing socially anxious thoughts early can reduce symptoms, altering the typical course of anxiety disorders and preventing additional mental health disorders.
Research underscores the role of exposure therapy in mitigating physical symptoms over time. Participating in guided role‑plays improves social interactions and fosters peer acceptance, reducing common risk factors for relapse. Consistent practice can transform fear‑driven patterns of social anxiety into opportunities for growth, preventing negative outcomes later in life.
Is ADHD linked to social anxiety?
Some research has found that ADHD and SAD may be linked. One 2024 review of 41 studies conducted after 2020 found that the prevalence of ADHD in adults and adolescents diagnosed with social anxiety ranged from 1.1% to 72.3% across all studies, and the prevalence of social anxiety disorder in adolescents and adults with ADHD was 0.4% to 46.7% across all studies. This review also found that comorbid ADHD and social anxiety disorder exacerbate ADHD symptoms.
That said, the authors of this review acknowledge that the studies included were of low quality, stating that their conclusions should be seen as preliminary. More studies are needed to say with confidence that ADHD is linked to social anxiety.
Socially anxious young people with ADHD often report more severe symptoms, such as difficulty maintaining eye contact and increased muscle tension, than peers with either condition alone. The co-occurrence of ADHD and social anxiety complicates treatment because overlapping symptoms can obscure the diagnosis of each mental health disorder. As ADHD and social anxiety fall under two different classifications (attention‑related conditions and anxiety disorders, respectively), integrated care models may better support young people facing these dual challenges. Untreated, the combination can heighten risk for additional mental health disorders, including depression and substance use, emphasizing the need for early, comprehensive assessment.
Early social phobia can magnify attentional struggles in socially anxious individuals with ADHD, making everyday interactions feel overwhelming. Left untreated, the overlap of both conditions often leads to other mental health conditions, such as depression or substance use disorders. Recognizing symptoms early in young people allows clinicians to implement a targeted treatment program and prevent negative outcomes later on.
What worsens social anxiety?
A number of factors can worsen social anxiety, including alcohol, caffeine, and poor sleep. Other things can include being criticized and being put into an unexpected social situation, like meeting someone new, being asked to make a speech, or feeling lonely. Other DSM-5 disorders may worsen the symptoms of social anxiety, too, including panic disorder, depression, substance use disorder, ADHD, or obsessive-compulsive disorder.
Caffeine and alcohol can intensify physical symptoms of anxiety, like rapid heartbeat and sweating. Chronic insomnia impairs coping and increases self-consciousness in social settings. Negative interpretations of others’ expressions fuel fear and deepen avoidance cycles. Comorbid anxiety disorders and other mental health disorders often exacerbate baseline distress. Heightened social anxiety disorder severity can raise sensitivity to minor stressors. For treating adolescents, early identification of triggers helps tailor interventions to their developmental needs.
Can school trigger social anxiety?
Yes, school can trigger social anxiety in various ways. Students with social anxiety may be extremely concerned with making mistakes or being laughed at or humiliated in this social context. Teachers and other students may interpret their behavior as just feeling shy, but their anxiety can prevent them from engaging in class and making close friends.
Signs of social anxiety that may occur in the school setting include not making eye contact when appropriate, not raising their hands to answer questions, not joining groups of other students to socialize, and not volunteering to go to the board or read aloud.
School assemblies and unplanned presentations are high-pressure social situations that can intensify social phobia symptoms because they introduce unique risk factors that magnify the fear of scrutiny. For socially anxious adolescents, group projects may feel like an insurmountable challenge in social interactions. Loud cafeterias and crowded hallways are challenging social situations where many children freeze. During the teenage years, peer dynamics and concerns about social relationships often heighten anxiety levels. Many young people experience increased self-consciousness when transitioning to new school environments. Classroom distractions and complex tasks can disrupt attentional allocation, leaving students more vulnerable to stress.
Understanding these risk factors can guide educators in implementing supportive treatment program elements in schools. Integrating exposure therapy into classroom activities helps normalize peer feedback and reduce avoidance. Recognizing social phobia in young people encourages teachers to adjust lesson formats for better inclusion.
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