5 questions for psychologist Birgit Schmid - Does Anna suffer from social anxiety disorder?

She is currently struggling almost every day to motivate Anna to go to school. Anna tells her that the other children at school are bullying her. Her school performance has also dropped significantly. Christine Meier wonders what could be the reason for her daughter's behavior. The psychologist asks Christine Meier more in-depth questions about the background to Anna's behavior and then suspects that Anna suffers from social anxiety disorder. She advises the mother to take her daughter to the pediatrician and, if the suspicion is confirmed, to register Anna with a child and adolescent psychotherapist.

When is social anxiety disorder diagnosed in children*?

Children and adolescents who suffer from social anxiety disorder live with the constant fear of embarrassing themselves in front of other people, being laughed at or teased. As a result, they avoid such situations or find it very difficult to cope with them. They withdraw more and more from social contact and even break off contact completely.

How do parents recognize whether their child is suffering from social anxiety disorder?

For parents, this process can usually be observed gradually. The child spends more time in his or her room, socializes less often with colleagues and they also get in touch less and less. At first, parents may even find this situation pleasant. After all, their child is at home more often. Children tell their parents that they don't feel like meeting up with others today. This is often accompanied by somatic complaints such as stomach ache or nausea. As soon as children refuse to go to school, conflicts usually begin between them and their parents. However, these behaviors are often signs that the child is afraid of social encounters.

Is the COVID-19 pandemic playing a role in the development of social anxiety?

Little can be said at present about the impact that the measures to combat the pandemic have had on children. Comprehensive study results that also include the 2021 lockdown are still lacking. However, studies from 2020 show that children often suffered from not being able to pursue their usual everyday activities during the lockdown. These studies describe an increase in behavioral problems in children, such as increased irritability and, in some cases, aggression, but also increased emotional stress, an increase in anxiety and sadness, and even sleep disorders.

How can parents support their children?

Talk to your child about what is bothering them. When advising parents in santé24's psychological-psychiatric consultation hours, it can be observed time and again that parents try to put pressure on their child to meet more friends or go to school regularly again. This is perfectly understandable, as parents can become anxious about their children's future. Children need to feel that they are understood by their parents if they are to implement their parents' solutions. But even then, implementation is difficult for them. Fears almost always trigger avoidance behavior of unpleasant situations. This avoidance behavior must be overcome and this requires a good mix of understanding and support.

What are possible first steps for those affected?

One possible support for children is the online self-help training program "Sophie" developed by the University of Bern. Interested parties can find information about this via this link: https://selfhelp.psy.unibe.ch/sophie/homepage.

In addition to these recommendations, it is important that parents seek professional support for their children if their behavior does not change. The first point of contact here is usually the pediatrician. However, teachers can also be important. Many schools now employ school social workers who offer good support for social anxiety.

Birgit Schmid is a psychologist in santé24's psychological-psychiatric consultation service. santé24's telemedical consultation is a central service that is available free of charge to SWICA policyholders for all health-related questions on 044 404 86 86. A practice license for telemedicine also enables santé24 doctors to provide further medical services for medical conditions that are suitable for telemedicine. SWICA policyholders can also use the BENECURA medical app to carry out a digital symptom check for symptoms of illness and receive recommendations for further action. In a subsequent telephone call with santé24, the customer decides for themselves in each individual case whether they wish to release the information provided in the SymptomCheck to santé24.

*) also applies to young people