Social anxiety, also known as social phobia, is a common mental health condition that involves an intense fear of social situations. People with social anxiety are often worried about being watched or judged by others. They may avoid social events and speaking in front of groups due to worries about embarrassment or humiliation.
Social anxiety typically begins in childhood or the early teen years. Most research suggests that the average age of onset is around 13 years old, though it can develop earlier or later than the teens for some. Here is an overview of when social anxiety commonly emerges and key factors that influence its development.
Early Signs in Childhood
While social anxiety disorder is uncommon in young children, some early signs can emerge in kids as young as 5 or 6 years old. These include:
- Extreme shyness around unfamiliar people
- Refusing to speak in social settings
- Crying, tantrums or clinging when in unfamiliar social situations
- Avoiding activities like show-and-tell or birthday parties
- Physical symptoms like stomachaches and headaches before social events
At this age, anxiety may be most noticeable around strangers or unfamiliar environments. Many kids grow out of this shy phase as they get more comfortable in school and social settings. But some with early signs go on to develop more severe social anxiety later in childhood.
Onset in Middle Childhood
From ages 7 to 9, social anxiety may become more apparent. At this stage kids have more demands like speaking in front of the class, working in groups, or attending sleepovers. Signs in middle childhood include:
- Crying, throwing tantrums or freezing up when called on in class
- Actively avoiding oral reports, show-and-tell or other speeches
- Refusing to attend birthday parties or sleepovers
- Not participating in group projects or play with other children
- Physical symptoms like stomachaches, headaches and nausea in social situations
- New nervous habits like skin picking or hair pulling
At this age, the anxiety is likely to happen in many different social situations, not just with unfamiliar people. The avoidance of school activities and social isolation from peers becomes more pronounced.
Onset in Pre-Adolescence
Later in childhood, from about age 10 on, social anxiety continues to increase. Peer relationships take on more importance, and academic demands like public speaking intensify. Common signs in pre-adolescence are:
- School refusal and frequent visits to the school nurse due to somatic symptoms
- Difficulty talking in front of the class or asking questions
- Avoiding group work and partner activities in school
- Not getting involved in extracurricular activities
- Preferring to play alone or with much younger kids
- Worrying for days before a presentation or speech
At this stage, anxiety may lead to more school absences and difficulty participating. Kids may also try to mask their anxiety by misbehaving or acting out.
Average Onset Age in Adolescence
The most common age for social anxiety to have its official onset is in the early teen years. According to research, the average age that social anxiety disorder first develops is:
- 13.2 years for males
- 13.7 years for females
Puberty ushers in many bodily changes, and teens face new social pressures and interactions with peers. All of these changes provoke anxiety in some teens. Key signs in the teen years include:
- Extreme anxiety about talking to or being around peers, especially dating
- Skipping school or dropping out due to social fears
- Withdrawing from activities and friendships
- Spending time alone and avoiding social events
- Panic attacks in social situations
- Rituals likeCounting steps or checking the locks to cope with anxiety
By the teen years, social anxiety is very impairing for school, activities, relationships and overall quality of life. Panic attacks may also start at this time.
Onset in Adulthood
It is less common for social anxiety to appear for the first time in adulthood, but it can still happen. Adults may start experiencing disabling anxiety due to:
- New social situations like college or a demanding job
- Life stressors like divorce, moves, grief or unemployment
- Changes in health, appearance or abilities
- Substance abuse or withdrawal
- Co-occurring mental health disorders
The first panic attacks and avoidance patterns of social anxiety may not emerge until the 20s, 30s or later for some adults. It is important to seek help for new-onset anxiety that is interfering with daily life.
Risk Factors for Early Onset
While social anxiety typically starts in the teen years, it can begin earlier for those with certain risk factors. Risks for developing the condition at a younger age can include:
- Being very shy and inhibited as a young child
- Having an immediate family member with social anxiety or other anxiety disorders
- Experiencing traumatic or abusive events as a child
- Facing bullying, teasing, rejection or humiliation from peers
- Changing schools or environments frequently
- Having another mental health disorder like depression or obsessive-compulsive disorder
Kids with behavioral inhibition and strong genetic risks may start to exhibit social anxiety symptoms quite early. Trauma, bullying and family instability can also contribute to early onset.
Is Early Onset More Severe?
There is some evidence that people who develop social anxiety early in life tend to have more severe symptoms. One study found that patients with onset before age 10 had higher rates of:
- Comorbid mental health conditions
- Suicidal thoughts and suicide attempts
- Poorer quality of life
Another study found that people with adolescent onset had more severe social anxiety as adults than those with adult onset. Early onset seems linked to greater severity and impact of symptoms over time.
Getting Help at the First Signs
In many cases, social anxiety emerges slowly over time, beginning with shyness in childhood that intensifies into avoidance and panic attacks. The average age of the first symptoms is around 7-11 years old, though children as young as 5 may show signs. The peak age of onset is about 13 years old.
While anxiety at this age is common, it is still important to pay attention to signs and seek help when needed. With supportive treatment, many kids and teens can overcome symptoms before they cause lasting effects on education and socialization. Getting help in the early stages leads to better outcomes. Talk to your child’s doctor, school counselor or a mental health provider if you notice any of the red flags described above.
Treatment Options for Social Anxiety
Whether symptoms start early or later in life, effective treatments for social anxiety exist and can help anyone regain confidence and control. Some of the main treatment options include:
- Therapy: Cognitive behavioral therapy (CBT) helps patients learn new thought patterns while gradually facing feared social situations. Other types of talk therapy can also help.
- Medication: Antidepressants, benzodiazepines and beta blockers may help relieve symptoms. Many medications are approved for social anxiety in kids, teens and adults.
- Social skills training: This teaches strategies for social interaction, eye contact, public speaking and making small talk to build confidence.
- Mindfulness and relaxation: Meditation, deep breathing, yoga, visualization and mindfulness manage anxiety symptoms.
- Support groups: Group therapy reduces isolation and helps anxious individuals learn from others’ experiences.
- School accommodations: Individualized education programs (IEPs) and 504 plans provide academic support for anxious students.
A combination of psychotherapy, social skills training, and medication (if needed) is often most effective. Support groups and school assistance can also help young people with social fears overcome obstacles and reach their full potential.
When to Seek Help
Look for professional help when anxiety about social situations significantly interferes with school, activities, relationships or daily life. Signs it may be time to reach out include:
- Ongoing struggle with public speaking at school
- Refusing to go to parties or make friends
- Dropping out of extracurriculars due to anxiety
- Falling grades and school avoidance
- Panic attacks about social events
- Living in isolation and avoiding others
- Depression, suicidal thoughts or self-harm
Social fears can hold children and adolescents back from crucial chances to connect, learn and grow. Seek help from a doctor, therapist or school counselor when anxiety is taking over and disrupting development.
Outlook with Proper Treatment
While social anxiety may arise early and grow over the pre-teen and teen years, professional treatment makes a difference at any age. Cognitive behavioral therapy produces significant improvement for more than 75% of people with social phobia. Medications and other therapies can also be very effective.
With appropriate support, school accommodations, and social skills training, children and teens can overcome anxiety and succeed academically and socially. Prioritizing mental health helps those with early onset social anxiety go on to lead healthy, fulfilling lives.
Conclusion
Social anxiety typically develops in childhood or the early teen years, with an average onset around age 13. However, signs can emerge in kids as young as 5 or only surface for the first time in adulthood. The earlier anxiety appears, the more severe symptoms often are. Seeking help early on leads to better outcomes. With effective treatment combining therapy, medication, social skills training and other tools, people of all ages can overcome social anxiety and thrive.