One of the most common psychiatric conditions is the social anxiety disorder. A research shows that about 14% of the adults and 1% of the children have it. The cause for social anxiety is a combination of two factors – genetics and environment. When anxiety disorder is inherited – the cause of course is genetic.

Many children have one or two parents with an anxiety disorder, but not necessarily with social anxiety disorder. Children who are permanently irritable as babies, shy and fearful as toddlers, and cautious, quiet, and self-conscious at school age are lot more likely to have biological parents with anxiety disorders. They are also more likely to develop social anxiety disorder later in life. By environmental cause is meant everything outside genetics. Most common of the environmental causes of social anxiety disorder are – speech or language problem, physical illness, abuse, neglect, nervous parents and certain quite embarrassing experiences. Most of the cases are a combination of both causes – genetic and environmental. The genetic load must be massive – both parents with multiple anxiety disorders – to cause social anxiety disorder in the lack of any environmental problem. And the other way round, it takes a huge environmental cause – a huge abuse and neglect – to cause an anxiety disorder if there is no family history of such illnesses.

The symptoms of social anxiety disorder can be seen in children as young as one year old. The children who have this condition are less interested in exploring new things. Instead of being excited by new things, they are more likely to be scared. During the preschool, they are shy with strangers and might not speak and contact well to people outside the family. Quite a lot of children with social anxiety disorder have some speech or language problems. Others are shy and have some physical medical problem, which makes them more noticeable, but most have no language or physical problems. This is why children with this condition almost never have been considered to require assessment at this point. Here are the most feared social situations: reading aloud in front of class; musical or athletic performances;  joining in on a conversation; starting a conversation; writing on the blackboard; speaking to adults;  ordering food in a restaurant; attending dances or birthday parties. Not so common are: answering questions in class; working or playing with other kids; asking the teacher for help; gym class; inviting a friend over; eating in a cafeteria with kids; walking in the hallway; answering the phone; eating in front of others.

Social anxiety disorder is very disabling. Children suffering from it are often loners but they do not really want to be. They have poor social skills. They are very lonely. Children with social anxiety disorder have no or few friends. Half of them are not taking part in any after school activities. Half do not like school and 10% refusing to go to school. There is a big number of different anxiety disorders, which are often found with social anxiety disorder. Separation anxiety disorder – it is a fear of separation from the parents. About 6% of children with social anxiety disorder have this. Generalized anxiety disorder – children who worry all the time over nothing – themselves, others safety, their health, the world, and everything else you can imagine. Panic disorder – when the brain is giving a rush of adrenaline for no good reason. Post-traumatic stress disorder – when something horrible happened to a child, they would keep thinking of it repeatedly, avoid things that remind them of that, being very nervous. Phobias- an unreasonable fear of all sorts of things. Being in crowds, in the dark, dying, and heights are common ones.

Many children with social anxiety disorder have other psychiatric disorders as well. Some have panic attacks, attention deficit disorder, generalized anxiety disorder, agoraphobia, or depression. Quite often, you can see a child with two anxiety disorders, depression, and attention deficit disorder at the same time.

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