Everyone has moments of fear over their performance on things like college exams and projects or they worry whether they’ll please their boss or colleagues. For those who suffer from social anxiety, however, concerns like these may not only impact their ability to learn, they may also lead them to make different education or career choices than they would actually prefer.
Everyone looks forward to going off to college, right? High school graduates eagerly plan to meet new friends, enjoy parties, learn about their future degree field, and have the chance to live their own life without having to follow rigid rules at home. For most teens, college represents a rite of passage – it’s a symbol of adulthood and independence. For someone with social anxiety, though, the new world of being a college student is not so friendly. Instead, all they can see is an endless list of potential situations in which they will have to fight their physical anxiety symptoms and battle to manage their anxious thoughts.
Students with social anxiety often avoid or don’t participate in group projects or lectures in college due to embarrassment and self-consciousness, their fear of being criticized, or worrisome physical symptoms, such as sweating or stuttering. Research also indicates that socially anxious students judge their own competence poorly when participating in a seminar or presentation (Austin, 2004) and this worry continues regardless of whether or not the student performs well academically. In fact, social anxiety can make college life so terrifying that some studies have reported that students with social anxiety fail to complete school and drop out before they can graduate (Van Ameringen, et al, 2003).
When it comes to careers, social anxiety can negatively impact career choices and occupational functioning. According to a study by Himle, et al (2014), people with social anxiety “have significantly different career aspirations than job-seekers without social anxiety.” Carnevale, et al (2010), reported that job sectors requiring strong workplace-based social capabilities (for example: healthcare or hospitality) “are among the most active in the current economy, yet people with social anxiety routinely avoid jobs requiring social interaction”.
As far as occupational functioning, a study done by Stein and Kean (2000) suggests that approximately 20% of people with social anxiety disorder reported declining a job offer or a promotion due to social fears.
People with social anxiety who want to get past their fears in order to have a wider choice of jobs or to find jobs with a more social aspect can benefit from Cognitive Behavioral Therapy (CBT) and exposure therapy.
Additionally, a study by Beidel, et al (2014), suggests that people with social anxiety can be helped even more effectively through a combination of CBT/exposure therapy and social skills training.
During the Beidel, et al, study, participants used modeling, behavior rehearsal, and feedback to learn such things as basic conversational skills, assertiveness training, and effective public speaking. They also went through exposure sessions consisting of scenes designed to address each person’s unique fears. At the conclusion of the study, 67% of the people treated with the combination of social skills training and CBT no longer met the diagnostic criteria for social anxiety disorder.
The National Social Anxiety Center is a national association of regional clinics with certified cognitive therapists specializing in social anxiety and anxiety-related problems. We have compassionate therapists who can help you to reduce social anxiety. Currently, we have regional clinics in San Francisco, District of Columbia, Los Angeles, Pittsburgh, New York City, Chicago, Newport Beach / Orange County, Houston / Sugar Land, St. Louis, Phoenix, South Florida, Silicon Valley / Sacramento Valley, and Dallas. Contact our national headquarters at (202) 656-8566 or visit our Regional Clinics contact page to find help in your local area.
Article written by:
Austin, B.D. (2004). Social anxiety disorder, shyness, and perceived social self-efficacy in college students. Dissertation Abstracts International: Section B: The Sciences and Engineering, 64 (7-B), 31–83.
Beidel, Deborah C. et al. “The Impact of Social Skills Training For Social Anxiety Disorder: A Randomized Controlled Trial.” Journal of anxiety disorders 28.8 (2014): 908–918. PMC. Web. 28 June 2018.
Carnevale AP, Smith N, Strohl J. Help Wanted: Projections of Jobs and Education Requirement through 2018. Washington, DC.: Georgetown University Center on Education and the Workforce; 2010.
Himle, Joseph A et al. “A Comparison of Unemployed Job-Seekers with and without Social Anxiety.” Psychiatric services (Washington, D.C.) 65.7 (2014): 924–930. PMC. Web. 24 June 2018.
Stein MB, Kean YM. Disability and quality of life in social phobia: Epidemiologic findings. American Journal of Psychiatry. 2000;157:1606–3.
Van Ameringen, M., Mancini, C. & Farvolden, P. (2003). The impact of anxiety disorders on educational achievement. Journal of Anxiety Disorders, 17(5), 561–571.
A hypochondriac is someone who lives with the fear that they have a serious, but undiagnosed medical condition, even though diagnostic tests show there is nothing wrong with them. Hypochondriacs experience extreme anxiety from the bodily responses most people take for granted. For example, they may be convinced that something as simple as a sneeze is the sign they have a horrible disease.
Hypochondria accounts for about five percent of outpatient medical care annually. More than 200,000 people are diagnosed with hypochondria (also known as health anxiety or illness anxiety disorder) each year. While health anxiety generally begins in early adulthood, children can also experience hypochondria.
True hypochondria is a mental health disorder. Hypochondria may show up in a child after they or someone they know has gone through an illness or a serious medical condition. Its symptoms can vary, depending on factors such as stress, age, and whether the person is already an extreme worrier.
In children, hypochondriac symptoms may include:
· Regularly checking themselves for any sign of illness
· Telling you about a new physical complaint almost every day
· Fearing that anything from a runny nose to a gurgle in their gut is the sign of a serious illness
· Frequently asking their parent to take them to the doctor
· Asking to have their temperature taken daily (or more than once per day)
· Talking excessively about their health
· Happily wearing bandages like badges of honor, has one on almost constantly
· May focus excessively on things most children typically don’t: a certain disease (example: cancer) or a certain body part (example: worrying about a brain tumor if they have a headache)
· Having frequent pains or finds lumps that no one else can feel
· Fearing being around people who are sick
Health anxiety can actually have its own symptoms because it’s possible for the child to have stomachaches, dizziness, or pain as a result of their overwhelming anxiety. In fact, illness anxiety can take over a hypochondriac’s life to the point that worrying and living in fear are so stressful, the child refuses to go to school or participate in outside activities.
You may be wondering what triggers hypochondria. Although there really isn’t an exact cause, we do know that people with illness anxiety are more likely to have a family member who is also a hypochondriac. The child with health anxiety may have gone through a serious illness and fear that their bad experience may be repeated. Or, they may already be suffering from a mental health condition and their hypochondria may be part of it.
Self-help for child hypochondria can include:
Professional treatments for hypochondria include:
Being a hypochondriac negatively affects the lives of the child who suffers from it. The child psychologists at the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida are experienced in helping those with illness anxiety. For more information, contact us or call us today at (561) 223-6568.
Following the Netflix release of 13 Reasons Why in 2017, many mental health, suicide prevention, and education experts from around the world expressed a common concern about the series’ graphic content and portrayal of difficult issues facing youth. Resources and tools to address these concerns were quickly and widely disseminated in an effort to help parents, educators, clinical professionals and other adults engage in conversations with youth about the themes found in the show.
In advance of the release of season 2, SAVE (Suicide Awareness Voices of Education) brought together a group of 75 leading experts in mental health, suicide prevention and education as well as healthcare professionals (see full list below) to develop tools to help encourage positive responses to the series. In just a few short months, this group has developed a toolkit providing practical guidance and reliable resources for parents, educators, clinicians, youth and media related to the content of the series (suicide, school violence, sexual assault, bullying, substance abuse, etc.).
Using the toolkit and resources developed will help to encourage conversations, identify those at risk and prevent unexpected tragedies. Hopefully, it will also help those in need get the appropriate level of support and professional care to ensure that youth are protected, nurtured and our communities are stronger.
Executive Director – SAVE
SAVE especially thanks the following sub-group leaders in this effort:
Katherine C. Cowan
The organizations listed below represent thousands of mental health and suicide prevention, education experts and healthcare professionals from around the world with decades of experience working with youth, parents, schools and communities.
While it’s simply “being human” to occasionally pick at your skin, at calluses, or at the cuticles on your fingers, when a person obsessively self-grooms, it could be a sign of dermatillomania or excoriation disorder. In layman’s terms, this is a skin picking disorder. The condition is a form of obsessive-compulsive disorder and is one of a group of body-focused repetitive behaviors (BFRB). Dermatillomania damages skin and is characterized by compulsively picking, touching, pulling, rubbing, digging into, scratching, or even biting at one’s own skin as a way to get rid of perceived skin irregularities.
Research shows that anywhere between 2% and 5% of people compulsively pick at their skin. Females make up about 75% of those who are diagnosed with excoriation disorder. Skin picking can begin at any age, but commonly shows up in adolescence or at the onset of puberty. The condition made come and go over time, and the location the person picks at may change, but the disorder is generally chronic.
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) signs and symptoms of dermatillomania include:
Picking at the skin can cause anxiety, depression and embarrassment in those who have dermatillomania. They may attempt to cover their skin lesions with makeup or clothing and may avoid situations in which their condition may be discovered. This can lead to isolation and emotional distress, which can increase the risk of having a mood or anxiety disorder in addition to their dermatillomania. Another complication can be the need for medical care because it isn’t uncommon for the person to get a skin infection, open wound, or scars from picking too much.
It is thought that fewer than one in five people will seek treatment for excoriation disorder, however Cognitive Behavioral Therapy (CBT) is very helpful for those who do. CBT helps patients identify the negative or inaccurate thoughts, feelings and behaviors that have become problematic and teaches them how to challenge and change their reaction to them.
While the main therapy for dermatillomania is behavioral therapy, medication is sometimes used to reduce the feelings that lead to compulsive skin picking. Although psychiatric medications have limited success, there are some people who benefit from temporary use of them, particularly if they have a concurrent condition, such as anxiety or depression. Additionally, some skin medications can help the underlying condition (such as acne) that causes the individual to pick at their skin.
As a family member, it can be difficult to be supportive of a person with dermatillomania or other BFRBs. The behavior can strain relationships with friends and family. Remember to communicate with patience and empathy and remain calm when talking to the person. If you feel overwhelmed, join a support group or explore the resources in self-help groups or in books on the subject.
For more information about how a child psychologist at the Children’s Center can help your child overcome skin picking, contact the Children’s Center for Psychiatry, Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.
Our team presented at the 2018 ADAA Conference on Treatment Resistant Panic Disorder: A Multidisciplinary Multimodality Approach. You can access the audio recording of our session here with the below login credentials.
We hope you find the recording of our presentation helpful and informative!
It’s only been in the last twenty years or so that young people who identify as lesbian, gay, bisexual, transgender, or queer/questioning (LGBTQ) have become more open about their sexuality. For many of these youths, their fear of not being accepted by their families and peers kept them from telling anyone about their orientation until they were adults. Recently, however, these teens have found more access to support through an increase in social acceptance, internet communities, school diversity programs, and youth groups for LGBTQ adolescents. These resources have allowed them to feel more comfortable with their sexual orientation and helped them come out to others at a younger age than in the past. Even though LGBTQ teens are finding more support, however, they still face unique mental health risks.
Despite the fact that identifying as LGBTQ has become more socially acceptable, a gay teen has a disproportionately higher amount of mental health concerns than their heterosexual counterpart. The Centers for Disease Control and Prevention (CDC) reports that LGBTQ teens have an increased risk of personal violence:
The National Institutes of Health (NIH) reports that sexual minorities, such as LGBTQ teens, face not only chronic stress from their stigmatized identities, but also victimization, prejudice, and discrimination. How much these external stressors affect these youths depends on their own negative internalization of their sexual orientation, their expectation or personal experience with discrimination or rejection, and their ability to cope with these stressors.
Studies have also shown that teens and adolescents who identify as LGBTQ are at greater risk for mental health problems across all developmental stages. Among other things, they have:
Positive parenting behaviors can have a huge impact on an LGBTQ teen’s mental and physical health, both now and in the future. When parents show their child they are valued, their teens have healthier mental and emotional outcomes. Not unsurprisingly, the CDC reports that parental rejection has been linked to drug and alcohol use, risky sexual behavior, and depression in LGBTQ youths.
As a parent, you can support your LGBTQ teen in many ways:
For more information about how you can support your LGBTQ youth, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.
Stress surrounds us on a daily basis. From traffic delays to work projects, worries about finances or health, and news reports of world events, the demands of our everyday lives produce both positive and negative stress. Stressors (which are the things that cause your stress) can be physical, emotional, theoretical, or environmental. Even positive events like weddings and job promotions cause stress.
Whether negative or positive, one thing is certain – stress raises the body’s anxiety levels. When we’re under stress, the “fight or flight” response kicks in. It raises your heart rate and your blood pressure. It sometimes causes you to lose sleep or feel like you can’t breathe. While this response generally subsides after the stressor is removed, a prolonged or permanent stress response can develop in someone who is under frequent or constant stress. This is called toxic stress and it can affect children just the same as adults.
The incidence of diabetes, obesity, heart problems, cancer and other diseases increases when a child lives with toxic stress. Additionally, a child’s chances of smoking, depression, substance abuse and dependence, teen pregnancy and/or sexually transmitted disease, suicide and domestic violence escalates. So does their tendency to be more violent or to become a victim of violence.
Studies done by the Centers for Disease Control and Prevention (CDC) show that when a child is subjected to frequent or continual stress from thing like neglect, abuse, dysfunctional families or domestic abuse – and they lack adequate support from adults – their brain architecture is actually altered and their organ systems become weakened. As a result, kids who live with stress risk lifelong social and health problems.
Of the 17,000 people participating in the CDC study, two thirds reported an Adverse Childhood Experiences (ACE) score of 1 or higher. Of these, 87% had more than one ACE. By measuring and scoring ten types of trauma ranging from neglect or bullying to childhood sexual abuse and even divorce, researchers could assess the chronic disease risk for the study’s mostly white, middle class participants. Their results showed that the problem of toxic stress isn’t limited to children of certain ethnic groups or those who face poverty – children from all walks of life can have high ACE scores which will affect their entire lives.
If you would like to find out your ACE score and what it might mean for you, go here.
Children who are exposed to toxic stress exhibit:
Research on children who face continued toxic stress shows they are more likely to have:
The key to preventing and reducing toxic stress in kids is awareness. Now that we know about the effects of ACEs, many states have conducted their own research. Some cities formed task forces, while others are working with pediatricians, schools, daycare centers and the justice system to set up screening programs that can turn lives around.
Protecting children from toxic stress involves a multi-faceted approach that targets both the caretaker and the child in order to strengthen family stability. Treatment includes intervention and implementation of methods that reduce stressors and reinforce the child or caregiver’s response to stress.
As more programs are formed, researchers have found that children can benefit even when the solutions are solely focused on their caregiver and aren’t aimed at the child. This is most likely because the caregiver’s altered interaction with the child makes the child feel safer. Parenting classes, family-based programs, access to social resources for parents, peer support and telephone support are beneficial. Cognitive behavioral therapy and relaxation methods like yoga and mindfulness are also helpful. Additionally, community-based programs like Head Start have been shown to be effective.
For more information about toxic stress and its effects on child development, contact the Children’s Center for Psychiatry Psychology and Related Services in Delray Beach, Florida or call us today at (561) 223-6568.