SOCIAL ANXIETY WITH SELECTIVE MUTISM


WHAT IS SOCIAL ANXIETY WITH SELECTIVE MUTISM?

All children suffer from fears at one time or another, this is normal. But when a fear creates feelings of overwhelming danger that are disproportionate to the actual situation, the child is most likely suffering from an anxiety disorder.  

Social Anxiety with Selective Mutism produce excessive fear related to social situations and having to talk in front of people. Children with these disorders find it difficult to control their anxiety and stay focused. Sufferers try to avoid activities they believe will cause them discomfort, such as school settings and attending social gatherings. If the situation can’t be avoided, the child becomes distressed.


SYMPTOMS

Emotional symptoms of a child with Social Anxiety with Selective Mutism Disorders may include:  
·      temper tantrums  
·      clinging to parents or refusing to speak in social situations
·      being anxious in anticipation of a feared situation 
·      fear of situations that may cause embarrassment or judgement 
·      expecting the worst possible consequences during a social situation
·      intense fear of interacting or talking with strangers
·      lack of confidence
·      difficulty concentrating
·      a sense of panic

Physical symptoms may include:
·      blushing
·      a racing heartbeat
·      headaches
·      stomachaches
·      trembling
·      difficulty breathing
·      feeling weak
·      sweating
·      fatigue
·      difficulty sleeping                              

When Social Anxiety with Selective Mutism interfere with the child’s sleep, concentration, ability to have fun or function normally, intervention from a mental health professional is needed. 


CAUSES

Predisposition – Some children are prone to being more anxious than others and are less capable of handling stress.  

Genes - If the child comes from a long line of anxious people, chances are that the child will develop an anxiety disorder.

Environment – Situations that may be a factor in developing Social Anxiety with Selective Mutism in a child include: 
·      experiencing an embarrassing social situation
·      overly protective or controlling parents
·      living with an anxious parent – the parent’s anxieties can be passed on
·      living in a volatile home
·      attending a new school
·      being bullied, teased, or ridiculed  


TREATMENT

 Cognitive Behavioral Therapy (CBT) 

CBT helps children recognize their thought patterns and identify where and when those patterns help and where they hurt. In other words, how we think and act affects how we feel. By incorporating Graded Exposure into CBT, the child slowly and systematically faces his fears and learns to better manage the symptoms of his anxiety. With practice the child gains mastery over fear and experiences reduced symptoms.

Dr. Madeleine Vieira's Anxiety Disorder Series, I’M AFRAID, introduces CBT techniques to help children overcome their anxiety disorders. 

Darcy Deer Is Afraid to Talk, Sometimes! focuses on Social Anxiety with Selective Mutism. In this book, Darcy wants to perform in the school play, but he’s afraid of crowds and is worried that he won't be able to say his lines. To overcome his fear, he uses a stepladder process (i.e., Graded Exposure) to gradually expose himself to social situations in which he will need to talk. He starts with small steps and gradually builds up to more fearful situations. 

In treatment, mental health professionals help children to control their Social Anxiety with Selective Mutism and uncomfortable feelings using specific techniques such as:
·      Understanding that the imagined outcome associated with the anxiety isn’t realistic. 
·      Using self-talk to ‘fight’ the fear. The child might tell himself that what he thinks will happen won’t actually happen.
·      Using relaxation techniques. The child is taught to use controlled breathing exercises to help lessen anxious feelings.
·      Using role-playing techniques, such as practicing worst-case outcomes. The mental health professional will help the child realize that the outcomes are not possible or highly unlikely. 
·      Teaching the child that he can manage his uncomfortable feelings successfully without avoidance. This takes time, repetition, and practice!

Anti-Anxiety Medication

When a child’s Social Anxiety with Selective Mutism doesn’t fully respond to CBT, anti-anxiety medication prescribed by a child & adolescent psychiatrist may be beneficial.

Additional Help 

Based on the therapeutic technique of Graded Exposure, a component of Cognitive Behavioral Therapy (CBT), Darcy Deer Is Afraid to Talk, Sometimes! demonstrates that it is possible for children to manage their anxiety. The story guides children through steps that research shows help them overcome the harmful habits and patterns they’ve developed while struggling with their fears. Along with the story, there is an About Anxiety page, a Coping Strategies page, and a Stepladder page. These additional tools can help alleviate anxiety symptoms. 


REFERENCES

  1. https://emedicine.medscape.com/article/917147-overview  

  2. https://www.psycom.net/selective-mutism-kids

  3. https://selectivemutismcenter.org/whatisselectivemutism/

  4. https://www.psycom.net/social-anxiety-how-to-help-kids

  5. https://www.mayoclinic.org/diseases-conditions/social-anxiety-disorder/symptoms-causes/syc-20353561