Dear Teen Parenting Coach

Q: My Teen Has Only Online Friends — Will Screen Time Limits Help?

Avoiding face-to-face interaction with others can be a symptom of social anxiety disorder, which occurs more frequently in children and adults with ADHD. Anxious teens may turn away from their peers toward the relative anonymity of the Internet, but this can exacerbate the problem. Here’s how to tell when it’s more than just shyness and where to find your child help.

Q: “My 16-year-old son doesn’t like to be around a lot of people. He would rather stay in his room by himself. He has online friends but only one friend who he has over to our house about once every month or two. He refuses to go through a drive-thru restaurant; he says it causes anxiety. I encourage him to get involved in group activities, but he says that will just increase his anxiety. He is a junior in high school and earlier said that he wanted to go to a community college after graduation, but now he says he wants to take a year off to learn computers on his own. I’m afraid this is another instance of social anxiety that he just doesn’t want to admit. It seems to have become worse as he’s gotten older, and he’s spending more and more time on his computer. Should I limit screen time or take him to see a psychiatrist? How can I help him?”—VAMom

Dear VAMom,

It must be really tough to see your child struggle so much with social situations. Whether it’s ordering fries at the drive-thru or inviting a friend over to watch a basketball game, his discomfort and insecurity about interacting with others in real, face-to-face situations is clearly interfering with his ability to live as fully as both of you would like. Even if he may not admit it (teens often don’t), he’s showing you that he feels isolated and lonely. His recent desire to study computers at home instead of continuing school could be another sign that he needs help managing his teenage social anxiety and learning social skills.

Everybody needs friends — people who laugh at our jokes, comfort us during low points, and share in our successes. These relationships sustain us. Living a satisfying life means finding people to interact with and navigating the normal ups-and-downs that come with connections. Teenage social anxiety is often misunderstood. People frequently hide their difficulties by spending time alone. They try to keep their nervousness from peers, ashamed that they can’t be like everyone else and engage with peers more easily. Often, these teens want to change but can’t figure out what to do or how to do it.

Social media and excessive time spent on the computer may exacerbate your son’s social anxiety. Negative comments, teasing, and bullying happen online almost instantaneously. With 24/7 access, there’s no escaping the backlash if you misspeak or do something foolish. Worried about what others think or post about them, teens who are already tentative about social interactions become more afraid of putting themselves in novel situations and reaching out to make friends. There’s nothing like other kids’ posts about their wonderful lives to intimidate your son even more. When you throw in the challenges that many teens with attention deficit disorder (ADHD or ADD) have with reading and processing social and emotional cues, they feel unable to measure up. It’s a frightening, self-defeating cycle.

So, what can you do to help? I recommend that you take your son to see his pediatrician for an assessment of what’s going on and a referral for therapy and/or a consultation with a psychiatrist for medication. I’ve seen many boys like your son experience some relief from the intensity of their symptoms with medication. But pills don’t teach skills. He has to learn how to interact with people more comfortably, despite whatever protests he may voice. Therapy can help; he’ll build a relationship with a caring adult who, through discussions and role plays, can show him how to reach out to others with more confidence. The therapist can also offer you support and facilitate family discussions on hot-button issues such as screen time limits and college plans.

[Self-Test: Does My Child Have Generalized Anxiety Disorder?]

Online friends satisfy one aspect of relating to others, but they don’t assist teens with learning how their words and actions affect others and vice versa. Your son would likely benefit from limits on his computer time. If nothing else, he could use that time to interact with you —  maybe watch a TV show together or do a big puzzle. You can’t read someone’s facial reaction or body language online. Without practicing these skills in real time and shared space, he’ll continue to experience the social awkwardness that is holding him back.

You’ll have to get him on board for this plan of action to work. Try these steps:

  1. Call his pediatrician to discuss the current situation and your thoughts about therapy and possibly medication. Ask for an appointment where the doctor can make these recommendations. Your son is more likely to listen to any suggestions when they don’t come from you.
  2. Before this appointment, make a time to talk with your son about the topic of improving his social interactions. Use the metaphor of exercising: Like muscles, social skills require practice to strengthen over time. The goal is for him to become the independent adult you both want him to be. Just like professional athletes need trainers and a customized workout, you now realize that you and your son need a plan of action to reduce his anxiety with social situations. That’s why you’re going to meet with his pediatrician.
  3. Expect him to push back. He’s been isolating himself successfully for quite a while, and it’s comforting and safe for him. Before the appointment, remind him of a time in the past when he did something that frightened him and he succeeded. Anxiety combined with ADHD frequently erase memories of past successes. He’ll need these to reassure himself that he is indeed capable of moving forward.

[Read This: You’re Not Shy or Stuck Up. You Have Social Anxiety Disorder]

Reducing social anxiety, like building muscles, takes time and repetition. Whatever small successes he experiences along the way will eventually lead him to improved self-confidence and willingness to take further steps forward in the future.

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The opinions and suggestions presented above are intended for your general knowledge only and are not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your own or your child’s condition.