If you suspect that your teenager may suffer from social anxiety disorder (SAD), it can be hard to know what to do and how to bring the topic up in conversation. Dr. Steven Richfield, a child psychologist and author, provides the following tips to broach the topic of social anxiety with a teenager.

• Be Curious. There is nothing more off-putting to a teenager than a parent who seems meddlesome and concerned. Instead, talk with your teen from a curious perspective to learn more about how she is feeling.
  
  

• Talk Openly. Your teen may be embarrassed by the topic but that doesn't mean that you should be. Be as calm and direct as you can to encourage further conversation.
  
  
• Challenge Your Teen. It is never too late to overcome social anxiety. Suggest that your teen start with peers who seem open and approachable when taking those difficult first steps.
  
  
• Encourage Cultural Literacy. Suggest that your teen become aware of what is popular; music, television, movies, clothes, sports, school clubs and social networking sites are good topics of conversation.

Above all else, remember that your teen is an individual. If she prefers reading books to wild parties, that is her prerogrative. However, when self-imposed isolation interferes with the natural socialization process, it may be time to step in.

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You have probably heard of people bringing service animals on airplanes to help with a variety of conditions. When animals are companions for people with mental health problems they are generally referred to as emotional support animals. With the right documentation, someone with social anxiety disorder (SAD) could bring a dog along on a flight, as long as that dog is an emotional support animal.

A woman in Missouri decided to take the concept of a service animal a few steps further. Debby Rose recently sued Wal-Mart (among other organizations) in a bid to be able to bring her pet monkey Richard along while shopping. Rose argued that Richard was a service animal and that she suffered with SAD. The judge ruled in favor of Wal-Mart, arguing that Rose had not received a proper diagnosis or treatment for her condition, and that the monkey posed a health risk to other customers.

In general I am in favor of emotional support animals however I believe that this woman may have crossed the line. What are your thoughts about this case? Vote in the poll below.

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Selective mutism is a form of social anxiety that renders a child or adult unable to speak in certain social situations. For children with selective mutism, heading back to school in the fall can be more than just a drag. It can be the beginning of anxiety-filled days, lonely lunches, and pressure to speak from teachers.

Middle-school teacher Eileen Dame has written an interesting account of her experiences teaching a boy with undiagnosed selective mutism. Above all else, she stresses the importance of recognizing the disorder in children so that the problem can be addressed. Although selective mutism is more prevalent than obsessive-compulsive disorder and Tourette's syndrome, it often goes undiagnosed.

Below are some tips for teachers of students with selective mutism according to Dame.

• Remove all pressure on the student to speak.
  
  
  
• Let the child know you will not call on him unless his hand is raised.
  
  
  
• Do not comment about his silence or make a big deal out of it if he does speak.
  
  
  
• Be aware that the student cannot ask you for help. Quietly review material and instructions if it seems the student does not understand.

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If you haven't seen Melanie Lynskey on the television show "Two and a Half Men", the release of three new films will be sure to raise the profile of this under-appreciated star. "The Informant!" with Matt Damon, "Up in the Air" with George Clooney, and "Leaves of Grass" with Edward Norton are already receiving rave reviews. However, unlike most Hollywood actresses, Lynskey is a little unsure about the fame and celebrity that comes with acting.

The actress reports being "awkward and shy" in real life, and terrified of fancy parties and having to sell herself. Instead, Lynskey enjoys acting as an escape; a way to "get out of herself". Perhaps she will be able to follow in the footsteps of other Hollywood stars who have avoided the spotlight and focused on acting.

Personally, I have enjoyed Lynskey on-screen and look forward to her becoming more well-known. She is soft-spoken but compelling and interesting to watch, and it seems that Hollywood is finally starting to take notice.

Photo: Charles Eshelman / Getty Images

In a recent article in the New York Times, the work of Jerome Kagan, an influential developmental psychologist now in his 80's is discussed. One of the major contributions that Kagan has made to the understanding of child development is the fact that anxiety as an adult can be somewhat predicted by tempermant as a baby.

Kagan's work includes longitudinal studies (studies over time) that compared the behavior of babies to their behavior as adults. One of the most important findings was that highly reactive babies (those who fussed when exposed to novelty) were more likely to be anxious as adults. The common thread is physiology that causes a person to be highly sensitive.

Does this mean that fretful babies are doomed to become anxiety-filled adults? According to Kagan, although babies who are highly sensitive will be at greater risk as adults, a disorder is not inevitable. The development of an anxiety disorder may be prevented by a protective environment and upbringing. In the end, it is your emotions and behavior that determine whether a disorder develops, and these are at least to some extent, under your control.

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I was recently reading an article about a school board in Fredericksburg, Virginia that had cut students' recess time in half; down to 30 minutes per day for those in kindergarten through second grade, and only 15 minutes per day for those in grades three through five. Recess had been cut in order to rearrange the school day to better focus on academic achievement.

In the article, the parent of a child suffering with severe social anxiety noted that her son's progress would be impeded by the reduction in recess. He had been working with teachers and counselors to learn how to interact with peers on the playground. Already successful academically, what he really needed was more social time.

I have a few perspectives about this story.

Having worked for a school board I am acutely aware of the emphasis that is placed on standardized test scores, sometimes to the detriment of other less measurable aspects of development such as social skills.

As a former student, I remember long recesses spent in the company of friends learning double-dutch, making snow forts, and generally just making connections with other children.

As the parent of an active toddler, I have fears about the lack of free time for my daughter to form friendships at school.

In general, I think that social and emotional development are just as important as academic achievement (if not more so) for youngsters today and decisions like this are a step in the wrong direction. What is your take on this issue?

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Musical performance anxiety is a type of social anxiety specific to musicians. Musicians who suffer with musical performance anxiety may worry weeks or months before a performance and may perform below their abilities because of anxiety. Anxiety about performing as a musician can be distressing for those who experience this type of performance anxiety.

What can you do to cope with anxiety about musical performances? Below are a few quick tips to help you through that next big solo:

• realize that everyone is a little bit nervous when performing; a little bit of nervousness gives energy to your performance
  
  

• don't dwell on minor errors or mistakes; the audience probably won't even notice small slips if you keep going
  
  
• visualize the performance in advance and see yourself succeeding
  
  
• practice relaxation techniques during practice and when performing

If coping strategies are not helping you overcome musical performance anxiety, it may be time to seek professional help. Medications such as beta blockers can be helpful for performers who are unable to manage stage fright. Talk to your doctor about your symptoms and the best course of action can be determined between the two of you.

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The recently released children's book Brave: Be Ready and Victory's Easy, co-written by Marjie Knudsen and children's psychologist Jenne Henderson aims to help kids manage social anxiety by being prepared.

Knudsen writes from the experience of having two children with social anxiety. In the book, a fifth grader named Danny deals with the social challenges of school. If you have a school-aged child who suffers with SAD, this book may be a good way to introduce coping strategies and start talking about social anxiety.

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Researchers have proven what has been known anecdotally for several years; clinican-supported online therapy for social anxiety disorder (SAD) can be just as effective as traditional treatment.

Gavin Andrews and Nick Titov of the University of New South Wales (UNSW) and St. Vincent's Hospital conducted randomized controlled trials to look at the effectiveness of online therapy for depression, generalized anxiety disorder (GAD), and SAD. Therapy consisted of online lessons, regular emails and online discussion forums.

Of those with SAD, 85% showed improvement over the course of therapy. The researchers hope to have treated close to 1200 clients by the end of 2009, and are hopeful that this type of program will mean more that more people with anxiety and depression will receive help. Not only is online therapy easier to adminster, but it is also more cost-effective.

For more information about the program, visit the virtual clinic.

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Many people with social anxiety disorder (SAD) have fears about eating and drinking in front of others. You may be afraid that your dining companion will notice your shaking hand as you raise a spoonful of soup to your mouth. Or you may be so consumed with anxiety that you can't even eat your meal for fear of spilling your food or worse yet, becoming sick. Living with these fears can be terribly limiting since food and drink are intertwined in so many life experiences.

Fortunately, there are steps that you can take to quell your anxiety about eating in front of others. Below are some resources to get you started.

• Overview of the fear of eating in front of others

• How to use exposure training to overcome the fear of eating in front of others
• Share your stories - How do you handle eating in front of others?

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