What’s the difference between shyness and social anxiety?
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What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.
The terms “shyness” and “social anxiety” are often used interchangeably because they both involve feeling uncomfortable in social situations.
However, feeling shy, or having a shy personality, is not the same as experiencing social anxiety (short for “social anxiety disorder”).
Here are some of the similarities and differences, and what the distinction means.
How are they similar?
It can be normal to feel nervous or even stressed in new social situations or when interacting with new people. And everyone differs in how comfortable they feel when interacting with others.
For people who are shy or socially anxious, social situations can be very uncomfortable, stressful or even threatening. There can be a strong desire to avoid these situations.
People who are shy or socially anxious may respond with “flight” (by withdrawing from the situation or avoiding it entirely), “freeze” (by detaching themselves or feeling disconnected from their body), or “fawn” (by trying to appease or placate others).
A complex interaction of biological and environmental factors is also thought to influence the development of shyness and social anxiety.
For example, both shy children and adults with social anxiety have neural circuits that respond strongly to stressful social situations, such as being excluded or left out.
People who are shy or socially anxious commonly report physical symptoms of stress in certain situations, or even when anticipating them. These include sweating, blushing, trembling, an increased heart rate or hyperventilation.
How are they different?
Social anxiety is a diagnosable mental health condition and is an example of an anxiety disorder.
For people who struggle with social anxiety, social situations – including social interactions, being observed and performing in front of others – trigger intense fear or anxiety about being judged, criticised or rejected.
To be diagnosed with social anxiety disorder, social anxiety needs to be persistent (lasting more than six months) and have a significant negative impact on important areas of life such as work, school, relationships, and identity or sense of self.
Many adults with social anxiety report feeling shy, timid and lacking in confidence when they were a child. However, not all shy children go on to develop social anxiety. Also, feeling shy does not necessarily mean a person meets the criteria for social anxiety disorder.
People vary in how shy or outgoing they are, depending on where they are, who they are with and how comfortable they feel in the situation. This is particularly true for children, who sometimes appear reserved and shy with strangers and peers, and outgoing with known and trusted adults.
Individual differences in temperament, personality traits, early childhood experiences, family upbringing and environment, and parenting style, can also influence the extent to which people feel shy across social situations.
However, people with social anxiety have overwhelming fears about embarrassing themselves or being negatively judged by others; they experience these fears consistently and across multiple social situations.
The intensity of this fear or anxiety often leads people to avoid situations. If avoiding a situation is not possible, they may engage in safety behaviours, such as looking at their phone, wearing sunglasses or rehearsing conversation topics.
The effect social anxiety can have on a person’s life can be far-reaching. It may include low self-esteem, breakdown of friendships or romantic relationships, difficulties pursuing and progressing in a career, and dropping out of study.
The impact this has on a person’s ability to lead a meaningful and fulfilling life, and the distress this causes, differentiates social anxiety from shyness.
Children can show similar signs or symptoms of social anxiety to adults. But they may also feel upset and teary, irritable, have temper tantrums, cling to their parents, or refuse to speak in certain situations.
If left untreated, social anxiety can set children and young people up for a future of missed opportunities, so early intervention is key. With professional and parental support, patience and guidance, children can be taught strategies to overcome social anxiety.
Why does the distinction matter?
Social anxiety disorder is a mental health condition that persists for people who do not receive adequate support or treatment.
Without treatment, it can lead to difficulties in education and at work, and in developing meaningful relationships.
Receiving a diagnosis of social anxiety disorder can be validating for some people as it recognises the level of distress and that its impact is more intense than shyness.
A diagnosis can also be an important first step in accessing appropriate, evidence-based treatment.
Different people have different support needs. However, clinical practice guidelines recommend cognitive-behavioural therapy (a kind of psychological therapy that teaches people practical coping skills). This is often used with exposure therapy (a kind of psychological therapy that helps people face their fears by breaking them down into a series of step-by-step activities). This combination is effective in-person, online and in brief treatments.
For more support or further reading
Online resources about social anxiety include:
- This Way Up’s online program for managing excessive shyness and fear of social situations
- Beyond Blue’s resources on social anxiety
- a guide to looking after yourself if you have social anxiety, from the Western Australian health department
- social anxiety online program for children and teens from the University of Queensland
- inroads, a self-guided online program for young adults who drink alcohol to manage their anxiety.
We thank the Black Dog Institute Lived Experience Advisory Network members for providing feedback and input for this article and our research.
Kayla Steele, Postdoctoral research fellow and clinical psychologist, UNSW Sydney and Jill Newby, Professor, NHMRC Emerging Leader & Clinical Psychologist, UNSW Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Pear vs Peach – Which is Healthier?
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Our Verdict
When comparing pears to peaches, we picked the peaches.
Why?
Both are great! But peaches are exceptional in some ways that pears just can’t match up to:
In terms of macros, pears have more carbs and fiber, the ratio of which results in an approximately equal glycemic index. Thus, we’ll say that pears win this round by virtue of being the nutritionally denser option.
Looking at the vitamins, pears have (slightly) more of vitamins B6, B9, and K, while peaches have (much) more of vitamins A, B1, B2, B3, B5, B7, C, E, and choline—thus sweeping this category easily for peaches.
In the category of minerals, pears have more calcium and copper, while peaches have more iron, magnesium, manganese, phosphorus, potassium, and zinc. This time, the margins of difference for each mineral are comparably low (i.e. pears are close behind peaches on all those minerals), but still, by strength of numbers, it’s a clear win for peaches.
When it comes to polyphenols, not only do peaches have more, but also, they have anticancer properties that pears don’t—see our link below for more about that!
Meanwhile, adding up the sections makes for an overall win for peaches, but as ever when it comes to fruits, by all means enjoy either or both; diversity is good!
Want to learn more?
You might like to read:
Top 8 Fruits That Prevent & Kill Cancer ← peaches in the #2 spot! They induce cell death in cancer cells while sparing healthy ones
Enjoy!
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Here’s the latest you need to know about bird flu
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What you need to know
- Although bird flu continues to spread in wild birds, livestock, and humans, the risk to the public remains low.
- The majority of U.S. bird flu cases have been reported in farm workers who had direct contact with infected birds and cattle. Health officials are working to monitor the spread of the virus and improve protections for those most at risk.
- Recent data suggests that mutations in bird flu viruses could make them more dangerous to humans and potentially increase the risk of a pandemic.
- On January 6, Louisiana health officials confirmed the first U.S. death from bird flu.
Throughout 2024, dozens of human cases of H5N1 bird flu were detected as the virus spreads rapidly in livestock. The current risk to humans is low but not nonexistent. Here’s everything you need to know about the current status and future outlook of H5 bird flu in the United States.
Current U.S. bird flu status (as of January 6, 2025)
As of January 6, 66 human bird flu cases have been reported in eight states. Over half of all cases are in California. The state’s governor declared a state of emergency as a “proactive” action against bird flu on December 18.
On January 6, the Louisiana Department of Health reported the first U.S. bird flu death. The patient, a man over age 65, was previously confirmed to be the first severe bird flu case in the U.S. and the first case linked to backyard flocks. The department emphasized that the risk to the public is low and that no new cases or evidence of human transmission have been detected in the state.
All but two human bird flu cases this year were in farm workers who were exposed to infected livestock. The exposure source of the remaining cases—one in California and one in Missouri—is unknown.
The CDC reported on November 22 that a child in California tested positive for bird flu, the first known pediatric bird flu case in the U.S. However, it is unclear how the child contracted the virus, as they had no known contact with infected animals.
To date, there have been no reports of human transmission of bird flu during the current outbreak. Additionally, most human cases have not been severe, and no deaths have been reported. For these reasons, experts are confident that the bird flu risk to humans remains low.
“In the short term, there is very little threat,” Dr. Scott Roberts, an infectious diseases specialist with Yale Medicine said. “The risk for the general public is so low,” he emphasized to Yale Medicine.
How the U.S. is monitoring bird flu
The CDC continues to monitor the circulation of bird flu in humans as part of its year-round flu monitoring. The agency is also working to improve protections for farm workers, who are at the highest risk of contracting bird flu.
In November 2024, the CDC also announced expanded actions and updated guidance for farm workers, including improved access to and training for using personal protective equipment (such as N95 face masks), more rigorous testing procedures, and increased outreach. These updates followed a CDC report finding that 7 percent of participating dairy workers had signs of a recent bird flu infection. A second CDC study, also released in November, found inadequate use of personal protective equipment among dairy workers on farms with bird flu outbreaks.
After the H5N1 virus was found in raw milk being sold in California, the U.S. Department of Agriculture announced on December 6 that unpasteurized milk must be tested for bird flu. The USDA order also requires dairy farms with positive bird flu cases to cooperate with health officials in disease surveillance.
Is a bird flu pandemic possible?
In early November, a Canadian teen was hospitalized with bird flu caused by a virus that’s closely related to the H5N1 virus circulating in the U.S. The case has troubled experts for a few reasons.
First, it is Canada’s first human bird flu case where the patient was not infected while traveling, and the source of exposure is unknown. Second, the teen experienced severe symptoms and developed a lung infection requiring critical care, raising concern that bird flu infections may be more severe in younger people.
The final and biggest concern about the case is that genetic analysis revealed several changes in the virus’s DNA sequence, called mutations, that could potentially make the virus better able to infect humans. Researchers say that two of those mutations could make it easier for the virus to infect humans, and another one may make it easier for the virus to replicate after infecting a human. However, it’s unclear if the changes occurred before or after the teen was infected.
Scott Hensley, a professor of microbiology at the University of Pennsylvania, told Nature that “this should serve as a warning: this virus has the capacity to switch very quickly into a form that can cause severe disease.”
Notably, even in this more severe case, there is still no evidence of human transmission, which is necessary for a potential bird flu pandemic. However, the case underscores the risk of new and potentially dangerous mutations emerging as the H5N1 virus continues to spread and multiply.
A study published in Science on December 5 found that a genetic change on a protein on the surface of the virus could make it easier for the virus to attach to and infect human cells. But none of the mutations observed in the Canadian case are those identified in the study.
Importantly, the researchers stressed that the ability of the virus to attach to a specific part of human cells “is not the only [factor] required for human-to-human transmission of influenza viruses.”
How to stay safe
Most people are not at high risk of being exposed to bird flu. The virus is spreading between animals and from animals to humans through direct contact. The CDC recommends avoiding the consumption of raw milk products and direct contact with wild birds and potentially infected livestock.
“Pasteurization kills the bird flu virus and other harmful germs that can be found in raw milk,” says a November 24 California Department of Public Health press release. “CDPH advises consumers not to drink raw milk or eat raw milk products due to the risk of foodborne illnesses.”
Additionally, although the annual flu shot does not protect against bird flu, getting vaccinated helps prevent infection with seasonal flu and bird flu at the same time. In very rare instances, getting infected by two influenza viruses at the same time can result in a combination of genetic material that produces a new virus.
This phenomenon, known as antigenic shift, triggered the 2009 swine flu pandemic.
Learn more about how to protect yourself and your loved ones against bird flu.
For more information, talk to your health care provider.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Ghanaian Red Bean & Sweet Potato Groundnut Stew
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This is a dish popular in principle throughout West Africa. We say “in principle” because that’s a big place, and there is a lot of regional variation. The archetypal peanut stew is from Senegal (as maafe) or Mali (as tigadèguèna), but for its more balanced nutritional profile we’ve chosen one from Ghana—and since there are regional variations within Ghana too, we should specify that this one is from the south.
If you are allergic to nuts, you can substitute a seed butter (or tahini) for the nut butter, and omit the nuts—this will work in culinary terms and be fine healthwise, but we can’t claim it would be the same dish, having lost its defining ingredient. If your allergy is solely to peanuts, then substituting with any oily nut would work. So, not almonds for example, but cashews or even walnuts would be fine.
You will need
- 1½ lbs sweet potatoes, peeled and cut into ½” cubes
- 2 cups low-sodium vegetable stock
- 2 cans kidney beans, drained, cooked, and rinsed (or 2 cups same; cooked, drained, and rinsed)
- 1 can chopped tomatoes
- ½ cup unsalted dry-roasted peanuts
- 1 onion, chopped
- 1 red bell pepper, deseeded and chopped
- ¼ bulb garlic, finely chopped
- 2 heaped tbsp unsalted peanut butter, minimal (ideally: no) additives
- 2 tsp white miso paste
- 2 tsp grated fresh ginger
- 1 tsp ground cumin
- 1 tsp cayenne pepper
- 1 tsp black pepper
- ½ tsp MSG or 1 tsp low-sodium salt
- ½ tsp coarsely ground nigella seeds
- Extra virgin olive oil
Method
(we suggest you read everything at least once before doing anything)
1) Heat some oil in a sauté pan, or other pan suitable for both frying and fitting the entire stew in. Fry the onions until softened, turn the heat down low, and add the garlic, ginger, red bell pepper, cumin, cayenne, black pepper, and MSG/salt.
2) Add ¼ cup of the vegetable stock, and the sweet potato, and turn the heat back up, on high for about 30 seconds to get it to temperature, and then take it down to a simmer.
3) Stir in the miso paste and chopped tomatoes.
4) Add most of the rest of the vegetable stock, keeping ¼ cup aside. Simmer for about 20 minutes.
5) Stir in the kidney beans, and simmer for about 30 minutes more—the sweet potato should be soft now; if it isn’t, let it simmer a while longer until it is.
6) Combine the peanut butter with the remaining ¼ cup vegetable stock, and blend until smooth. Stir it into the stew.
7) If the stew is looking more like a soup than a stew, take out 1 cup and blend this 1 cup to a purée, adding it back in.
8) Add half the peanuts unto the stew. Taste, and adjust the seasonings if necessary.
9) Crush the remaining peanuts using a pestle and mortar; not too much though; you want them broken into bits, not pulverised.
10) Garnish with the crushed nuts and nigella seeds, and serve.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Eat More (Of This) For Lower Blood Pressure
- Lycopene’s Benefits For The Gut, Heart, Brain, & More
- Our Top 5 Spices: How Much Is Enough For Benefits? ← we used 4/5 today!
Take care!
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6 Signs Of A Heart Attack… A Month In Advance
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Many people know the signs of a heart attack when it’s happening, but how about before it’s too late to avoid it?
The signs
- Unusual fatigue: persistent tiredness that doesn’t improve with rest
- Shortness of breath: unexplained breathlessness during light activities or rest, which can be caused by fluid buildup in the lungs (because the heart isn’t circulating blood as well as it should)
- Chest discomfort: pain, pressure, tightness, or aching in the chest due to reduced blood flow to the heart muscle—often occurring during physical exertion or emotional stress
- Frequent indigestion: means that heartburn could be heart-related! This is about persistently reoccurring discomfort or pain in the upper abdomen
- Sleep disturbances: difficulties falling asleep, staying asleep, or waking up abruptly
- Excessive sweating: unexplained cold sweats or sudden sweating without physical exertion or excessive heat, can be a response to the decreased oxygen levels caused by less efficient blood flow
Note: this is a list of warning signs, not a diagnostic tool. Any or even all of these could be caused by something else. Just, don’t ignore the signs and do get yourself checked out.
For more details on each of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
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You might also like to read:
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Homeopathy: Evidence So Tiny That It’s Not there?
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Homeopathy: Evidence So Tiny That It’s Not There?
Yesterday, we asked you your opinions on homeopathy. The sample size of responses was a little lower than we usually get, but of those who did reply, there was a clear trend:
- A lot of enthusiasm for “Homeopathy works on valid principles and is effective”
- Near equal support for “It may help some people as a complementary therapy”
- Very few people voted for “Science doesn’t know how it works, but it works”; this is probably because people who considered voting for this, voted for the more flexible “It may help some people as a complementary therapy” instead.
- Very few people considered it a dangerous scam and a pseudoscience.
So, what does the science say?
Well, let us start our investigation by checking out the position of the UK’s National Health Service, an organization with a strong focus on providing the least expensive treatments that are effective.
Since homeopathy is very inexpensive to arrange, they will surely want to put it atop their list of treatments, right?
❝Homeopathy is a “treatment” based on the use of highly diluted substances, which practitioners claim can cause the body to heal itself.
There’s been extensive investigation of the effectiveness of homeopathy. There’s no good-quality evidence that homeopathy is effective as a treatment for any health condition.❞
The NHS actually has a lot more to say about that, and you can read their full statement here.
But that’s just one institution. Here’s what Australia’s National Health and Medical Research Council had to say:
❝There was no reliable evidence from research in humans that homeopathy was effective for treating the range of health conditions considered: no good-quality, well-designed studies with enough participants for a meaningful result reported either that homeopathy caused greater health improvements than placebo, or caused health improvements equal to those of another treatment❞
You can read their full statement here.
The American FDA, meanwhile, have a stronger statement:
❝Homeopathic drug products are made from a wide range of substances, including ingredients derived from plants, healthy or diseased animal or human sources, minerals and chemicals, including known poisons. These products have the potential to cause significant and even permanent harm if they are poorly manufactured, since that could lead to contaminated products or products that have potentially toxic ingredients at higher levels than are labeled and/or safe, or if they are marketed as substitute treatments for serious or life-threatening diseases and conditions, or to vulnerable populations.❞
You can read their full statement here.
Homeopathy is a dangerous scam and a pseudoscience: True or False?
False and True, respectively, mostly.
That may be a confusing answer, so let’s elaborate:
- Is it dangerous? Mostly not; it’s mostly just water. However, two possibilities for harm exist:
- Careless preparation could result in a harmful ingredient still being present in the water—and because of the “like cures like” principle, many of the ingredients used in homeopathy are harmful, ranging from heavy metals to plant-based neurotoxins. However, the process of “ultra-dilution” usually removes these so thoroughly that they are absent or otherwise scientifically undetectable.
- Placebo treatment has its place, but could result in “real” treatment going undelivered. This can cause harm if the “real” treatment was critically needed, especially if it was needed on a short timescale.
- Is it a scam? Probably mostly not; to be a scam requires malintent. Most practitioners probably believe in what they are practising.
- Is it a pseudoscience? With the exception that placebo effect has been highly studied and is a very valid complementary therapy… Yes, aside from that it is a pseudoscience. There is no scientific evidence to support homeopathy’s “like cures like” principle, and there is no scientific evidence to support homeopathy’s “water memory” idea. On the contrary, they go against the commonly understood physics of our world.
It may help some people as a complementary therapy: True or False?
True! Not only is placebo effect very well-studied, but best of all, it can still work as a placebo even if you know that you’re taking a placebo… Provided you also believe that!
Science doesn’t know how it works, but it works: True or False?
False, simply. At best, it performs as a placebo.
Placebo is most effective when it’s a remedy against subjective symptoms, like pain.
However, psychosomatic effect (the effect that our brain has on the rest of our body, to which it is very well-connected) can mean that placebo can also help against objective symptoms, like inflammation.
After all, our body, directed primarily by the brain, can “decide” what immunological defenses to deploy or hold back, for example. This is why placebo can help with conditions as diverse as arthritis (an inflammatory condition) or diabetes (an autoimmune condition, and/or a metabolic condition, depending on type).
Here’s how homeopathy measures up, for those conditions:
(the short answer is “no better than placebo”)
Homeopathy works on valid principles and is effective: True or False?
False, except insofar as placebo is a valid principle and can be effective.
The stated principles of homeopathy—”like cures like” and “water memory”—have no scientific basis.
We’d love to show the science for this, but we cannot prove a negative.
However, the ideas were conceived in 1796, and are tantamount to alchemy. A good scientific attitude means being open-minded to new ideas and testing them. In homeopathy’s case, this has been done, extensively, and more than 200 years of testing later, homeopathy has consistently performed equal to placebo.
In summary…
- If you’re enjoying homeopathic treatment and that’s working for you, great, keep at it.
- If you’re open-minded to enjoying a placebo treatment that may benefit you, be careful, but don’t let us stop you.
- If your condition is serious, please do not delay seeking evidence-based medical treatment.
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Never Enough – by Dr. Judith Grisel
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We’ve reviewed books about addiction before—specifically about alcohol, at least. This one’s more general in that it covers different addictions.
On the other hand, it’s also more specific, in that it covers them from the author’s field: neuroscience.
…and experience too. The author had a plethora of addictions (the serious kind), got sober, and then undertook to study neuroscience. Her hope was to help others avoid, or escape from the same as‚ what she went through.
Dr. Grisel (as she now is) takes a methodical approach in this book. She works her way through the addictive mechanisms of a broad selection of common drugs, explaining each.
The focus here is on neutral explanations, rather than the propagandizing scaremongering that failed at least one generation. Why each drug is alluring, what it really does do—and the neurological price it exacts, down to the molecular level.
She also covers risk factors for addiction; genetic, epigenetic, and environmental. There’s no “if you were stronger”, or “these people made bad choices”, so much as… Many addicts were, in effect, sabotaged from before birth.
That doesn’t mean that to become addicted or not is just fate, but it does mean… There but for the grace of factors completely outside of our control go we.
Why is this useful to us, be we a reader without any meaningful addiction (we’re not counting coffee etc here)? Well, as this book illustrates and explains, many of us could be one (more) mishap away from a crippling addiction and not know it. Forewarned is forearmed.
Bottom line: almost all of us are, have been, or will be touched by addiction in some way. Either directly, or a loved one, or a loved one’s loved one, or perhaps a parent who gave us an epigenetic misfortune. This book gives understanding that can help.
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