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.

Robert F. Kennedy Jr, who oversees the health of more than 340 million Americans, says vitamin A can prevent the worst effects of measles rather than urging more people to get vaccinated.

In an opinion piece for Fox News, the US health secretary said he was “deeply concerned” about the current measles outbreak in Texas. However, he said the decision to vaccinate was a “personal one” and something for parents to discuss with their health-care provider.

Kennedy mentioned updated advice from the Centers for Disease Control (CDC) to treat measles with vitamin A. He also cited a study he said shows vitamin A can reduce the risk of dying from measles.

Here’s what the vitamin A study actually says and why public health officials are so concerned about Kennedy’s latest statement.

Why is a measles outbreak so worrying?

Measles is a highly contagious disease caused by a virus. It spreads easily including when an infected person breathes, coughs or sneezes.

Measles initially infects the respiratory tract and then the virus spreads throughout the body. Symptoms include a high fever, cough, red eyes, runny nose and a rash all over the body.

Measles can also be severe, can cause complications including blindness and swelling of the brain, and can be fatal. Measles can affect anyone but is most common in children.

The Texan health department has confirmed 150-plus cases of measles and one death of an unvaccinated child during the current outbreak. While this is by far the largest measles outbreak in the US in 2025, the CDC has reported smaller outbreaks in several other states so far this year.

Why vitamin A?

Vitamin A is essential for our overall health. It has many roles in the body, from supporting our growth and reproduction, to making sure we have healthy vision, skin and immune function.

Foods rich in vitamin A or related molecules include orange, yellow and red coloured fruits and vegetables, green leafy vegetables, as well as dairy, egg, fish and meat. You can take it as a supplement.

Vitamin A can also be used therapeutically. In other words, doctors may prescribe vitamin A to treat a deficiency. Vitamin A deficiency has long been associated with more severe cases of infectious disease, including measles. Vitamin A boosts immune cells and strengthens the respiratory tract lining, which is the body’s first defence against infections.

Because of this, the CDC has recently said vitamin A can also be prescribed as part of treatment for children with severe measles – such as those in hospital – under doctor supervision.

One key message from the CDC’s advice is that people are already sick enough with measles to be in hospital. They’re not taking vitamin A to prevent catching measles in the first place.

The other key message is vitamin A is taken under medical supervision, under specific circumstances, where patients can be closely monitored to prevent toxicity from high doses.

Vitamin A toxicity can cause birth defects and increase the risk of fractures in elderly people. Vitamin A and beta-carotene (which the body turns into vitamin A) from supplements may also increase your risk of cancer, especially if you smoke.

How about the study Kennedy cites?

Kennedy cites and links to a 2010 study, a type known as a systematic review and meta-analysis. Researchers reviewed and analysed existing studies, which included ones that looked at the effectiveness of vitamin A in preventing measles deaths.

They found three studies that looked at vitamin A treatment by specific dose. There were different doses depending on the age of the children, measured in IU (international units). Having two doses of vitamin A (200,000IU for children over one year of age or 100,000IU for infants below one year) reduced mortality by 62% compared to children who did not have vitamin A.

The 2010 study did not show vitamin A reduced your risk of getting measles from another infected person. To my knowledge no study has shown this.

To be fair, Kennedy did not say that vitamin A stops you from catching measles from another infected person. Instead, he used the following vague statement:

Studies have found that vitamin A can dramatically reduce measles mortality.

It’s easy to see how a reader could misinterpret this as “take vitamin A if you want to avoid dying from measles”.

We know what works – vaccines

The World Health Organization recommends all children receive two doses of measles vaccine.

The CDC states two doses of the measles vaccine (measles-mumps-rubella or MMR vaccine) is 97% effective against getting measles. This means out of every 100 people who are vaccinated only three will get it, and this will be a milder form.

But these facts were missing from Kennedy’s statement. Should we be surprised? Kennedy is well known for his vaccine sceptism and for undermining vaccination efforts, including for the measles vaccine.

As Sue Kressly, president of the American Academy of Pediatrics, told the Washington Post:

relying on vitamin A instead of the vaccine is not only dangerous and ineffective […] it puts children at serious risk.

Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia

This article is republished from The Conversation under a Creative Commons license. Read the original article.