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.

Head hair comes in many colours, shapes and sizes, and hairstyles are often an expression of personal style or cultural identity.

Many different genes determine our hair texture, thickness and colour. But some people’s hair changes around the time of puberty, pregnancy or after chemotherapy.

So, what can cause hair to become curlier, thicker, thinner or grey?

Curly or straight? How hair follicle shape plays a role

Hair is made of keratin, a strong and insoluble protein. Each hair strand grows from its own hair follicle that extends deep into the skin.

Curly hair forms due to asymmetry of both the hair follicle and the keratin in the hair.

Follicles that produce curly hair are asymmetrical and curved and lie at an angle to the surface of the skin. This kinks the hair as it first grows.

The asymmetry of the hair follicle also causes the keratin to bunch up on one side of the hair strand. This pulls parts of the hair strand closer together into a curl, which maintains the curl as the hair continues to grow.

Follicles that are symmetrical, round and perpendicular to the skin surface produce straight hair.

Life changes, hair changes

Our hair undergoes repeated cycles throughout life, with different stages of growth and loss.

Each hair follicle contains stem cells, which multiply and grow into a hair strand.

Head hairs spend most of their time in the growth phase, which can last for several years. This is why head hair can grow so long.

Let’s look at the life of a single hair strand. After the growth phase is a transitional phase of about two weeks, where the hair strand stops growing. This is followed by a resting phase where the hair remains in the follicle for a few months before it naturally falls out.

The hair follicle remains in the skin and the stems cells grow a new hair to repeat the cycle.

Each hair on the scalp is replaced every three to five years.

Hormone changes during and after pregnancy alter the usual hair cycle

Many women notice their hair is thicker during pregnancy.

During pregnancy, high levels of oestrogen, progesterone and prolactin prolong the resting phase of the hair cycle. This means the hair stays in the hair follicle for longer, with less hair loss.

A drop in hormones a few months after delivery causes increased hair loss. This is due to all the hairs that remained in the resting phase during pregnancy falling out in a fairly synchronised way.

Hair can change around puberty, pregnancy or after chemotherapy

This is related to the genetics of hair shape, which is an example of incomplete dominance.

Incomplete dominance is when there is a middle version of a trait. For hair, we have curly hair and straight hair genes. But when someone has one curly hair gene and one straight hair gene, they can have wavy hair.

Hormonal changes that occur around puberty and pregnancy can affect the function of genes. This can cause the curly hair gene of someone with wavy hair to become more active. This can change their hair from wavy to curly.

Researchers have identified that activating specific genes can change hair in pigs from straight to curly.

Chemotherapy has very visible effects on hair. Chemotherapy kills rapidly dividing cells, including hair follicles, which causes hair loss. Chemotherapy can also have genetic effects that influence hair follicle shape. This can cause hair to regrow with a different shape for the first few cycles of hair regrowth.

Hormonal changes as we age also affect our hair

Throughout life, thyroid hormones are essential for production of keratin. Low levels of thyroid hormones can cause dry and brittle hair.

Oestrogen and androgens also regulate hair growth and loss, particularly as we age.

Balding in males is due to higher levels of androgens. In particular, high dihydrotestosterone (sometimes shortened to DHT), which is produced in the body from testosterone, has a role in male pattern baldness.

Some women experience female pattern hair loss. This is caused by a combination of genetic factors plus lower levels of oestrogen and higher androgens after menopause. The hair follicles become smaller and smaller until they no longer produce hairs.

Reduced function of the cells that produce melanin (the pigment that gives our hair colour) is what causes greying.

Theresa Larkin, Associate professor of Medical Sciences, University of Wollongong

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