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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Surviving with Beans And Rice – by Eliza Whool
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If you’d like to be well-set the next time a crisis shuts down supply lines, this is one of those books you’ll want to have read.
Superficially, “have in a large quantity of dried beans and rice” is good advice, but obvious. Why a book?
Whool gives a lot of advice on keeping your nutrition balanced while subsisting on the same quite few ingredients, which is handy.
More than that, she offers 100 recipes using the ingredients that will be in your long-term pantry. That’s over three months without repeating a meal! And if you don’t think rice and beans can be tasty and exciting and varied, then most of the chefs of the Global South might want to have a word about that.
Anyway, we’re not here to sell you rice and beans (we’re just enthusiastic and correct). What we are here to do is to give you a fair overview of this book.
The recipes are just-the-recipes, very simple clear instructions, one two-page spread per recipe. Most of the book is devoted to these. As a quick note, it does cover making things gluten-free if necessary, and other similar adjustments for medical reasons.
The planning-and-storage section of the book is helpful too though, especially as it covers common mistakes to avoid.
Bottom line: this is a great book, and remember what we said about doing the things now that future you will thank you for!
Get yourself a copy of Surviving with Beans And Rice from Amazon today!
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Only walking for exercise? Here’s how to get the most out of it
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We’re living longer than in previous generations, with one in eight elderly Australians now aged over 85. But the current gap between life expectancy (“lifespan”) and health-adjusted life expectancy (“healthspan”) is about ten years. This means many of us live with significant health problems in our later years.
To increase our healthspan, we need planned, structured and regular physical activity (or exercise). The World Health Organization recommends 150–300 minutes of moderate-intensity exercise – such as brisk walking, cycling and swimming – per week and muscle strengthening twice a week.
Yet few of us meet these recommendations. Only 10% meet the strength-training recommendations. Lack of time is one of the most common reasons.
Walking is cost-effective, doesn’t require any special equipment or training, and can be done with small pockets of time. Our preliminary research, published this week, shows there are ways to incorporate strength-training components into walking to improve your muscle strength and balance.
Why walking isn’t usually enough
Regular walking does not appear to work as muscle-strengthening exercise.
In contrast, exercises consisting of “eccentric” or muscle-lengthening contractions improve muscle strength, prevent muscle wasting and improve other functions such as balance and flexibility.
Typical eccentric contractions are seen, for example, when we sit on a chair slowly. The front thigh muscles lengthen with force generation.
When you sit down slowly on a chair, the front thigh muscles lengthen.
buritora/ShutterstockOur research
Our previous research found body-weight-based eccentric exercise training, such as sitting down on a chair slowly, improved lower limb muscle strength and balance in healthy older adults.
We also showed walking down stairs, with the front thigh muscles undergoing eccentric contractions, increased leg muscle strength and balance in older women more than walking up stairs. When climbing stairs, the front thigh muscles undergo “concentric” contractions, with the muscles shortening.
It can be difficult to find stairs or slopes suitable for eccentric exercises. But if they could be incorporated into daily walking, lower limb muscle strength and balance function could be improved.
This is where the idea of “eccentric walking” comes into play. This means inserting lunges in conventional walking, in addition to downstairs and downhill walking.
In our new research, published in the European Journal of Applied Physiology, we investigated the effects of eccentric walking on lower limb muscle strength and balance in 11 regular walkers aged 54 to 88 years.
The intervention period was 12 weeks. It consisted of four weeks of normal walking followed by eight weeks of eccentric walking.
The number of eccentric steps in the eccentric walking period gradually increased over eight weeks from 100 to 1,000 steps (including lunges, downhill and downstairs steps). Participants took a total of 3,900 eccentric steps over the eight-week eccentric walking period while the total number of steps was the same as the previous four weeks.
We measured the thickness of the participants’ front thigh muscles, muscle strength in their knee, their balance and endurance, including how many times they could go from a sitting position to standing in 30 seconds without using their arms. We took these measurements before the study started, at four weeks, after the conventional walking period, and at four and eight weeks into the eccentric walking period.
We also tested their cognitive function using a digit symbol-substitution test at the same time points of other tests. And we asked participants to complete a questionnaire relating to their activities of daily living, such as dressing and moving around at home.
Finally, we tested participants’ blood sugar, cholesterol levels and complement component 1q (C1q) concentrations, a potential marker of sarcopenia (muscle wasting with ageing).
Regular walking won’t contract your muscles in the same way as eccentric walking.
alexei_tm/ShutterstockWhat did we find?
We found no significant changes in any of the outcomes in the first four weeks when participants walked conventionally.
From week four to 12, we found significant improvements in muscle strength (19%), chair-stand ability (24%), balance (45%) and a cognitive function test (21%).
Serum C1q concentration decreased by 10% after the eccentric walking intervention, indicating participants’ muscles were effectively stimulated.
The sample size of the study was small, so we need larger and more comprehensive studies to verify our findings and investigate whether eccentric walking is effective for sedentary people, older people, how the different types of eccentric exercise compare and the potential cognitive and mental health benefits.
But, in the meantime, “eccentric walking” appears to be a beneficial exercise that will extend your healthspan. It may look a bit eccentric if we insert lunges while walking on the street, but the more people do it and benefit from it, the less eccentric it will become.
Ken Nosaka, Professor of Exercise and Sports Science, Edith Cowan University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Can We Do Fat Redistribution?
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The famous answer: no
The truthful answer: yes, and we are doing it all the time whether we want to or not, so we might as well know what things affect our fat distribution in various body parts.
There’s a kernel of truth in the “no”, though, and where that comes from is that we cannot exclusively put fat on in a certain area only, and nor can we do “spot reduction”, i.e., intentionally lose fat from only one place.
How, then, do we do fat redistribution?
Your body is a living organism, not a statue
It’s easy to think “I’ve been carrying this fat in this place for 20 years”, but during that time the fat has been replaced several times and moved often; in fact, the cells containing the fat have even been replaced. Because: fat can seem like a substance that’s alien to your body because it doesn’t respond like muscles, isn’t controllable like muscles, doesn’t have the same sensibility as muscles, etc. But, every bit of fat stored in your body is stored inside a fat cell; it’s not one big unit of fat; it’s lots of tiny ones.
In reality, any given bit of fat on your body has probably been there for 18–24 months at most:
Fat turnover in obese slower than average
…and there are assorted factors that can modify the rate at which our body deals with fat storage:
Human white adipose tissue: A highly dynamic metabolic organ
So, how do I get rid of this tummy?
There are plenty of stories of people who try to lose weight from one part of their body, and lose it from somewhere else instead. Say, a person wants to lose weight from her hips, and with careful diet and exercise, she loses weight—by dropping a couple of bra cup sizes while keeping the hips.
So, we must figure out: why is fat stored in certain places? And the main driving factors are:
- hormones
- metabolic health
- stress
Hormones affect fat distribution insofar as estrogen and progesterone will favor the hips, thighs, butt, breasts, and testosterone will favor a more central (but still subcutaneous, not visceral) distribution. Additionally, estrogen and progesterone will favor a higher body fat percentage, while testosterone will favor a lower one.
This is particularly relevant later in life, when suddenly the hormone(s) you’ve been relying on to keep your shape, are now declining, meaning your shape does too. This goes for everyone regardless of sex.
See:
- What You Should Have Been Told About The Menopause Beforehand
- The BAT-pause! ← this is about the conversion of white adipose tissue to brown adipose tissue, and how estrogen helps this happen
- Topping Up Testosterone?
Metabolic health affects fat distribution insofar as poor metabolic health will result in more fat being stored in the viscera, rather than in the usual subcutaneous places. This is a serious health risk.
See: Visceral Belly Fat & How To Lose It
Stress affects fat distribution insofar as chronically elevated cortisol levels see more fat sent to the stomach, face, and neck. This fat redistribution isn’t dangerous itself, but it can be indicative of the chronic stress, which does pose more of a general threat to health.
See: Lower Your Cortisol! (Here’s Why & How)
What this means in practical terms
Assuming that you would like the fat distribution that says “this is a healthy woman” or “this is a healthy man”, respectively, then you might want to:
- Check your sex hormone levels and get them adjusted if appropriate
- Improve your overall metabolic health—without necessarily trying to lose weight, just, take care of your blood sugars for example, and they will take care of you in terms of fat storage.
- Manage your stress (which includes any stress you are experiencing about your body not being how you’d like it to be).
If you are doing these things, and you don’t have any major untreated medical abnormalities that affect these things, then your fat will go to the places generally considered healthiest.
Can we speed it up?
Yes, we can! Firstly, we can speed up our overall metabolism:
Let’s Burn! Metabolic Tweaks And Hacks
Secondly, we can encourage our body to “move” fat by intentionally “yo-yoing”, something usually considered bad in dieting when people just want to lose weight and instead are going up and down, but: if you lose weight healthily, it comes off everywhere evenly, and if you gain weight healthily, it goes mostly to the places where it should be.
So, a sequence of lose-gain-lose-gain might look like “lose a bit from everywhere, put it back in the good place, lose a bit more from everywhere, put it back in the good place”, etc.
So, you might want to gently cycle these a few months apart, for example:
How To Lose Fat (Healthily!) | How To Gain Fat (Healthily!)
You can also cheat a little, if it suits your purpose! By this we mean: if you’d like a little extra where you already have a little fat, then you can put muscle on underneath it, it will pad it up, and (because of the layer of actual fat on top) nobody will know the difference unless you flex it with their hand on it.
Let’s put it this way: people doing squats for a bubble-butt aren’t doing it to put on fat; they’re putting muscle on under the fat they have.
So, check out: How To Gain Muscle (Healthily!)
And finally, for all your body-sculpting needs, we present these excellent books:
Women’s Strength Training Anatomy Workouts – by Frédéric Delavier
Strength Training Anatomy (For Men) – by Frédéric Delavier
Enjoy!
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Debunking the vitamin D fad
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Throughout the pandemic, many unproven miracle COVID-19 “cures” emerged, and vitamin D claims have been one of the most persistent. This is not new for the vitamin. It’s been touted in recent decades as a way to “boost” the immune system, improve overall health, prevent a host of diseases, and allegedly even substitute for vaccines.
But as with many internet-popular health “remedies,” the reality is far less flashy and far more nuanced.
What is vitamin D, and why is it important?
Vitamin D is a nutrient that helps the body absorb calcium, which is essential for bone health. In the sunlight, your skin naturally produces vitamin D that is then stored in fat cells until it is used.
The skin pigment melanin absorbs the UV rays necessary for vitamin D production, meaning that more highly pigmented or darker skin produces less vitamin D than lighter skin with the same amount of sun exposure. Thus, people with darker skin are at higher risk of vitamin D deficiency.
Most of our vitamin D comes from the sun. An additional 10 percent to 20 percent of our vitamin D comes from foods like fatty fish (such as salmon), eggs, and mushrooms. Vitamin D supplements are another source of the nutrient for people who are unable to get enough from sun exposure and diet.
Vitamin D deficiency is real, but there’s no epidemic
Some people who promote vitamin D supplements claim that vitamin D deficiency is an epidemic causing widespread health issues. There is little evidence to support this claim. A 2022 analysis of 2001-2018 data found that 2.6 percent of people in the U.S. had severe vitamin D deficiency.
Severe vitamin D deficiency can cause serious health issues, such as muscle weakness, bone loss in adults, and rickets (weak bones) in children. Some people are at higher risk for the deficiency, including individuals with certain disorders that prevent the body from absorbing or processing vitamin D or those with a family history of vitamin D deficiency.
Black Americans have the highest rates of severe vitamin D deficiency at nearly 12 percent. Severe vitamin D deficiency is also slightly higher in the U.S. during the winter when people get less sun exposure. Rates of moderate vitamin D deficiency are higher at 22 percent overall and are highest among Black Americans (49 percent) and Mexican Americans (35 percent).
Although severe vitamin D deficiency exists in the U.S., it is far from common. Most tellingly, conditions that are directly linked to vitamin D deficiency are not widespread. There is no epidemic of rickets, for example, or bone loss in adults.
There’s little evidence that vitamin D supplements improve overall health
Vitamin D supplements have clear, proven positive effects for people with vitamin D deficiency. Other health benefits of vitamin D supplements are less certain.
There is some evidence that the supplement may reduce the risk of fracture in adults with osteoporosis, a condition that causes weak, fragile bones. However, the benefit appears to be limited to people who have low vitamin D levels. In adults with normal vitamin D levels, supplements have no effect on fracture risk.
The largest randomized controlled trial of vitamin D, called VITAL, investigated the effects of vitamin D supplementation in people without an existing deficiency. The study found that vitamin D supplements had no effects on the risk of cancer, diabetes, or cardiovascular disease, including heart attack and stroke. The study concluded that more research is necessary to determine who may benefit from vitamin D supplements.
Independent analyses found that vitamin D supplementation may be associated with a long-term decrease in cancer mortality, but results are mixed and also require more investigation.
A 2021 analysis of past vitamin D trials found no overall health benefits from vitamin D supplements in people with normal vitamin D levels. Most large-scale studies have found no link between vitamin D supplements and lower all-cause mortality (deaths from any cause), except in older adults and those with vitamin D deficiency.
Vitamin D provides modest protection against respiratory infections
Vitamin D is important for immune function, but this is often misconstrued as vitamin D “boosting” the immune system.
Some people falsely believe that taking vitamin D supplements will keep them healthy and prevent infections like the flu or COVID-19. In reality, clinical trials and large-scale studies of vitamin D have found only minimal protective effects against respiratory infections.
A 2021 analysis of 46 trials found that 61.3 percent of participants who took daily vitamin D supplements got respiratory infections during the study periods—compared to 62.3 percent of people who did not take the supplements. A 2024 meta-analysis of 43 trials found no overall protective effect against respiratory infections, but it detected a slight decrease in risk among people who took specific doses daily.
In young children, there is some evidence that vitamin D supplementation may reduce the length of respiratory infections. However, it does not affect the number or severity of infections that children have.
Despite claims that taking vitamin D can protect against COVID-19, two clinical trials found that taking daily vitamin D supplements did not reduce the risk or severity of COVID-19 infections, even at high doses.
Context is key when considering vitamin D’s benefits
None of these studies contradict the well-established evidence that people with vitamin D deficiency benefit from vitamin D supplements. But it’s important to remember that many of the most popular health claims about vitamin D’s benefits are based on research in people with vitamin D deficiency.
Research in vitamin D-deficient populations is important, but it tells us little about how vitamin D will affect people with normal or close to normal vitamin D levels. A closer look at vitamin D research in people without low levels reveals little evidence to support the idea that the general population benefits from taking vitamin D supplements.
For more information, or to learn about your vitamin D levels, 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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Should Men Over 50 Get PSA?
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Loved the information on prostate cancer. Do recommend your readers get a PSA or equivalent test annually for over 50 yr old men.❞
(This is about: Prostate Health: What You Should Know)
Yep, or best yet, the much more accurate PSE test! But if PSA test is what’s available, it’s a lot better than nothing. And, much as it’s rarely the highlight of anyone’s day, a prostate exam by a suitably qualified professional is also a good idea.
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Food for Life – by Dr. Tim Spector
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This book is, as the author puts it, “an eater’s guide to food and nutrition”. Rather than telling us what to eat or not eat, he provides an overview of what the latest science has to say about various foods, and leaves us to make our own informed decisions.
He also stands firmly by the “personalized nutrition” idea that he introduced in his previous book which we reviewed the other day, and gives advice on what tests we might like to perform.
The writing style is accessible, without shying away from reference to hard science. Dr. Spector provides lots of information about key chemicals, genes, gut bacteria, and more—as well as simply providing a very enjoyable read along the way.
Bottom line: if you’d like a much better idea of what food is (and isn’t) doing what, this book is an invaluable resource.
Click here to check out Food for Life, and make the best decisions for you!
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