Shyness and Social Anxiety Disorder - Essay Example

SHYNESS AND SOCIAL ANXIETY DISORDER Student’s Name Institution Shyness and Social Anxiety Disorder Social phobia, also known as social anxiety disorder, is an anxiety disorder that makes a person has unreasonable and excessive fear of situations with many people (Jefferson, 2001). Intense nervousness or anxiety and self-consciousness is due to fear of being criticized, judged, or closely watched by others. Individuals with social anxiety disorder are anxious that they might make mistakes that will make them humiliated, embarrassed, or look bad in front of others. The fear might be worse due to inadequate social experience or skills to help one feel comfortable in a social gathering. Due to fear, the person might find himself or herself enduring some of the social situations or avoiding them. Furthermore, people who are social phobia may suffer from "anticipatory" anxiety which is the fear of a given circumstances before it occurs (Rajender et al., 2009). Even though the person might know that there is nothing to fear, he or she may not be able to overcome it. On the other hand, shyness is the apprehension or awkwardness that some people experience when being approached or approaching some people. As opposed to introverts that might feel comfortable in lonely places, shy people in most instances want to socialize with other people but are not able to connect. The incompatibility is due to the intolerance of the anxiety caused by human interaction. Shyness is also called diffidence and occurs when the victim is with unfamiliar people or new situations. It is majorly associated with people of low self-esteem thus ego-driven fear. From the two definitions of social anxiety disorder and shyness, one can see some link, thus the question; is social phobia or social anxiety disorder just an extreme form of shyness? The question might be based on the fact that both shyness and social anxiety disorder share some characteristics including embarrassment and anxiety in social interactions. Social anxiety disorder is not extreme shyness. According to Dalrymple and Zimmerman (2013), the two conditions are qualitatively distinct and cannot be presented along a continuum. Even though the two share some features, the differences between them make them distinct. In explanation, shyness and social anxiety disorder share several features that include autonomic arousal, fear to be evaluated negatively, social situation avoidance, and social skills deficits that include difficulty in maintaining and initiating conversation and aversion of a gaze. Furthermore, both the two conditions are highly inheritable with the mothers of shy children having a higher rate of social anxiety disorder compared to those of the non-shy ones. However, there are no genetic or familial studies that have managed to compare familial and heritability of the aggregation in social anxiety disorder and shyness. If social anxiety disorder were shyness in its extreme form, then all those diagnosed with social anxiety disorder would have the characteristics of shyness. But that is not the case. Studies show that approximately half of the people that have been diagnosed with social anxiety disorder had the shyness features during their childhood (Cox, MacPherson, & Enns, 2005). Furthermore, shy people that meet the criteria of social anxiety disorder are less than a quarter of their total population (Burstein, Ameli-Grillon, & Merikangas, 2011). Since most of the shy people do not meet the social anxiety disorder criteria while those diagnosed with social disorder criteria were not shy in their earlier life stages, it can be concluded that the two have the qualitative distinction and cannot be placed on a continuum. Even though there is no clear line between shyness and social anxiety disorder, the difference between the two can be determined as per their disruption of one’s life. According to Jefferson (2001), shyness is less disruptive compared to the social anxiety disorder. In explanation, the latter causes distress and disrupt the functions and the relationship of the individual as opposed to the former that is often dormant. Furthermore, social anxiety disorder can either be generalized or specific. The generalized social anxiety is a social phobia which is triggered by almost each of the social situations including the interpersonal interactions and performance. On the other hand, specific social anxiety, also referred to as discrete or limited social anxiety, usually have one or two performance situations, for example, writing, musical performance, and speaking. People with social phobia, as opposed to those who are shy, can experience a panic attack in the presence of a gathering. Other associated physical symptoms that they might experience include respiratory and gastrointestinal distress, palpitations, blushing, garbled speech, shaking, and sweating. The notion that other people will be able to see the anxious feelings makes the situation even worse and more visible. Not all people that are shy are considered social phobic due to the intensity of the characteristics. A study conducted by Burstein, Ameli-Grillon, and Merikangas (2011) show that 88% of the youths who considered themselves shy did not meet the threshold of social anxiety disorder. The adolescents who considered themselves shy also had less role impairment compared to those who displayed social phobia characteristics. In explanation, the youths that displayed social phobia showed a significant difference in role impairment. They were also more prone to the several psychiatric disorders such as disorders of substance, use, behavior, mood, and anxiety. However, both the shy youths and those suffering from the social anxiety disorder preferred taking the prescribed drugs. The study, therefore, showed that social phobia is a more impairing psychiatric disorder compared to the conventional human shyness. Consequently, their medication ought to be different. However, the study also indicates that there might be no direct linear relationship between social phobia and shyness. That is, social anxiety disorder might occur in the absence of shyness thus making them distinct contrasts. Burstein, Ameli-Grillon, and Merikangas (2011) argue that there is a distinct contrast between shyness and social anxiety disorder. The study argues that social phobia can occur to people with or without shyness. However, the element of shyness does not affect the side effects of social phobia or characteristics. The impairment among people suffering from social phobia can be experienced in several domains that include family relationships, social life, and work or school ability (Kashdan & McKnight, 2010). However, adolescents with shyness were more likely to experience the social anxiety disorder. On the on the hand, individuals with psychiatric disorders were more prevalent among the people with the social disorder. People who are not shy are more frequently affected by substance use and behavior disorders compared to those who are shy. As a result, there is a close link between social phobia and substance or behavior use disorder. Studies have shown that shyness reduces the problems associated with substance use and the risks associated with it (Burstein, Ameli-Grillon, and Merikangas, 2011). Shyness, as opposed to social anxiety disorder, is connected to the gray and white matter. Yang, X. et al. (2013) argue that structural and functional of the body indicates that shyness is distinct from social anxiety even though the two correlate. According to the study, shyness, as opposed to social anxiety, has a positively correlated to the changes in the gray matter density. In explanation, it is influenced by the aspects of brain regions that affect the emotional and social processing which include the limbic or paralimbic system and the cerebellum posterior lobe that include the insula, parahippocampal gyrus, and the superior temporal gyrus. In addition, several functional connections in the named regions plus the amygdale are either negatively or positively correlated with shyness but not the social anxiety disorder. The functional connections involve links with the parietal and medial frontal regions. Even though the link between functional and structural connectivity in the brain is not yet fully established, the study indicates that there is a link between positive gray matter density and shyness. On the other hand, emotional hyper-reactivity is considered to be the features of more social anxiety's pathological forms and arises from social situation appraisal and distorted perception. The characteristics of shyness are the reduction in the threshold of the physiological arousal and increased sensitivity in the sensory processing. The finding that linked gray matter density to shyness agrees with the hyper-responsive theory of shyness thus increasing the neuroimaging evidence. Shy people tend to have higher gray matter densities due to the greater number of neuronal cells or synapses and a larger number of neurons that produce greater outputs compared to the smaller ones. The positive correlation between functional connectivity and shyness with increased gray mass density indicate that the resting state affects the neuronal activities. However, the parahippocampal gyrus’ functional connectivity is negatively correlated to shyness (Hedman et al., 2013). There is a significant but low correlation between social anxiety and shyness. According to Yang et al. (2013), there is only limited overlap between the two. In explanation, an individual might have the highest of shyness scores but not have the social anxiety disorder. Furthermore, even some of the shyest individuals do not have intense social anxiety disorder. Both social anxiety disorder and shyness indicate hyperactivity of the cortico-limbic circuitry, more so in the fronto-amygdalar pathway. In addition, it shows the connectivity between the cingulated cortex and insula. Shyness and social anxiety disorder are also linked to increased negative relationship between the right frontoparietal network and parahippocampal gyrus. However, the changes in the brain morphology with shyness and social anxiety disorder are in the opposite direction. In explanation, gray matter increases shyness but decreases social anxiety disorder. Therefore, the alteration of the gray matter density may affect the functional connectivity in the case of social anxiety and shyness in a different way. For the case of shyness, an increase in connectivity may be due to the increase in the activity that is caused by greater synapses or number of cells. On the other hand, in the case of anxiety, the reduction in the number of cells or synapses may lead to the changes in the synaptic sensitivity. The changes in the case of shyness, therefore, entail a non-pathological and natural consequence of having more synapses and cells while in the case of anxiety it reflects the attempted compensatory changes that result from pathology (Rajender et al., 2009). Understanding the difference between social anxiety and shyness is critical in the assessment of both. The similarity between the two might be confusing thus the need for guidance. Since shyness and social anxiety overlap, the latter can only be determined through a clinical determination of its severity with its associated degree of distress and impairment. When the anxiety is severe, and there is distress about having significant impairment and anxiety in several areas of functioning, then it can be said one has social anxiety disorder and not just usual shyness. However, cultural and environmental context should be taken into consideration in determining the patient's distress or impairment since immediate circumstances can give a false alarm (Brook & Schmidt, 2008). For instance, it might find it hard to talk in front of a group of people if he or she has never engaged in such an activity previously (Cox, MacPherson, & Enns, 2005). The normative range varies depending on several factors based on the development stage of an individual. First, children are considered to have a greater level of shyness thus considered normative if it appears during their developmental stages to which the separation anxiety is witnessed. Second, the adolescents' greater level of shyness might be considered normal during their early stages of adolescence in which social relationships are considered important and during their transition stages, for instance, when they are being admitted to high school. Lastly, during the adulthood, a greater level of social anxiety and shyness might surface whenever there is a major change in life such as beginning to date after losing a romantic or lengthy relationship (Shelton, 2004). In conclusion, social anxiety disorder, also known as social phobia, cannot be simply referred to as extreme shyness. Several people often feel shy or uncomfortable in the presence of familiar people or new situations. However, the feeling is usually tolerable upon relaxing for a given time and warming up. As opposed to shyness, people suffering from social anxiety disorder are not able to relax in performance or social settings. Therefore, there is a distinct contrast between shyness and social anxiety disorder. Even though the two can be linked, the relationship is not a direct linear. In explanation, shyness can make one more prone to the social disorder anxiety even though the two are different. Furthermore, social disorder anxiety can affect either those who are shy or those who are not. Even though the cause of anxiety might be the same in both the two scenarios, the effects are more extreme in the case of social disorder anxiety compared to shyness. Social anxiety disorder and shyness can only be related based on symptomatology and incident rate. However, even in such scenario, the relationship will still be unclear. Even though the relationship between shyness and social anxiety disorder might be significant, the correlation is low since the overlap is limited. Referring to social anxiety disorder as an extreme shyness would mean that the two can be placed on a quantum with the former having all the qualities of the latter. The major difference between shyness and social anxiety is based on how severe the anxiety is and the associated distress and impairment.   Reference Brook, C. A., & Schmidt, L. A. (2008). Social anxiety disorder: a review of environmental risk factors. Neuropsychiatric disease and treatment, 4(1), 123-143. Burstein, M., Ameli-Grillon, L., & Merikangas, K. R. (2011). Shyness versus social phobia in US youth. Pediatrics, 128(5), 917-925. Cox, B. J., MacPherson, P. S., & Enns, M. W. (2005). Psychiatric correlates of childhood shyness in a nationally representative sample. Behaviour research and therapy, 43(8), 1019-1027. Dalrymple, K.L., & Zimmerman, M. (2013). When does benign shyness become social anxiety, a treatable disorder? Current Psychiatry, 12(11), 21-23, 35-38. Hedman, E., Ström, P., Stünkel, A., & Mörtberg, E. (2013). Shame and guilt in social anxiety disorder: effects of cognitive behavior therapy and association with social anxiety and depressive symptoms. PloS one, 8(4), e61713. Jefferson, J. W. (2001). Social anxiety disorder: more than just a little shyness. Primary care companion to the Journal of clinical psychiatry, 3(1), 4-9. Kashdan, T. B., & McKnight, P. E. (2010). The darker side of social anxiety when aggressive impulsivity prevails over shy inhibition. Current Directions in Psychological Science, 19(1), 47-50. Rajender, G., Malhotra, S., Kanwal, K., & Chaudhary, D. (2009). Too shy to be shy: Current update on social anxiety disorder. Delhi Psychiatry Journal, 12(1), 61-66. Shelton, C. I. (2004). Diagnosis and management of anxiety disorders. The Journal of the American Osteopathic Association, 104(3_suppl_1), S2-S5. Yang, X. et al. (2013). Structural and functional connectivity changes in the brain associated with shyness but not with social anxiety. PloS one, 8(5), e63151. Read More

If social anxiety disorder were shyness in its extreme form, then all those diagnosed with social anxiety disorder would have the characteristics of shyness. But that is not the case. Studies show that approximately half of the people that have been diagnosed with social anxiety disorder had the shyness features during their childhood (Cox, MacPherson, & Enns, 2005). Furthermore, shy people that meet the criteria of social anxiety disorder are less than a quarter of their total population (Burstein, Ameli-Grillon, & Merikangas, 2011).

Since most of the shy people do not meet the social anxiety disorder criteria while those diagnosed with social disorder criteria were not shy in their earlier life stages, it can be concluded that the two have the qualitative distinction and cannot be placed on a continuum. Even though there is no clear line between shyness and social anxiety disorder, the difference between the two can be determined as per their disruption of one’s life. According to Jefferson (2001), shyness is less disruptive compared to the social anxiety disorder.

In explanation, the latter causes distress and disrupt the functions and the relationship of the individual as opposed to the former that is often dormant. Furthermore, social anxiety disorder can either be generalized or specific. The generalized social anxiety is a social phobia which is triggered by almost each of the social situations including the interpersonal interactions and performance. On the other hand, specific social anxiety, also referred to as discrete or limited social anxiety, usually have one or two performance situations, for example, writing, musical performance, and speaking.

People with social phobia, as opposed to those who are shy, can experience a panic attack in the presence of a gathering. Other associated physical symptoms that they might experience include respiratory and gastrointestinal distress, palpitations, blushing, garbled speech, shaking, and sweating. The notion that other people will be able to see the anxious feelings makes the situation even worse and more visible. Not all people that are shy are considered social phobic due to the intensity of the characteristics.

A study conducted by Burstein, Ameli-Grillon, and Merikangas (2011) show that 88% of the youths who considered themselves shy did not meet the threshold of social anxiety disorder. The adolescents who considered themselves shy also had less role impairment compared to those who displayed social phobia characteristics. In explanation, the youths that displayed social phobia showed a significant difference in role impairment. They were also more prone to the several psychiatric disorders such as disorders of substance, use, behavior, mood, and anxiety.

However, both the shy youths and those suffering from the social anxiety disorder preferred taking the prescribed drugs. The study, therefore, showed that social phobia is a more impairing psychiatric disorder compared to the conventional human shyness. Consequently, their medication ought to be different. However, the study also indicates that there might be no direct linear relationship between social phobia and shyness. That is, social anxiety disorder might occur in the absence of shyness thus making them distinct contrasts.

Burstein, Ameli-Grillon, and Merikangas (2011) argue that there is a distinct contrast between shyness and social anxiety disorder. The study argues that social phobia can occur to people with or without shyness. However, the element of shyness does not affect the side effects of social phobia or characteristics. The impairment among people suffering from social phobia can be experienced in several domains that include family relationships, social life, and work or school ability (Kashdan & McKnight, 2010).

However, adolescents with shyness were more likely to experience the social anxiety disorder. On the on the hand, individuals with psychiatric disorders were more prevalent among the people with the social disorder.

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