Social anxiety and loneliness.

Image: Pixabay.com

Fearnounan unpleasant emotion caused by the threat of danger, pain, or harm. 

Does that sound familiar to you and your experiences? Perhaps it may. Anxiety is often coined to be a particular type of persisting fear, wherein we worry about potential future outcomes associated with specific events. In fact, the way we feel when either frightened or anxious are extraordinarily similar, because the basic emotion for both remains the same. So, despite not being in any immediate danger, anxiousness can result in similar symptoms to that of fear: increased heart rate, feelings of sickness and/or dizziness, and a loss of appetite. For many, new social situations can be a common trigger of these symptoms, often termed as social anxiety. 

Social anxiety: what is it?

Also labelled as social phobia, social anxiety presents itself as a long-lasting fear of being humiliated or scrutinised by others. It is sometimes (and incorrectly) compared to general shyness. However, whilst shyness often manifests for many prior to an unfamiliar situation, this usually dissipates following exposure to the new social situation. This is not the case for social anxiety. The latter often manifests during adolescence, when the opinions of friends and peers become increasingly important. This impairment can continue into adulthood, wreaking havoc on a wide variety of important life events. Separating social anxiety symptoms from those of general shyness is thus essential before discussing management and treatment options. 

The symptoms

Symptoms of social anxiety (as with any form of anxious behaviour) can be wide ranging, and it is unlikely that any one individual would experience them all. All anxiety disorders can be associated with the symptoms mentioned previously. However, common identifiers for social anxiety usually include the feeling of dreading everyday activities, such as starting up conversations with strangers, speaking on the phone to unfamiliar people, or even going into work. As a consequence, social anxiety can result in the avoidance of many social activities such as eating out or going to parties.

Can social anxiety effect my health? 

Because of the primal need for social interaction between humans, the consequences of social isolation on both physical and emotional health can be catastrophic. A recent meta-analysis – a statistical approach which combines data from multiple studies – identified that a lack of social connections can heighten health risks as much as smoking fifteen cigarettes a day or having an alcohol consumption disorder. The analysis suggested that social isolation can significantly increase the risk of premature mortality, with the magnitude of risk exceeding that of other common leading health threats. A recent study in 2019 analysed the data from more than 580,000 adults, finding that social isolation increases premature death risk for every race.

The negative impact on both mental and cognitive health is also apparent. Evidence supports a link between social isolation and adverse health effects including poor sleep quality, depression and accelerated cognitive decline, the latter of which is associated with problems in memory, language and judgement. A 2018 study also discovered a clear association between loneliness and dementia, increasing a person’s risk of developing the latter by up to forty percent. Examining data from more than 12,000 U.S. adults aged fifty or older, participants rated their loneliness and social isolation alongside completing a battery of cognitive tests every two years for up to ten years. 

Do you think this applies to you?

As reported by a 2018 survey, loneliness levels have reached an all-time high. Of the 20,000 U.S. adults approached, nearly half reported feeling alone, with the youngest generation being the loneliest of all. However, isolation is also well characterised in the elderly. According to Age UK, over two million people in England over the age of 75 live alone, with over one million stating that they go for over a month without conversing with a friend, neighbour or family member10

It is essential to determine whether social anxiety and/or loneliness applies to either yourself or a loved one, and then take appropriate action. It is important to try and communicate with friends and family where possible. However if this is hindered, it is imperative to seek out advice from a qualified medical professional. 

Untreated depression: It will damage your brain.

Image: Kat Jayne

It is a scary prospect, but it is something that has accumulated serious momentum. From a scientific point of view, I have to admit I do find it fascinating. However, from a health perspective, this is rather worrying. The conclusions being drawn? Untreated depression may be causing brain degeneration.

Considering one in four people in the UK will experience a mental health problem each year, this might raise concern. It becomes even more alarming with the publication of a recent study highlighting that approximately 35% of people newly diagnosed with depression refused to seek treatment. Without professional help, how long can depression toxify and contaminate an individual’s identity? Easily an entire lifetime. Not seeking help for prolonged periods of sadness or emotional absence may not be just affecting your character, as was often thought for decades. 

The ‘all in the mind’ mentality is dead. The divide between physiology and psychology was clearly defined for many years. When patients were physically unwell – because of say, a broken bone or arthritis – any accompanying mental health instabilities were waived off. Depression often accompanied these ailments (and still does, of course), but the diagnostic significance of such was irrelevant. If a patient suffering from a chronic disorder like arthritis said they were depressed, the general consensus amongst medical practitioners was: ‘well you would be, wouldn’t you?’. The same conclusion was always drawn. The patient was simply depressed as a consequence of the pain associated with their arthritis, or their broken leg, and so forth. No real attention looked into the other potentiality; what if the depression causes physiological ailments? What if a psychological disturbance could be having serious negative effects on the body?

In the 21stcentury, the argument for this is strong. Chronic, untreated depression appears to have a degenerative effect on the brain, damaging it from the inside. Here I want to highlight some key pieces of research which link depression to neurodegeneration. The idea here is to help us all understand just how important seeking assistance might be if you think yourself or a loved one might be suffering from a chronic depressive episode. Trying out different methods to combat depression will be beneficial both for emotional stability and life fulfillment, but also for the health of our brains, too.

A major finding was published when discovering differences in the brain scans of depressed and non-depressed patients. Looking at cases of major (clinical diagnosis of chronic) depression which had lasted for more than a decade, the Centre for Addiction and Mental Health in Ontario, Canada identified that during episodes of major depression, the patients’ brains would show signs of inflammation. The study group identified that a key protein associated with the central nervous system (brain and spinal cord) inflammatory response was approximately 30% higher in the brains of people who lived with depression for more than a decade. However, this isn’t the only study to report such a finding. Another study published in 2016 looked at the whole-body levels of CRP (another biological marker of inflammation) in patients with depression and those without. The observational studyidentified that depressed individuals exhibited CRP levels more than 30% higher than those without depression.

The results presented here are startling, collectively indicating that we may need to change our thinking about depression and its effects. The evidence strongly affirms that depression truly is a biologically based disorder, rather than something that only exists in the field of psychology. But how does this link to degeneration of the brain?

Whilst inflammation is used to protect the body from infection amongst other functions, excessive inflammation can cause extensive cellular damage. Chronic inflammation within the brain has been linked to several destructive neurodegenerative diseases. One of which is Parkinson’s disease, which primarily manifests itself as a movement disorder, wherein patients begin to show signs of slowed movement (bradykinesia), until movement becomes practically impossible without medication. This primary symptom is caused by the destruction of neurons in the portion of the brain which is essential for movement. Unfortunately, there is currently no cure.

Whilst the contribution of inflammation to Parkinson’s disease does not appear to be the primary causation, in Alzheimer’s disease it may be a different story entirely. Alzheimer’s disease is the most common neurodegenerative disease in the world. In the United States alone, approximately 5.7 million peopleare currently suffering with the disease, which is primarily associated with progressive and severe memory loss. Again, there is currently no cure. Recent researchpublished in the Lancetnow appears to highlight neuroinflammation as a central cause of Alzheimer’s disease, with many otherstudies further supporting this idea.

Multiple lines of research therefore support the idea that ignoring a potential major depressive episode could have considerably devastating consequences for the long-term health of the brain. What can we do to fight back? Alongside seeking professional support, as little as 20 minutes of exercisecan reduce your bodily levels of inflammation. This is alongside the general health benefits of exercise, including reducing the risk of type 2 diabetes and cancer. Diet is the next big consideration. There are several foods which should be avoided due to their contribution towards inflammation, including red meat and refined carbohydrates. On the other hand, there are many foods which are considered to be anti-inflammatory, including green leafy vegetables such as spinach and kale, fatty fish like salmon, and a range of berries. A more exhaustive list of pro- and anti-inflammatory foods can be found here. Supporting this switch in diet, women whose diets include more foods which trigger inflammation and fewer foods which restrain inflammation have up to a 41% increased risk of being diagnosed with depressionthan those who mostly eat a less inflammatory diet.

Depression is a biological disorder and we all need to take this into consideration. Its link to inflammation and bodily damage cannot be underestimated, and it is something we must consider when either ourselves or a loved one is currently suffering a major depressive episode. If you are adamant about not seeing a professional (I highly advise you do, however), exercising more and switching up our diets may provide an answer that we desperately need.