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GABA Calm is a game changer for husband’s sound and tactile hypersensitivity, significant coordination problems and his anxiety

February 10, 2023 By Trudy Scott 18 Comments

gaba calm

My husband is low in GABA and he had significant coordination problems and sensory sensitivity ….. until GABA Calm. 3 tablets per day work great. If he has none, he gets hyper sensitive again and starts tripping over things in the house.

He has always struggled with anxiety and sound / tactile hypersensitivity. Alongside that he often tripped over things. He made great progress when he started using The Listening Program. I wonder if this sound therapy raises GABA and that was why it helped him (although it only partially helped with anxiety)?

When he stopped The Listening Program then his symptoms came back.

He started taking GABA Calm as I saw it in your blogs years ago. Then he found that he didn’t need to do the Listening Program any more.

GABA Calm is a game changer for him.

Denise shared this feedback about her husband’s great results on a blog post about GABA Calm helping with anxiety and sensorimotor skills in an autistic child.

I thanked her for sharing these wonderful results her husband is experiencing.  I am inspired to share this feedback as a blog to give others hope. And also because this illustrates the diversity of how GABA can help i.e. it works for adults and children, males and females, and there is different dosing according to each person’s unique needs.

Music therapy: calming effect and GABA mechanisms

This study, Emotional Inhibitory Effect of Music Therapy on Anxiety Neurosis Based on Neural Content Analysis in Hippocampus, reports that music therapy has a calming effect by adjusting the glutamate/GABA balance. This is likely why Denise’s husband found The Listening Program to be helpful in certain ways – glutamate is the main excitatory neurotransmitter and GABA is the main calming neurotransmitter.

GABA, the GABA Calm supplement, hypersensitivity and sensorimotor difficulties (research)

GABA (gamma-aminobutyric acid) is your main inhibitory neurotransmitter and the amino acid GABA can be used as a supplement to raise GABA levels and ease physical anxiety symptoms, help with insomnia, stress eating, intrusive thoughts and stiff/tense muscles.

GABA Calm is one of many different GABA supplements that I recommend to my clients. This particular one is a sublingual/chewable offered as a 125mg dose, which is where I have most of my clients start. Denise’s husband finds that 3 GABA Calm used throughout the day are enough for his needs. These alleviate his anxiety and also stop his sound and tactile hypersensitivity, and significant coordination problems such as tripping.

This paper reports that“Sensory over-responsivity (SOR), extreme sensitivity to or avoidance of sensory stimuli (e.g., scratchy fabrics, loud sounds)… is present in 5–15% of the general population and is even more common (rates over 50%) in individuals with both genetic and environmentally-based psychiatric and neurodevelopmental disorders such as anxiety, attention deficit hyperactivity disorder, early life adversity, and autism spectrum disorder (ASD).”

The authors discuss altered thalamic sensory gating and an excitatory (glutamate) / inhibitory (GABA) neurochemical imbalance in ASD youth. Most of the research on sensory issues and GABA has been done in ASD children but it clearly applies to adults with anxiety too.

I highlight the motor issues with GABA/glutamate imbalances in the above GABA sensorimotor skills blog. This research is also looking at ASD populations but these mechanisms may account for her husband’s significant coordination problems/tripping.

You can read the current list of low GABA symptoms here. This list will be updated with sound and tactile hypersensitivity, and coordination problems/tripping (and a few others like asthma and laryngospasm).

An occupational therapist who is training as a nutritional therapist

Denise is an occupational therapist (OT) who is training as a nutritional therapist so she can recommend supplements for the kids she works with, alongside the other therapies she uses as an OT.   I love this. I’m a big believer in using everything we have at our disposal and am a huge advocate of OT.  I would love to see more OTs and other practitioners using the amino acids and nutritional therapy.

Denise shared that she actually started her journey in nutritional therapy 20 years ago due to the impact she was seeing in diet and autism. She took a very long break and had her own children and has now restarted her training. She shared this:

I plan to integrate nutritional advice into my work with families. As I am currently a NT student I haven’t been able to advise families even regarding the GABA Oolong tea [more on that below]. I am excited to qualify as I see various sensory, motor and attention issues that can be easily treated through nutritional adjustments and supplements.

Denise is already using the amino acids personally and with her family, sharing: “I love using aminos e.g. 5-HTP and L-theanine for myself and my daughters and GABA for my husband, tyrosine occasionally for my son.”

She has my book “The Antianxiety Food Solution”, a great resource that is practical and fully referenced, for both consumers and practitioners.

I encouraged her to also look into the amino acid training I offer for practitioners once she has completed her training as a nutritional therapist, so she can confidently use them with her clients too.

Having her in the program is also an opportunity for me and others in the group to learn from Denise about her expertise on integrating amino acids, nutrition and OT.

Her feedback on GABA oolong tea or GABA Calm for children with autism?

She also commented that she loved reading the GABA Oolong research – GABA Oolong tea in children with autism: improvements in sensorimotor skills, autism profiles, anxiety and sleep (new research)

I asked for her feedback and if she has kids in her practice, see any benefits when drinking this GABA Oolong tea. And what their responses are to the taste. Since she is still a student she can’t yet advise families regarding the GABA Oolong tea but she did say this:

To be honest I think the Source Naturals GABA Calm sublingual will be easier to tolerate for lots of children compared with tea.

As fascinating as the GABA Oolong tea research is, I feel the same way and  I really appreciate this feedback from an OT. I have actually received similar feedback from a number of other practitioners too. Stay tuned as I continue to gather feedback.

Autism: diet, GABA and working with an OT

It’s amazing that 20 years ago Denise was seeing the impact of diet in kids with autism. If you would like to learn more, this blog – Nutritional and Dietary Intervention for Autism Spectrum Disorder – summarizes a 2018 study and offers many insights into to the progress since then.

As I mentioned above, her husband’s success with 3 GABA Calm illustrates the diversity of how GABA can help i.e. adults and children, males and females, and different dosing according to each person’s unique needs.

This is the blog Denise commented on – Half a crushed GABA Calm for my autistic child: sleep, anxiety and sensorimotor skills (writing, horse riding and swimming) improve.

In the above blog, I share Vic’s feedback about just half a GABA Calm improving her daughter’s sleep, social skills and sensorimotor skills such as pen and pencil use, horse riding and swimming. Her daughter is also working with an OT and getting those added benefits too.

Resources if you are new to using GABA and other amino acids as supplements

If you are new to using tryptophan, GABA or any of the other amino acids as supplements, here is the Amino Acids Mood Questionnaire from The Antianxiety Food Solution (you can see all the symptoms of neurotransmitter imbalances, including low GABA and low serotonin).

If you suspect low levels of any of the neurotransmitters and do not yet have my book, The Antianxiety Food Solution – How the Foods You Eat Can Help You Calm Your Anxious Mind, Improve Your Mood, and End Cravings, I highly recommend getting it and reading it before jumping in and using amino acids on your own so you are knowledgeable. And be sure to share it with the practitioner/health team you or your loved one is working with.

There is an entire chapter on the amino acids and they are discussed throughout the book in the sections on gut health, gluten, blood sugar control, sugar cravings, self-medicating with alcohol and more.

The book doesn’t include product names (per the publisher’s request) so this blog, The Antianxiety Food Solution Amino Acid and Pyroluria Supplements, lists the amino acids that I use with my individual clients and those in my group programs. You can find them all in my online store.

If, after reading this blog and my book, you don’t feel comfortable figuring things out on your own (i.e. doing the symptoms questionnaire and respective amino acids trials), a good place to get help is the GABA QuickStart Program (if you have low GABA symptoms). This is a paid online/virtual group program where you get my guidance and community support.

If you are a practitioner, join us in The Balancing Neurotransmitters: the Fundamentals program. This is also a paid online/virtual program with an opportunity to interact with me and other practitioners who are also using the amino acids.

Have you or a family member had GABA help with sound and tactile hypersensitivity, coordination problems and anxiety?

Which GABA product and how much?

And is the GABA product used sublingually or the capsule opened?

Are you an OT using amino acids and nutritional approaches with your clients, in addition to other approaches?

Do you find music therapy to be calming, in a similar way to the calming effects of GABA?

If you have other questions and feedback please share them here too.

Filed Under: Anxiety, GABA, Men's health Tagged With: adults, amino acids, anxiety, autism, children, coordination problems, diet, female, GABA, GABA Calm, GABA Oolong tea, husband, hypersensitivity, male, music, occupational therapist, sensorimotor, sensory sensitivity, sound, sound and tactile hypersensitivity, tactile, the GABA Quickstart online program; and Balancing Neurotransmitters: the Fundamentals program for practitioners, The Listening Program, tripping

Swings are fun for teens, college students and adults! And they reduce stress/anxiety, and improve mood, memory and PMS symptoms

June 18, 2021 By Trudy Scott 21 Comments

swings for anxiety

Earlier this month I met up with a dear childhood friend for a walk and catch-up and we both rediscovered the joy of swings. I always suggest a walk or hike or swim when meeting with friends and colleagues, and this time was no different except that I really wanted to go somewhere with a swing!

The reason that I wanted to find a swing set was because I had just read an article about swings and teen girls needing a better place to hang out. I love the outdoors and love to play, laugh and have fun, and I couldn’t resist it once I started looking at the research. I discovered all the wonderful benefits of improved mood, reduced anxiety and stress, improved cognition and memory, reduced PMS symptoms, improved social relationships and reduced pain.

These pictures are us swinging and catching up – we laughed and laughed and had such fun!  It’s hard to believe we’ve been friends for close to 50 years and it always feels like we were never apart when we do get together.

swings

Our swing experience made it extra special this time! You can see the pure joy on our faces!

Teen girls needing a better public space to hang out

The recent Bloomberg article I had read, Teen Girls Need Better Public Spaces to Hang Out shares this:

Making space for girls means rethinking which age groups need to swing and climb, how to encourage physical activity (and not just playing a sport), and how to make a safe, sheltered place for outdoor conversation.

And this about movement:

While lack of activity among teens is a major public health issue, many girls are looking for more creative, less competitive ways of moving their bodies.

It features really cool images of swings called “Swing Time.” They are designed by Höweler + Yoon Architecture and deliver “the kind of fun, physical outdoor experience with room for face-to-face conversation that many teen girls are looking for.”

As I mentioned above, I was immediately intrigued because I love the idea of outdoor play and social interaction in a safe place for young girls.

Beth Jones, a Mindset and Wellness Coach who works with teen girls and their moms incorporating movement, play and nutrition, posted the Bloomberg article on Facebook saying:

I love this idea so much. I used to love going to the playground in my teens to swing, hang out, just have a space for me. There’s a reason why my business logo has a girl on a swing. That swinging and twisting are also so great for the vestibular system and can help calm anxiety (the back and forth swinging). Maybe they should bring back some swings to middle and high schools.

I’m familiar with the use of swings in occupational therapy to address sensory processing disorders in children. But I was also very interested to know if there was any research on the health benefits of swings for teens and adults. I went searching and was very pleased with what I found, hence this blog post.

Before we get into the research I’d like to extend a big thanks to Beth Jones for the inspiration for all this! Now the research …..

PMS symptoms improved: mood, stress, anxiety, social relationships, pain and memory

This small study, Vestibular stimulation for management of premenstrual syndrome found the following benefits after 2 months of using the swing in females 18-30 years of age:

  • Depression and stress scores decreased
  • Anxiety scores decreased (although it was not statistically significant)
  • Serum cortisol levels decreased.
  • Social relationships improved
  • Systolic blood pressure decreased (there was no change in diastolic blood pressure and pulse rate)
  • Pain levels decreased
  • Spatial and verbal memory improved

These are amazing benefits using something as simple as a swing. I feel we could safely extrapolate to younger teen girls and even women above 30 years of age too.

Swings for stress management in college students

Vestibular stimulation using swings is the specialty of Dr. Mukkadan, Founder and Research Director of Little Flower Medical Research Centre in India. Together with his team, he published the above PMS paper and this paper on Vestibular Stimulation for Stress Management in Students.

They recommend “placement of swings in college campuses … which may be a simple approach to alleviate stress among college students.”

This is such a simple and yet powerful (and also fun!) intervention especially given the huge rise in anxiety and mental health issues in students. It would be a perfect approach to use in conjunction with amino acid supplements and nutritional psychiatry for these students.

According to another study published by his team, college students will also see improved spatial and verbal memory.

What about swings for teen boys and all adults too?

Once I saw the images in the Bloomberg article, and after reading the research, and after playing on swings again after all these years, my thinking started expanding. I believe everyone could benefit from using a swing.

I certainly wanted to swing right away (hence the walk and swing meet up with my friend a few weeks ago) and now seek out swings when I go for walks. I would love to see an area set aside in parks for teen girls (and boys too) and as Beth says, in middle and high schools too. And how about a designated area in parks for adults who want to swing too?

There are now parks with Liberty swings for children and adults in wheelchairs. The vestibular benefits of rocking chairs are helping veterans dealing with substance abuse and mood issues. I also see an application for stress reduction in the workplace. The opportunities are endless.

Here are some of my recommendations:

  • Seek out swings in parks. Give it a try to see how you feel and how much you enjoy it!
  • Advocate for swings in your communities, middle schools, high schools, colleges and place of business.
  • Get a rocking chair for yourself and/or older family members
  • Get a swing for your backyard (suitable for teens and adults). I’m looking into options for my backyard and will share more once I find some suitable options.

When did you last go for a swing as an adult? How much fun was it!?

If it’s been some time, does this – my pictures and the research – inspire you to want to look for a swing and have a go again?

Does your teen or college student seek out outdoor play like swings and see benefits?

If you are an OT/occupational therapist or exercise physiologist or other health professional using vestibular therapy with swings please do share so we can all learn.

Feel free to post any questions here too.

Filed Under: Anxiety, Joy and happiness, Stress, Teens, Women's health Tagged With: adults, amino acids, anxiety, calm anxiety, cognition, college students, Dr. Mukkadan, fun, joy, laugh, liberty swing, memory, mood, nutritional psychiatry, pain, play, PMS, premenstrual syndrome, social relationships, stress, stress management, swing, Swings, teen girls, teens, vestibular system, veterans

Theanine for easing stress and anxiety, and improving cognition and sleep in healthy adults

January 24, 2020 By Trudy Scott 42 Comments

theanine for anxiety

L-Theanine is a “unique non-protein amino acid found in green tea” which according to the study below, has shown benefits when used short-term or acutely as a supplement for it’s anti-stress effects, reducing anxiety, improving sleep quality, improving cognition and even easing depression.

This 2019 study, Effects of L-Theanine Administration on Stress-Related Symptoms and Cognitive Functions in Healthy Adults: A Randomized Controlled Trial, aimed to examine the effects of four weeks use of l-theanine:

on stress-related symptoms and cognitive functions in healthy adults. Participants were 30 individuals (nine men and 21 women; aged 20-69) who had no major psychiatric illness.

The trial was randomized, placebo-controlled, crossover, and double-blind.

L-theanine (200 mg/day of Suntheanine), was used by study participants before going to bed each night and was used for four-weeks.

Study participants who used the theanine for two weeks observed the following:

  • For sleep: Reductions in sleep latency (the amount of time it takes to fall asleep), sleep disturbance and less use of sleep medication
  • For cognitive function: Improvements in verbal fluency (especially letter fluency) and improvements in executive function (planning, multi-tasking etc)

The Japanese versions of The Self-rating Depression Scale, State-Trait Anxiety Inventory-trait, and Pittsburgh Sleep Quality Index (PSQI) scores decreased and the study concludes as follows:

Our findings suggest that L-theanine has the potential to promote mental health in the general population with stress-related ailments and cognitive impairments.

The authors also note that “there were no significant adverse events, demonstrating the safety of four weeks of L-theanine administration.”

As expected, the participants saw increases in serum theanine concentrations. What is unusual and inconsistent with previous studies, is the fact that there was “no significant effect on cortisol or immunoglobulin A levels in the saliva or serum.” I’m not sure I understand  the reasoning they propose i.e. that “the reduction of salivary cortisol and immunoglobulin A levels may be short term, recoverable effect of L-theanine administration.”  I’ll be digging deeper into this to try and get a better understanding of these differences.

Some of the reported possible mechanisms of action

Here are some of the reported possible mechanisms of action of theanine from some studies referenced in his paper:

  • via glutamate receptors (improving cognitive dysfunction)
  • as a neuroprotective agent and “increases in brain serotonin, dopamine, GABA levels” (improving mood and focus and reducing anxiety)
  • enhances hippocampal activity (the hippocampus has a major role in learning and memory)
  • via a proposed increase in the expression of brain-derived neurotrophic factor (BDNF) in the hippocampus (BDNF is a protein implicated in the stress response, long-term memory, Alzheimer’s disease, and psychiatric disorders)

Theanine or GABA – which one to use when?

I typically start my clients with a trial of GABA Calm for low GABA symptoms like physical tension, stress and overwhelm, panic attacks and insomnia. If we are not getting all the expected benefits with GABA and there is a need for added cognitive benefits then we’ll consider adding theanine too. Some folks find one works better than the other and some like a combination (at the same time or theanine in the day/GABA at night or GABA in the day/theanine at night).

I recently reached out on facebook asking: “Theanine or GABA? Which do you prefer for anxiety and why? How much helps? And any other benefits (like reduced body pain, better thinking/cognition, easing IBS gut pain, reduced cravings, less negative self-talk etc)?Or do you like a combination of both?”

As you can see from these varied responses it’s a matter or trialing both to find what works for each person’s unique needs:

  • Lorraine shared this: “They are both good, but I reach for GABA Calm first.. 2 or 3 lozenges. If anxiety doesn’t leave quickly with GABA ( which works well for a panic attack), and I continue to have anxiety humming along in the background, then I’ll reach for theanine.”
  • Jackie shared this: “I take 200mg theanine in morning, then 100mg GABA around 4pm, when the kids get home from school. I had a panic attack in the middle of the night last week, took GABA 100 mg, then seemed to calm down.” I asked if theanine gives her a feeling of calm focus and she said: “yes, I think so. I noticed if I take 200mg of GABA, it makes me drowsy.”
  • Evelyn shared this: “I use both at night for sleep. If I could only use one it would be l-theanine.” Theanine is more consistently helpful for stress reduction and sleep for me. I use 200mg. When I use GABA it’s 500mg of chewables.”
  • Sara shared this: “GABA during the day, theanine at night.”
  • Karine shared this: “GABA!! The Source Naturals Theanine Serene with Holy Basil is really good. But GABA Calm (also Source Naturals which is a sublingual lozenge) is the only thing for a severe issue/episode and helps me concentrate right before an important presentation at work etc. Pure GABA from any supplier is good for long periods where you need a boost or to tone down general anxiety. I also bought a probiotic that also includes GABA (Jarrodophilus Mood) and notice it improves digestion too.”

You can find my favorite GABA/theanine combination product, a theanine-only product and my most popular GABA products on the supplements blog here (and with details for how to set up an account for my online store)

Nutritional Fundamentals for Health GABA-T SAP: 300mg GABA, 150mg theanine. This is pleasant-tasting when opened on to the tongue and works very well when GABA Calm can’t be used.

Pure Encapsulations L-Theanine: 200mg theanine. This is also pleasant-tasting when opened on to the tongue. Unlike like GABA, it can also be swallowed.

Source Naturals GABA Calm. This is a pleasant-tasting sublingual product that is my most popular and most effective form of GABA I use with my clients. It can be used in conjunction with theanine.

Enzymatic Therapy GABA: 250 mg GABA. This is also pleasant-tasting when opened on to the tongue and works very well when GABA Calm can’t be used. It can also be used in conjunction with theanine.

Please let us know … theanine or GABA: which do you prefer for anxiety and why? How much helps? And any other benefits (like reduced body pain, better thinking/cognition, easing IBS gut pain, reduced cravings, less negative self-talk etc)? Or do you like a combination of both?”

Filed Under: Amino Acids Tagged With: adults, anxiety, BDNF, cognition, cognitive function, GABA, GABA Calm, panic attack, sleep, stress, theanine

Buddy Bench for introverted adults with social anxiety, shyness and feelings of overwhelm?

July 26, 2019 By Trudy Scott 6 Comments

buddy-bench

Buddy Benches or Friendship Benches are being used in many countries around the world in schools to help children who feel lonely or are shy or anxious. I propose we do something similar for introverted adults with social anxiety, shyness and feelings of overwhelm or intimidation when they attend conferences.

This BBC article, How ‘Buddy Benches’ are making playtime less lonely shares this about how they are helping children fit in more:

The school playground can be a lonely place for a child if they haven’t got anyone to play with. But a special type of bench is helping pupils make friends.

The idea is simple – if a child feels lonely, they can go to the bench as a signal that they need someone to play with. Another child will see them, go and talk to them and include them in their games.

Also from the BBC article, we learn that Buddy Bench Ireland is taking it a step further and trying to do something different with them, using the bench to engender empathy and as

a reminder for children of things like communication, mutual support and opening up about feelings

Other objectives of these Buddy Benches in schools is:

  • reducing social isolation
  • improving mental wellbeing
  • end bullying

I propose we take these Buddy Benches – that work so well with children – to another level and set them up at conferences for adults too. I believe they could work very well for introverts (who make up around 50% of the population) with social anxiety and/or anyone feeling overwhelmed and/or intimidated and/or shy.

I get kickback when I talk about introverts feeling socially anxious but it’s common as you can see by these comments from introverted individuals

  • It isn’t always a comfortable place to be when I must be in a crowd.
  • The hardest aspect of living life as in introvert is we all live in an extroverted world. School pushes kids to do group projects, that are just awkward and when you don’t do well in it you’re doing something wrong or something is wrong with you. The moment I step out of the door I am no longer me, I am a character that has to put on a show in order to succeed in the work place.
  • Sometimes I can communicate with friends well and sometimes I fake it really badly. I always wonder if people can see past my half smile and fake laugh. It’s painful to be honest. But there are times when I don’t mind so much.

One big question is this: would adults use one or would they feel more self-conscious than children? Would they worry more about what others will think if they sit down at an empty bench waiting for someone to join them, essentially saying “I’m shy” or “I’m anxious” or “I’m an introvert” or “I feel intimidated”?

In the BBC article they address this stigma and worry aspect:

But do children actually use the bench? And are they worried about how it makes them look?

“They don’t see it as stigmatised,” says Sinead McGilloway, director of the Centre for Mental Health and Community Research at Maynooth University, who led a study of 117 pupils at three schools which have benches.

Forty per cent of the children she questioned said they had used the bench, and 90% said if they saw someone else sitting on it they would talk to them.

I have these questions for you about using a Buddy Bench at a business or health conference:

1) How likely are you to use a Buddy Bench as an adult diagnosed with social anxiety and/or know you have the social anxiety condition called pyroluria and you’re working to address your symptoms with nutrients but are not quite there yet.

2) How likely are you to use a Buddy Bench as an adult who identifies with being an introvert and are easily overwhelmed at the networking and mingling aspects that comes when you attend a conference?

3) How likely are you to use a Buddy Bench as an adult who feels shy and/or easily overwhelmed and/or intimidated in new settings with large groups of people you don’t know?

4) How likely are you to be the “Big Buddy” (I just made this term up because it makes me think of Big Brother or Big Sister) and go up to someone sitting on a designated Buddy Bench in order to offer moral support, conversation, connection, encouragement and kindness?

Of course, I love the idea of these Buddy Benches and would have used one for support and connection in the past. I have pyroluria and used to have dreadful social anxiety (and considered myself an introvert). But now that I’m on the pyroluria protocol I feel like a social butterfly and I am very relaxed at big group events. I would definitely go and buddy-up with someone looking for support.

And let’s not forget that Buddy Benches are just one part of the solution – for both children and adults – and we don’t want to forget food, nutrients and functional medicine:

  • While you’re figuring out the role of diet, gut health, adrenal/thyroid health, toxin exposure etc, a good place to start is to assess for and address low GABA and low serotonin with the amino acids GABA and tryptophan. This  provides quick nutritional support for worry, fear, anxiety, tension, overwhelm, lack of confidence and feelings of intimidation.
  • My next step would be to assess for and address pyroluria with zinc and B6 (and other key nutrients) to help ease and often eliminate the social anxiety completely.  Believe it or not, there is a strong connection between pyroluria and introversion and many of my clients and folks in my community no longer feel introverted when they address their pyroluria. I write about this in another blog: Am I an anxious introvert because of low zinc and vitamin B6? 

Feel free to comment and let us know what you think about Buddy Benches for adults. Do you have other ideas as to where these adult Buddy Benches could be used?

Let us know if you’ve seen these Buddy Benches work successfully with children and what ideas we could take away to get similar results for adults using them.

And do share if a nutritional approach or if addressing pyroluria has eased your social anxiety, and maybe got you wondering if you are an introvert after all.

Feel free to post your questions too.

 

Filed Under: Mental health Tagged With: adults, anxious, Buddy Benches, children, intimidated, introverts, lonely, mental health, overwhelmed, pyroluria, shy, social anxiety

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