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David Baxter

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How Social Anxiety Affects the Brain

Psych Central
Sept 7, 2022

Research shows changes in important areas of the brain, such as the hippocampus and amygdala, can be affected by social anxiety.​

Social anxiety disorder, also known as social phobia, is a form of anxiety that causes intense fear and embarrassment in social situations.

For example, it’s common to feel slightly nervous when meeting new people or speaking in public. People with social anxiety disorder can experience a paralyzing fear that makes it hard for them to live everyday life.

We now know that social anxiety disorder affects more than just relationships, work, and other daily activities — it also affects the brain.

Researchers have found that critical areas in the brains of socially anxious people function differently. These areas mainly involve processing emotion, danger, and social cues.

Areas of the brain affected by social anxiety​

Differences in five critical brain areas may explain how social anxiety impacts how people think and act. Let’s take a closer look.

Amygdala​

The amygdala is the part of the brain that deals with emotions, especially fear, anxiety, and aggression. It controls the “fight, flight, freeze, or fawn” response when faced with a threat. It’s not surprising then that the amygdala plays a central role in social anxiety.

So how is the amygdala different in people with social anxiety?

The most crucial difference is that the amygdala is often overactive in response to social interactions. For example, when socially anxious people are shown fearful faces, their amygdala lights up — a sign of a heightened fear response.

Oxytocin, a chemical messenger in the brain that decreases anxiety, may have something to do with this.

According to a 2016 study, when people with social anxiety were given oxytocin, their amygdalas were no longer as active in response to angry or fearful faces. This suggests oxytocin levels are lower in socially anxious people.

Research from 2020 notes that the amygdala is slightly larger in people with social anxiety. Even more interesting, the more severe anxiety symptoms, the larger the amygdala is.

This shows that the brains of socially anxious people have adapted to spending more time and energy processing threats and emotions.

Prefrontal cortex​

The prefrontal cortex (PFC) is involved in many aspects of our behavior, including planning, decision-making, and self-control.

In contrast to the amygdala, the PFC is generally underactive and smaller in those with social anxiety.

There are also significant differences in how the PFC communicates with other brain areas. Typically, the PFC sends signals to the amygdala to keep it from becoming too active during routine social interactions.

But this connection doesn’t work well in people with social anxiety disorder.

Instead of decreasing amygdala activity, the PFC instead increases amygdala activity. This causes fear and anxiety.

The PFC also controls what your brain pays attention to. In socially anxious people, the PFC tends to be more active in response to social threats.

For example, a 2016 study suggests that people with social anxiety will focus on angry faces more closely and have a more challenging time shifting their attention away from them.

Anterior cingulate cortex​

The anterior cingulate cortex (ACC) plays a vital role in regulating emotions. It’s especially involved in processing social rejection and coping with stress due to social interactions.

The ACC becomes overactive in socially anxious people when they look at faces with negative facial expressions. This supports 2019 research showing that people with taijin-kyofusho, a subtype of social anxiety, are overly sensitive to how others perceive them.

The ACC also helps the prefrontal cortex communicate with the amygdala. However, in people with social anxiety, this channel is disrupted. This makes it harder for them to control their emotions and emotional behavior.

These findings help explain why socially anxious people tend to exaggerate the effects of a stressful social situation and place so much importance on social rejection.

Fusiform gyrus​

The fusiform gyrus is a part of the brain that is involved in processing faces and determining the emotional state of others. As such, it plays a crucial role in social interactions.

2021 research found fusiform gyrus can be either overactive or underactive in people with social anxiety disorder, depending on the coping strategies that person has developed.

If a person with social anxiety has made it a habit to avoid looking at faces, then the fusiform gyrus will be less active.
But if the person tends to overly focus on faces, the fusiform gyrus will be much more active than usual. This may be why socially anxious people view emotionally neutral faces as angry.

Hippocampus​

The hippocampus is actively involved in learning and memory. Research suggests it may also play an essential role in social anxiety.
Some evidence shows that social anxiety may be a behavior pattern that people learn after having several bad social interactions. Over time, they become used to acting a certain way and expect people to react negatively to them.

According to 2016 research, when socially anxious people see faces of people they haven’t seen before, their hippocampus goes into overdrive. When they are repeatedly shown these faces, they never learn to become familiar as a person without anxiety does.

Instead, they continue to identify the faces as threatening. This explains why people with social anxiety have a much harder time meeting new people.

What happens in the body during social anxiety?​

In addition to changes in the brain, many changes occur in the body when someone experiences social anxiety. These changes include:
  • blushing
  • excessive sweating
  • increased heart rate
  • muscle tension and rigid posture
  • nausea and stomach pain
  • shortness of breath
There are also increases in stress hormones like cortisol and adrenaline.

What causes social anxiety?​

It’s still not clear exactly what causes social anxiety. Research from 2022 suggests that genetic and environmental influences cause social anxiety, such as upbringing and life experiences.

Research has revealed certain areas of the brain that play a role in fear and anxiety, and we know that genetics affects their function. But researchers don’t yet know which specific genes those are.

Children of controlling, overprotective, or intrusive parents are more likely to develop a social anxiety disorder. Stressful life events such as sexual or emotional abuse also increase the risk of developing the disorder.

The hope is that by studying how the brain is affected by social anxiety, researchers can develop more effective treatments for the disorder.

Next steps​

Social anxiety negatively affects the areas of the brain that help you process fear, anxiety, and information about other people. As a result, it can distort your perception of reality and how you relate to others.

While social anxiety can be difficult, it doesn’t have to ruin your life. The good news is that there are effective treatments for social anxiety.

Cognitive behavioral therapy (CBT) helps people identify negative thoughts and patterns of behavior and replace them with positive ones.

A small 2016 study suggests CBT benefits socially anxious people by changing how the brain reacts to social criticism. CBT also helps teach people important social skills to overcome their anxiety.

Medications can also help manage social anxiety. These include selective serotonin reuptake inhibitors (SSRIs) and anti-anxiety drugs, such as benzodiazepines. Many people with social anxiety see greater benefits when these medications are combined with therapy.

Lastly, join an online or in-person support group. You can connect with others who share your struggles and offer strategies and advice on dealing with social anxiety. All these resources can help you manage your anxiety and regain control of your life.
 

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