What Happens in the Brain During Social Anxiety?

Welcome to the third blog of Brain Behind Behavior! Today we will dive into the neurological mechanisms behind social anxiety, specifically the overactivation of the amygdala and disrupted communication within the prefrontal cortex. Then we will explore its impact on decision-making and fear responses in social situations.

Many people find social interactions to be a source of dread. Some may revel in gatherings, parties, and lunches while others immediately plan their exit strategy even before they step into a room. According to Fallon Goodman, Assistant Professor of Psychology, 40 million Americans suffer from social anxiety disorder, a mental health condition that makes social situations not only uncomfortable or awkward but a source of crippling panic and terror.

Social anxiety can often be dismissed as introverted behavior or simply just being shy. In reality, this condition is neither harmless nor fleeting. Rather, it is linked to elevated risk of drug or alcohol abuse and mental illnesses like depression. Alarmingly, this type of anxiety can cause individuals to avoid or hide from social interactions. Goodman explains that "'Humans are hard-wired to connect with each other...But social anxiety gets in the way of people living the lives they want to live'" (DiConsiglio).

It is extremely crucial for us to address the rising prevalence of this disorder in our world today. According to Goodman, "'More than 12% of Americans will have diagnosable social anxiety disorder at some point in their lives'" (DiConsiglio). Having personally experienced debilitating social anxiety, I realize how critical it is to spread awareness of this mental condition with other individuals who may feel lost, alone, or confused too. So let's dive into the neuroscience and psychology behind anxiety to gain a better understanding of what exactly is going on in the brain.

Social anxiety disorder does not just affect your relationships, work, and day-to-day life. More importantly, it significantly affects the brain. Research has found that critical regions of the brain in socially anxious people actually function differently. These specific areas involve the processing of emotion, social cues, and perception of danger. Studies also show that the cause of the disorder likely stems from a compound interaction between biological and environmental influences just like many other mental illnesses.

Let's take a look at the reaction a brain undergoes when it perceives a threat. "If your brain decides that a fear response is justified in a particular situation, it activates a cascade of neuronal and hormonal pathways to prepare you for immediate action. Some of the fight-or-flight response—like heightened attention and threat detection—takes place in the brain. But the body is where most of the action happens... Several pathways prepare different body systems for intense physical action. The motor cortex of the brain sends rapid signals to your muscles to prepare them for quick and forceful movements. These include muscles in the chest and stomach that help protect vital organs in those areas” (Javanbakht). This can explain why you tend to feel tightness in your stomach or your chest during stressful situations.

Additionally, the sympathetic nervous system in your body "speeds up the systems involved in fight or flight. Sympathetic neurons are spread throughout the body and are especially dense in places like the heart, lungs and intestines. These neurons trigger the adrenal gland to release hormones like adrenaline that travel through the blood to reach those organs and increase the rate at which they undergo the fear response” (Javanbakht), which is why people with social anxiety often feel symptoms such as trembling, shaking, sweating, rapid heartbeat, or chest pain.

Moreover, "To assure sufficient blood supply to your muscles when they’re in high demand, signals from the sympathetic nervous system increase the rate your heart beats and the force with which it contracts. You feel both increased heart rate and contraction force in your chest, which is why you may connect the feeling of intense emotions in your heart...In your lungs, signals from the sympathetic nervous system dilate airways and often increase your breathing rate and depth. Sometimes this results in a feeling of shortness of breath... As digestion is the last priority during a fight-or-flight situation, sympathetic activation slows down your gut and reduces blood flow to your stomach to save oxygen and nutrients for more vital organs like the heart and the brain. These changes to your gastrointestinal system can be perceived as the discomfort linked to fear and anxiety” (Javanbakht).

Psychologically, at the very core of social anxiety, there exists a strong fear of rejection. Individuals with this disorder often intertwine rejection with their own views of themselves. This is where people start to develop thoughts like "I am not good enough" or "I am not loveable". And it doesn't just stop there. "Each nerve-wracking encounter makes it harder for them to risk rejection again. ‘For some people, rejection is so painful, so traumatic, that they systematically avoid social interactions throughout their life'" (DiConsiglio). Socially anxious people are found to consistently underperform, underestimate themselves, and have negative self-evaluative views. Even further, the amygdala, an area in the brain that elicits fear when danger is present, triggers an alarm response and increases cortisol levels when an individual feels threatened or unsafe in a social setting, causing them to feel anxious” (Callan).

In neurological terms, studies by Columbia University discovered that cells located in the hippocampus, a region of the brain involved in anxiety and memory, become increasingly active when anxiety is elicited. Additionally, isolation from loved ones or closed friends raise anxious behavior and cortisol levels (a primary stress hormone) in people with social anxiety. Those with small social circles also show high cortisol levels and symptoms of anxiety akin to socially isolated individuals. The effect causes lonely people to be cautious of social threats such as rejection or exclusion.

Biologically, social anxiety can be passed down genetically. Research has found that 30-40% of the disorder can be attributed to genetic influence, meaning that social anxiety is transgenerational and can be inherited to an individual's children. This only solidifies the urgency in which mental health needs to be addressed and supported.

Moreover, studies reveal that an extended amygdala plays a critical role in anxiety disorders. Exposure to frightening situations increases amygdala activity as well as the frontal-striatal cortex. "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" and "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” (LeMarco).

Research finds revelations in the growing importance of facial expression on social anxiety. The anterior cingulate cortex, a part of the limbic system, is crucial to 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...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” (LeMarco). It is clear that the brain's neurological processes are inhibited by the mental disorder, proving to effectuate significant consequences on not just the mind but the brain.

What can you do to address and reduce your social anxiety?

Taking the first step to healing your mental health constitutes taking risks and challenging yourself to venture out of your comfort zone. Researchers recommend engaging in social courage. Intentionally putting yourself into situations you would otherwise be too afraid or anxious to take part in can actually help you conquer or overcome your fears. Most of the time, people find that their biggest fears don't come true. To add, resocialization can reverse the anxiety and stress that is associated with social isolation. How to resocialize? Take things slow. Once you are ready to step back into the world, focus on the present, on your situation, and on the things you can control. Pace yourself and try not to avoid everything. You don't need to strike up a long conversation, rather, a simple "hello" or "how are you doing" will suffice. Take it one step at a time.

This is why Brain Behind Behavior is dedicated to providing resources and education to others that want to learn more about the connection between neuroscience and mental health. Reducing the stigma and harmful stereotypes surrounding mental illness is an essential part of our mission. Goodman says, "'We’ve got a long way to go in understanding what social anxiety is and not equating it to some sort of weakness'" (DiConsiglio). We aim to create lasting and meaningful change in a world where anxiety is a top contributing factor to mental illness.

Next, it is critical to identify your triggers. "Pinpointing why and when you feel most anxious can help you manage those feelings...You may feel anxious in situations where you worry about others judging you. On the other hand, you could feel fine being around others—as long as they don’t expect you to share your thoughts" (Raypole). Begin by listing situations that elicit the most discomfort. Then identify what symptoms you experience in these situations. Being aware of what you're dealing with significantly help you manage your symptoms effectively.

Here is a crucial step to reducing your social anxiety: Limit or challenge negative thoughts, especially those regarding yourself. Individuals with social anxiety often have negative self-views. When you find yourself having unkind thoughts toward yourself or any sort of negative self-talk, shut them down. Change your thinking. Be kind to yourself and mindful of the way you talk to yourself because you are the ultimate determinant of your worth. In addition, during anxiety-inducing situations, "You may spend a lot of time thinking about the potential negative outcomes of social situations...Understanding the spotlight effect—the tendency to think others notice your mistakes more than they actually do—can also go a long way toward easing feelings of social anxiety" (Raypole). Don't forget that it is all in the mind.

Lastly, receiving professional medical attention is always an option. "A trained mental health professional can: help you identify social anxiety triggers; teach helpful coping strategies, social skills, and relaxation techniques; and offer guidance on reframing negative thoughts” (Raypole). To add, there are definitely effective medical treatments for social anxiety, the most prominent one being Cognitive Behavioral Therapy which can help people identify negative patterns of behavior or thoughts in order to 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" (LeMarco). Always remember that you can reach out for help. Make the choice to treat yourself with kindness-that is the first step to healing.

"You are not weak. People like us, we’re brave. We’re the ones who get up and face our worst fears every day. We keep fighting.”

- Jen Wilde

Lauren Lee is a high school junior fascinated with neuroscience and creative expression. She founded Brain Behind Behavior to explore the neuroscience behind mental health challenges facing teens today.