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This is Your Brain on Social Anxiety

brain-on-sa-intro-animationYou open the door to the sight of a crowded party. You hear the interviewer call your name. That cute guy or girl you have a crush on sits next to you and asks about your weekend.

Suddenly, your heart starts to pound. Sweat soaks your t-shirt and your face feels hot. You open your mouth to speak but your mind goes blank. Your chest tightens and you feel like you can’t breathe.

Almost everyone can recall a situation like this when they experienced social anxiety. It turns out social anxiety is not only normal, it’s actually an evolutionary adaptation meant to keep us from harm. Scientists have learned that when social anxiety strikes, your brain and body respond the same way as if you were face-to-face with a bear: your instinctive fight-or-flight response kicks in, putting your body into overdrive so you can get out of the situation fast. Neuroscientists have also learned that if you have clinical social anxiety, your brain is actually wired a bit differently. We’ll talk about what happens in the average brain when social anxiety strikes, and how this is different in the brains of people with clinical social anxiety.

Your brain on social anxiety: why you’re basically an ‘emotional lizard’

In the average human brain, social anxiety starts when some event catches your attention and sets off the alarm systems in your brain. Our brains are evolutionarily ancient, and this instinct evolved to prevent us from being eaten by saber tooth tigers. For example, when we’re in the wilderness, a sudden movement that might signify an attacking predator sets off the alarms.

In the modern world, we rarely face predators anymore, but this age-old reaction system has been repurposed to protect us from new kinds of threats, like judgment from our peers. Even though the stakes are usually much lower, our brain still uses the same reaction system, and that’s why a seemingly disapproving stare can send us into a panic.

Your alarm system has two ways of getting your attention: the “low road” of instant panic and the “high road” of considered concern. These map to separate pathways in your brain. First, the sign of possible danger is picked up by a part of your brain called the thalamus. The thalamus then routes the sensory information in two directions: a faster, direct path to a part of your brain called the amygdala, and a slower path that goes through your cerebral cortex and back to your amygdala.

The low road directly to the amygdala happens within a fraction of a second–so fast it’s pretty much automatic. The amygdala is often called the “emotional center” of your brain, because it is essential to instincts and feelings like fear and pleasure. When your amygdala gets the sign that possible danger is nearby, it starts your fight-or-flight reaction. You’ll freeze momentarily as your senses become hyper-aware, which helps you scan for immediate threats. Your heart will race and your breathing will become rapid so that blood can reach your muscles faster. Stress hormones will flood your system, causing your muscles to tense and your blood sugar to spike, resulting in a superhuman surge of energy. Your mouth goes dry, your palms sweat, and your chest tightens; essentially, you’ll feel all the physical sensations associated with anxiety.

Only after your body has gone through this immediate, visceral response does your mind catch up. On the high road, you actually think about whether the event is a threat to you, and as you might imagine, this takes a few seconds. On this path, the sensory information goes from the thalamus to the cortex, where it’s integrated into your conscious awareness. Your cortex, especially a part of it called the prefrontal cortex, is associated with reason and logical thinking. Your cortex identifies the thing that alarmed you and decides whether or not it is really dangerous. This is when you realize whether that movement that made you jump was really a snake, or just a leaf blowing in the wind. If it was just a leaf, your body shuts down the fight-or-flight response.

In other words, your brain is wired so that your body responds to danger before it even knows whether or not you truly are in danger. And there’s a reason it evolved this way: our ancestors who paused long enough to identify a pouncing predator were eaten. Evolutionarily speaking, it’s generally better to overreact to something harmless than to underreact to something dangerous.

The amygdala, which turns on your fight-or-flight response, is one of the oldest structures in the brain. Joseph Ledoux, the neuroscientist who mapped out the low and high road, postulated that the amygdala has served this same function since the age of the dinosaurs. On the other hand, the prefrontal cortex, which turns the response off, is more recently evolved. Its modern development in humans is associated with our capacity for higher reasoning. Yet when it comes to fear and anxiety, we still respond with fear first and reason following. Which is why Ledoux mused of mankind, “in some ways, we are emotional lizards” (Ledoux, 1996, p.174).

How the brains of people with clinical social anxiety are different

Neuroscientists have studied the brains of people with clinical social anxiety and have found two key differences in the way socially anxious brains execute the reaction we described above.

Amygdala hyperactivity: why you’re anxious in seemingly ‘normal’ situations

The first difference neuroscientists have found is that people with clinical social anxiety (referred to as people with social anxiety from here on) have hyperactive amygdalae, causing them to be extra vigilant in social situations. A 2005 study compared FMRIs of people with and without social anxiety when looking at pictures of human faces with different emotions. They found that the people with social anxiety showed higher amygdala activation when looking at faces with negative expressions like anger, distrust, and fear. In addition, the study found that the more socially anxious a person was, the higher the activity in their amygdala when they viewed the harsh faces.

This study suggests that people with social anxiety are more sensitive to signs of possible social threat than others, and the more socially anxious they are, the more hypervigilant they are to any possible signals of danger. So, if you’re at a party with friends and you wonder why everyone else seems to be enjoying the party while you’re nervous and super worried about all the things that are going (and might go wrong)— it might be because you have a hyperactive amygdala that causes you to question small things like an eye roll or an insincere laugh. Your brain is literally scanning for cues that something is going wrong while your friends’ brains are not as fine-tuned to such signals.

Switched signals: why you can’t simply tell yourself to ‘just stop’ being anxious

If having a bias towards seeing threats wasn’t enough, the brains of people with social anxiety also show a difference in how that high road path from the prefrontal cortex to the amygdala operates. You’ll remember that in the average brain on social anxiety, the amygdala reacts first but then the prefrontal cortex kicks in a few seconds later to restore calm if there’s no rational reason to become anxious. Many of us are probably familiar with this experience–we get nervous the moment we stand up to speak, but then that voice of reassurance in our head kicks in and says, “there’s nothing to worry about,” so we calm down. But a 2015 study found that for people with clinical social anxiety, this calm may never come due to a change in this regulatory circuit. Normally, the prefrontal cortex “downregulates” the amygdala, sending it a signal to stop. But the study found that the brains of people with social anxiety often do the opposite. Their prefrontal cortex sends a signal to “upregulate” their amygdala–effectively telling it to increase activity (and your anxiety). So, if you’ve ever wondered why it seems like the longer you stay in a situation, the worse your anxiety becomes, it might be because your brain is sending signals to amplify your anxiety instead of reduce it.

Why a socially anxious brain ≄ a life of social anxiety

These studies suggest that if you have clinical social anxiety, it may be due to differences in your brain that cause you to perceive the world as more threatening. If you believe (as many people do) that any behavior rooted in the brain is permanent, then it’s easy to look at this research and feel discouraged. It would imply that you’re doomed to a life of overreacting to social situations. Fortunately, we know this isn’t true because the brain can be rewired.

The brain is remarkably plastic, which means it can be changed and shaped by learning and experience. Even in old age, your brain is still forming new connections and writing over old ones. Research shows that Cognitive Behavioral Therapy (CBT), the leading treatment for social anxiety, actually changes the brain and rewires connections that contribute to anxiety. A 2016 study showed that socially anxious participants’ amygdalae shrunk and decreased in activity after only nine weeks of treatment with CBT. The researchers also found a correlation between the amount a participant’s amygdala shrunk and the amount their anticipatory anxiety about giving a speech had dropped.

Another way CBT rewires the brain is it creates new, faster and stronger connections between parts of the brain that are key to an emotional regulation process called cognitive reappraisal. Cognitive reappraisal is when you actively change your emotional reaction to a situation by reinterpreting its meaning. For example, if you’re out to dinner with a friend and she isn’t being very talkative, you might automatically interpret this as her thinking you’re boring, leading you to feel anxious. But if you pause to consider that your friend might be quiet because she’s tired from a long day at work, you’d likely feel less bad about yourself. A 2013 study found that people with social anxiety have a harder time doing this kind of reframing than most people due to delayed connectivity between the prefrontal cortex and the amygdala. However, after treatment with CBT, the socially anxious participants not only showed increased connections between these regions, they also showed faster and stronger activation between them. Through training and practice, the participants had actually rewired their own brains to create the connections needed for reappraisal. By the time they finished CBT, participants were “spontaneously” reappraising events on their own.

So the good news is, if you have social anxiety, change is possible. Cognitive Behavioral Therapy helps you retrain and rewire your brain so you can feel more in control in situations that make you anxious. If social anxiety is keeping you from living the life you want, you might want to try CBT through a therapist, a counselor, or an online program like Joyable.

Sources

  1. LeDoux, J. (2012, January 22). Searching the Brain for the Roots of Fear. The New York Times. Retrieved May 9, 2016, from http://opinionator.blogs.nytimes.com/2012/01/22/anatomy-of-fear/
  2. LeDoux, J. (1996). The Emotional Brain: The Mysterious Underpinnings of Emotional Life. New York: Simon & Schuster.
  3. Steimer, T. (2002, September). The biology of fear- and anxiety-related behaviors. Dialogues in Clinical Neuroscience, 4(3), 231–249.
  4. Sladky, R., Höflich, A., Küblböck, M., Kraus, C., Baldinger, P., Moser, E., Lanzenberger, R., & Windischberger, C. (2013, October 9). Disrupted Effective Connectivity Between the Amygdala and Orbitofrontal Cortex in Social Anxiety Disorder During Emotion Discrimination Revealed by Dynamic Causal Modeling for fMRI. Cerebral Cortex, 25 (4), 895-903. doi:10.1093/cercor/bht279
  5. Phan, K. L., Fitzgerald, D.A., Nathan, P.J., & Tancer, M.E. (2005, June 8). Association between Amygdala Hyperactivity to Harsh Faces and Severity of Social Anxiety in Generalized Social Phobia. Biological Psychiatry, 59 (5), 424–429. doi: http://dx.doi.org/10.1016/j.biopsych.2005.08.012
  6. Goldin P.R., Ziv M., Jazaieri H., Hahn K., Heimberg R., Gross J.J. (2013, October). Impact of Cognitive Behavioral Therapy for Social Anxiety Disorder on the Neural Dynamics of Cognitive Reappraisal of Negative Self-beliefs: Randomized Clinical Trial. JAMA Psychiatry. 2013;70(10):1048-1056. doi:10.1001/jamapsychiatry.2013.234.
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