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Social Anxiety Diminished By Brain Signals and Re-Thinking
For people with social anxiety, even everyday encounters with others can cause an agonizing degree of apprehension. This problem, affecting three to 13% U.S. adults, may be related to abnormal signals from part of the brain’s front end – the developmentally advanced prefrontal cortex.
These signals normally turn down activity in the primitive amygdala below the brain’s surface, a site for threatening memories. But when social anxiety is serious enough to be termed a disorder, they turn it up instead – as if turning up the volume of an audio speaker – according to analysis of brain activity with functional magnetic resonance imagery (fMRI) reported by psychologist Ronald Sladky and others in the journal Cerebral Cortex, April 2015.
Ramping up this volume could turn an ordinary meeting or party into an ordeal. The anxiety can be accompanied by a fight-or-flight reaction when the sympathetic nervous system produces physical or somatic responses such as increased heart rate, blood pressure, and pupil size.
Other studies show a trend of emerging research based on advances in therapy and in brain scans. Cognitive behavioral therapy (CBT), which includes re-thinking immediate impressions, such as realizing that a coworker’s angry expression was due to a sprained back muscle or their own stress, was described as an effective treatment for social anxiety disorder, according to Philip Goldin and his colleagues in JAMA Psychiatry in 2013. Their study showed that before treatment, prefrontal cortex responses in social anxiety disorder were smaller and more delayed compared to normal responses, but may become normalized afterward.
Another viewpoint is from Katherine Narr, PhD, from the state-of-the-art UCLA Ahmanson-Lovelace Brain Imaging Center, a principal investigator who uses advanced brain imaging to study psychological disorders and their treatment.
“In addition to downstream connections that elicit the fight or flight response,” she said, “the amygdala is in a key location which has strong connections…to the hypothalamus which has connections to the endocrine system…The point being that when you’re feeling anxious you have these somatic experiences that you know aren’t normal but you can’t tell your frontal lobe to control them.” However, she added, “When you do CBT you are teaching people to control things that are usually an autonomic response.”
The suggestion is that your emotional life requires an understanding of brain mechanisms. People can brake a car without being able to diagram the braking system – and braking has some similarities to modulating emotional reactions.
These studies provide exciting glimpses of brain activity that may underlie successful treatment of social anxiety and related disorders. Find a therapist trained in CBT if you need help with your anxiety.
