What Is Social Anxiety?

Social anxiety, also known as social anxiety disorder (SAD), is a condition where people experience severe and often irrational fear and nervousness in social situations.((Stein, Dan J. 2015. “Social Anxiety Disorder and the Psychobiology of Self-Consciousness.” Frontiers in Human Neuroscience 9 (September). https://doi.org/10.3389/fnhum.2015.00489)) The two primary types of social anxiety are:

• Generalized social anxiety disorder, where people are fearful of most social situations
• Non-generalized social anxiety disorder, where people are nervous about performing specific activities, like giving a speech, dancing in public, etc.

Depending on the type and severity, a person might experience severe fear of interacting with others and avoid certain social situations.((Rose, G. M., and P. Tadi. 2022. Social Anxiety Disorder. Treasure Island, FL: StatPearls Publishing)) Many people with social anxiety struggle to make new friends, have trouble communicating with people, and experience fears when attending social events.

Social anxiety is different from shyness. The latter is often temporary and has no real impact on one’s life. In contrast, social anxiety is a persistent and recurring problem that can impact your relationships, professional life, and health.

What’s perhaps even sadder about social anxiety is that most people realize how irrational their fears are.((Zimmerman, Mark, Kristy Dalrymple, Iwona Chelminski, Diane Young, and Janine N. Galione. 2010. “Recognition of Irrationality of Fear and the Diagnosis of Social Anxiety Disorder and Specific Phobia in Adults: Implications for Criteria Revision in DSM-5.” Depression and Anxiety 27 (11): 1044–49. https://doi.org/10.1002/da.20716)) But, despite the knowledge, they feel powerless to maintain composure when surrounded by other people.

Some notable symptoms of social anxiety include:

• Nervousness
• Worry
• Fear
• Blushing
• Sweating
• Difficulty speaking
• Rapid heart rate

The Neurochemistry Behind Social Anxiety

Despite seeming like a slightly more serious case of shyness, social anxiety disorder is an actual condition. An ever-growing body of research suggests several notable brain activity differences in people with social anxiety disorder.
In one paper from 2015, researchers noted that people with high public self-consciousness (awareness of how one appears and is perceived in public) were more likely to experience social anxiety.((Stein, Dan J. 2015. “Social Anxiety Disorder and the Psychobiology of Self-Consciousness.” Frontiers in Human Neuroscience 9 (September). https://doi.org/10.3389/fnhum.2015.00489)) The idea makes sense because anxiety needs an origin, and feeling inadequate is the perfect recipe for feeling extreme unease around others.

A brain imaging study from over a decade ago finds an increased activity in the amygdala and insula in people with SAD. ((Stein, Murray B, and Dan J Stein. 2008. “Social Anxiety Disorder.” The Lancet 371 (9618): 1115–25. https://doi.org/10.1016/s0140-6736(08)60488-2)) The insula is more involved in basic survival, whereas the amygdala is the center for emotions and emotional behavior.((Shin, Lisa M, and Israel Liberzon. 2009. “The Neurocircuitry of Fear, Stress, and Anxiety Disorders.” Neuropsychopharmacology 35 (1): 169–91. https://doi.org/10.1038/npp.2009.83)) Data from animal research suggests that the amygdala plays an important role in fear conditioning––a process where living beings are taught to predict adverse consequences following particular events.((Davis, M. 1990. “Pharmacological and Anatomical Analysis of Fear Conditioning.” NIDA Research Monograph 97: 126–62))

While fear conditioning differs from social anxiety, the two share some commonalities, which is also discussed in a review from 2009. ((Shin, Lisa M, and Israel Liberzon. 2009. “The Neurocircuitry of Fear, Stress, and Anxiety Disorders.” Neuropsychopharmacology 35 (1): 169–91. https://doi.org/10.1038/npp.2009.83)) Just as a rodent learns to associate a specific environment with an electric shock, leading to fear, a person can experience fear or nervousness when they are in public.

Another study also finds that the amygdala plays a role in social anxiety. Researchers suggest that people with generalized social anxiety disorder experience more exaggerated limbic system responses.((Phan, K. Luan, Daniel A. Fitzgerald, Bernadette M. Cortese, Navid Seraji-Bozorgzad, Manuel E. Tancer, and Gregory J. Moore. 2005. “Anterior Cingulate Neurochemistry in Social Anxiety Disorder: 1H-MRS at 4 Tesla.” NeuroReport 16 (2): 183–86. https://doi.org/10.1097/00001756-200502080-00024)) The amygdala, along with the thalamus, hypothalamus, and other parts of the brain, makes up the limbic system. In the study, the authors suggest that the glutamatergic system serves as a mediator. One of their findings is that glutamate (the most abundant excitatory neurotransmitter) levels were high in the anterior cingulate cortex. Researchers also found a connection between anterior cingulate glutamate levels and social anxiety intensity, concluding:
“These findings provide new evidence of glutamate’s involvement in the neural mechanism underlying social phobia.”

In one review we shared above, the authors examined the existing data and laid out the potential causes of social anxiety and how it relates to fear.((Shin, Lisa M, and Israel Liberzon. 2009. “The Neurocircuitry of Fear, Stress, and Anxiety Disorders.” Neuropsychopharmacology 35 (1): 169–91. https://doi.org/10.1038/npp.2009.83)) The authors looked at data from three broad categories:

• Fear circuits in animals
• Brain responses to emotional stimuli in humans
• Neuroimaging studies of anxiety disorders

Some of their more interesting findings are:

1. Fear is a crucial component in anxiety disorders
2. Key components in fear circuitry include the amygdala, hippocampus, and several other brain regions
3. Each region of the brain plays unique roles in cognition and fear
4. A lack of a clear source often characterizes human anxiety disorders
5. The amygdala is crucial in fear conditioning
6. There is an overlap between fear/anxiety neurocircuitry and the mechanisms behind the stress response
7. Cortisol, the primary stress hormone, is likely highly relevant in the neurocircuitry of fear and anxiety
8. Stress can have a short-term impact on anxiety (e.g., a stressful situation leads to the production of stress-related hormones, causing anxiety) and a long-term effect (e.g., exposure to specific stressors during childhood can impact anxiety later in life)

How Nootropics Can Help Treat Social Anxiety

Nootropics are a class of drugs, supplements, and substances with favorable effects on the brain.((Suliman, Noor Azuin, Che Norma Mat Taib, Mohamad Aris Mohd Moklas, Mohd Ilham Adenan, Mohamad Taufik Hidayat Baharuldin, and Rusliza Basir. 2016. “Establishing Natural Nootropics: Recent Molecular Enhancement Influenced by Natural Nootropic.” Evidence-Based Complementary and Alternative Medicine 2016: 1–12. https://doi.org/10.1155/2016/4391375)) These compounds can lead to better cognition, focus, attention, memory, motivation, and more.

Interestingly, nootropics can also have favorable effects on social anxiety. One notable reason for these effects is that many nootropics can relieve stress by inducing relaxation without causing drowsiness. L-theanine is one such compound. ((Dietary Interventions in Liver Disease. 2019. “Theanine – An Overview.” ScienceDirect. https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/theanine#:~:text=Theanine%2C%20also%20known%20as%20L,GABA%2C%20serotonin%2C%20and%20dopamine)) ((Hidese, Ogawa, Ota, Ishida, Yasukawa, Ozeki, and Kunugi. 2019. “Effects of L-Theanine Administration on Stress-Related Symptoms and Cognitive Functions in Healthy Adults: A Randomized Controlled Trial.” Nutrients 11 (10): 2362. https://doi.org/10.3390/nu11102362)) The amino acid promotes alpha wave production in the brain, leading to practical benefits like.((Nobre, Anna C., Anling Rao, and Gail N. Owen. 2008. “L-Theanine, a Natural Constituent in Tea, and Its Effect on Mental State.” Asia Pacific Journal of Clinical Nutrition 17 (Suppl 1): 167–68))((Mason, Russ. 2001. “200 Mg of Zen: L-Theanine Boosts Alpha Waves, Promotes Alert Relaxation.” Alternative and Complementary Therapies 7 (2): 91–95. https://doi.org/10.1089/10762800151125092))

• Better concentration
• More creativity
• Relaxation and ease

L-theanine can promote these effects by decreasing neurotransmitters that cause excitement and increasing brain chemicals that promote calmness. As a result, groups of neurons in the brain release more alpha waves––a middle frequency linked to ease and an improved ability to tackle stressors.((Handbook of Computational Intelligence in Biomedical Engineering and Healthcare. 2021. “Brain Waves – An Overview.” ScienceDirect. https://www.sciencedirect.com/topics/engineering/brainwave))

Specific Nootropics With Favorable Effects on Social Anxiety

Ashwagandha

Ashwagandha has been a big part of Ayurvedic medicine for centuries and has primarily been used to promote energy levels and protect us from stress. Despite its somewhat limited functions inside the body, ashwagandha can be effective for reducing social anxiety.

A systematic review examined ashwagandha’s impact on stress and anxiety.((Pratte, Morgan A., Kaushal B. Nanavati, Virginia Young, and Christopher P. Morley. 2014. “An Alternative Treatment for Anxiety: A Systematic Review of Human Trial Results Reported for the Ayurvedic Herb Ashwagandha (Withania somnifera).” The Journal of Alternative and Complementary Medicine 20 (12): 901–8. https://doi.org/10.1089/acm.2014.0177)) In the paper, researchers had five human trials that met the inclusion criteria. Each study found notable benefits of ashwagandha supplementation for stress and anxiety.

Another review suggests that ashwagandha can relieve stress and anxiety by modulating the hypothalamic-pituitary-adrenal (HPA) and sympathetic-adrenal-medullary (SAM) axes.((Speers, Alex B., Kadine A. Cabey, Amala Soumyanath, and Kirsten M. Wright. 2021. “Effects of Withania somnifera (Ashwagandha) on Stress and the Stress-Related Neuropsychiatric Disorders Anxiety, Depression, and Insomnia.” Current Neuropharmacology 19 (9): 1468–95. https://doi.org/10.2174/1570159×19666210712151556)) HPA and SAM are crucial systems related to the body’s stress response.((Chu, B., K. Marwaha, T. Sanvictores, and D. Ayers. 2022. Physiology, Stress Reaction. Treasure Island, FL: StatPearls Publishing)) For example, the HPA refers to the interaction between the hypothalamus, pituitary gland, and adrenal glands.((Smith, Sean M, and Wylie W Vale. 2006. “The Role of the Hypothalamic-Pituitary-Adrenal Axis in Neuroendocrine Responses to Stress.” Dialogues in Clinical Neuroscience 8 (4): 383–95. https://doi.org/10.31887/dcns.2006.8.4/ssmith)) A threat causes the adrenal glands to release stress-related hormones, leading to rapid heartbeat, sweating, and fast breathing, all symptoms typical of social anxiety.

While we need more research on the matter, early data suggests that ashwagandha can modulate stress-response, leading to lower anxiety scores.

Aniracetam

Aniracetam is a nootropic commonly used to improve memory and attention problems relative to degenerative brain disorders. Despite its somewhat mixed reputation, the nootropic has scientific backing.

In one rodent study, aniracetam was shown to alleviate anxiety and treat neurodegenerative disorders.((Elston, Thomas W., Ashvini Pandian, Gregory D. Smith, Andrew J. Holley, Nanjing Gao, and Joaquin N. Lugo. 2014. “Aniracetam Does Not Alter Cognitive and Affective Behavior in Adult C57BL/6J Mice.” Edited by Philip Allen. PLoS One 9 (8): e104443. https://doi.org/10.1371/journal.pone.0104443)) Researchers noted that the nootropic works by promoting glutamatergic neurotransmission, which can explain the anxiety-relieving effects. As we saw in a study above, the glutamatergic system mediates anxiety responses.((Phan, K. Luan, Daniel A. Fitzgerald, Bernadette M. Cortese, Navid Seraji-Bozorgzad, Manuel E. Tancer, and Gregory J. Moore. 2005. “Anterior Cingulate Neurochemistry in Social Anxiety Disorder: 1H-MRS at 4 Tesla.” NeuroReport 16 (2): 183–86. https://doi.org/10.1097/00001756-200502080-00024))

Another rodent study found aniracetam to have favorable effects on anxiety.((Nakamura, Kazuo, and Mitsue Kurasawa. 2001. “Anxiolytic Effects of Aniracetam in Three Different Mouse Models of Anxiety and the Underlying Mechanism.” European Journal of Pharmacology 420 (1): 33–43. https://doi.org/10.1016/s0014-2999(01)01005-6)) The anxiety-lowering effects were mimicked by various metabolites and groups, suggesting that the nootropic has a wide range of anxiety-alleviating functions. Researchers concluded:

“Thus, our findings suggest the potential usefulness of aniracetam against various types of anxiety-related disorders and social failure/impairments.”

Tianeptine

Tianeptine is a nootropic commonly sold under the names Stablon and Coaxil. The drug is classified as an antidepressant and is widely used to treat major depressive disorder. Interestingly, it can also work well to alleviate social anxiety.

Despite being unique conditions, anxiety and depression are connected on many levels and often go hand in hand. For instance, people suffering from depression are more likely to experience anxiety in various situations.

In one study, 314 patients with major depression and anxiety were treated with 37.5 mg of tianeptine, split into three equal daily doses for six weeks.((Sonawalla, Shamsah, Nabonita Chakraborty, and Rajesh Parikh. 2003. “Treatment of Major Depression and Anxiety with the Selective Serotonin Re-Uptake Enhancer Tianeptine in the Outpatient Psychiatric Care Setting of India.” Journal of the Indian Medical Association 101 (2): 116–17, 124)) Some patients dropped out due to side effects, but the majority remained until the end. Researchers noted marked improvements in the Montgomery Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating Scale (HARS) for most subjects after six weeks of treatment.

An overview of clinical trials also shows tianeptine to be beneficial in treating depression and anxiety, particularly among elderly individuals.((Defrance, R., C. Marey, and A. Kamoun. 1988. “Antidepressant and Anxiolytic Activities of Tianeptine: An Overview of Clinical Trials.” Clinical Neuropharmacology 11 (Suppl 2): S74–82)) According to some research, the nootropic modulates the glutamatergic system––effects similar to those seen from aniracetam.((Elston, Thomas W., Ashvini Pandian, Gregory D. Smith, Andrew J. Holley, Nanjing Gao, and Joaquin N. Lugo. 2014. “Aniracetam Does Not Alter Cognitive and Affective Behavior in Adult C57BL/6J Mice.” Edited by Philip Allen. PLoS One 9 (8): e104443. https://doi.org/10.1371/journal.pone.0104443))((McEwen, B. S., S. Chattarji, D. M. Diamond, T. M. Jay, L. P. Reagan, P. Svenningsson, and E. Fuchs. 2009. “The Neurobiological Properties of Tianeptine (Stablon): From Monoamine Hypothesis to Glutamatergic Modulation.” Molecular Psychiatry 15 (3): 237–49. https://doi.org/10.1038/mp.2009.80))

Bacopa Monnieri

Bacopa Monnieri is a nootropic that’s also classified as an adaptogen. Aside from showing promise with its brain-boosting activities, the herb can also strengthen the body’s ability to handle stress.

The herb has been part of Ayurvedic medicine thanks to its favorable memory-enhancing, anti-inflammatory, and antiepileptic effects.((Russo, A., and F. Borrelli. 2005. “Bacopa monniera, a Reputed Nootropic Plant: An Overview.” Phytomedicine 12 (4): 305–17. https://doi.org/10.1016/j.phymed.2003.12.008)) Research also suggests that bacopa monnieri can alleviate anxiety, possibly thanks to its benefits related to stress management.

For example, one rodent study found that the herb had comparable anxiety-lowering effects to benzodiazepine––a medication used to treat anxiety.((Bhattacharya, S. K., and S. Ghosal. 1998. “Anxiolytic Activity of a Standardized Extract of Bacopa Monniera: An Experimental Study.” Phytomedicine 5 (2): 77–82. https://doi.org/10.1016/s0944-7113(98)80001-9)) Human research also finds bacopa monnieri beneficial for anxiety and cognitive function.((Stough, C., P. Nathan, J. Lloyd, J. Clarke, C. Hutchison, L. Downey, and T. Rodgers. 2001. “The Chronic Effects of an Extract of Bacopa monniera (Brahmi) on Cognitive Function in Healthy Human Subjects.” Psychopharmacology 156 (4): 481–84. https://doi.org/10.1007/s002130100815))

Researchers are yet to unravel the ​​neurochemistry effects of the herb. One possible explanation is that it overrides the stress response, which studies link to anxiety.((Shin, Lisa M, and Israel Liberzon. 2009. “The Neurocircuitry of Fear, Stress, and Anxiety Disorders.” Neuropsychopharmacology 35 (1): 169–91. https://doi.org/10.1038/npp.2009.83)) In one study, researchers noted that the herb could lower cortisol levels––the key stress hormone.((Benson, Sarah, Luke A. Downey, Con Stough, Mark Wetherell, Andrea Zangara, and Andrew Scholey. 2013. “An Acute, Double-Blind, Placebo-Controlled Cross-over Study of 320 Mg and 640 Mg Doses of Bacopa monnieri (CDRI 08) on Multitasking Stress Reactivity and Mood.” Phytotherapy Research 28 (4): 551–59. https://doi.org/10.1002/ptr.5029))

Picamilon

Picamilon is a nootropic agent that appears to target the brain and reduce feelings of anxiety. The nootropic consists of GABA (an inhibitory neurotransmitter) and niacin (vitamin B3).

One of picamilon’s functions is stimulating GABA receptors that communicate with gamma-aminobutyric acid (GABA).((Akopian, V. P., L. S. Balian, and N. A. Avetisian. 2006. “The effect of hypokinesia on depression and on the central GABA-A receptor complexes in the rat brain.” Eksperimental’naia I Klinicheskaia Farmakologiia 69 (2): 10–13)) GABA is a vital neurotransmitter for anxiety management because it blocks specific signals within the brain and nervous system, promoting relaxation.((Allen, M. J., S. Sabir, S. Sharma. GABA Receptor. Treasure Island, FL: StatPearls Publishing; 2022))

As we saw from previous research, these inhibitory mechanisms can counter the common symptoms of social anxiety: nervousness, overthinking, fear, etc.((Stein, Dan J. 2015. “Social Anxiety Disorder and the Psychobiology of Self-Consciousness.” Frontiers in Human Neuroscience 9 (September). https://doi.org/10.3389/fnhum.2015.00489))((Rose, G. M., and P. Tadi. 2022. Social Anxiety Disorder. Treasure Island, FL: StatPearls Publishing))

L-Theanine

L-theanine is a unique amino acid with calming effects on the brain. Primarily found in green tea, the amino acid stimulates alpha wave production in the brain.((Nobre, Anna C., Anling Rao, and Gail N. Owen. 2008. “L-Theanine, a Natural Constituent in Tea, and Its Effect on Mental State.” Asia Pacific Journal of Clinical Nutrition 17 (Suppl 1): 167–68))((Mason, Russ. 2001. “200 Mg of Zen: L-Theanine Boosts Alpha Waves, Promotes Alert Relaxation.” Alternative and Complementary Therapies 7 (2): 91–95. https://doi.org/10.1089/10762800151125092))

As discussed above, the amino acid has been shown to promote relaxation by decreasing excitatory neurotransmitter actions while raising levels of compounds that promote a mindful state. The practical benefit is that alpha wave production increases, leading to calmness and an improved ability to tackle stress.((Handbook of Computational Intelligence in Biomedical Engineering and Healthcare. 2021. “Brain Waves – An Overview.” ScienceDirect. https://www.sciencedirect.com/topics/engineering/brainwave))

As we saw in previous research, stress is linked to anxiety, so learning to manage it can help us deal with fear, nervousness, and other symptoms.((Shin, Lisa M, and Israel Liberzon. 2009. “The Neurocircuitry of Fear, Stress, and Anxiety Disorders.” Neuropsychopharmacology 35 (1): 169–91. https://doi.org/10.1038/npp.2009.83))

Data shows that as little as four weeks of l-theanine administration decreases stress-related symptoms like depression and anxiety while promoting cognitive abilities.((Hidese, Ogawa, Ota, Ishida, Yasukawa, Ozeki, and Kunugi. 2019. “Effects of L-Theanine Administration on Stress-Related Symptoms and Cognitive Functions in Healthy Adults: A Randomized Controlled Trial.” Nutrients 11 (10): 2362. https://doi.org/10.3390/nu11102362))

Conclusion

While doctors often prescribe antidepressants to help patients deal with disorders like social anxiety, nootropics could prove to be a much better and safer alternative.

We still need more research on these compounds, but numerous papers show promise for many of the popular compounds available on the market.