The Effect of Hormones on Your Social Anxiety

Hormones can influence social anxiety
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Hormones act on the brain in a variety of ways. When hormone levels are too high or too low, it can influence neurotransmitters, resulting in problems such as increased anxiety.

People who live with social anxiety disorder (SAD) may find that levels of certain hormones relate to feelings of increased or decreased social anxiety.

Hormones That May Increase Social Anxiety

1. Stress hormones (adrenaline, cortisol)

Stress hormones, or those that are released during times of stress (think, the fight-or-flight response) such as adrenaline and cortisol, can have a negative effect on your social anxiety.

When you experience a stressful social or performance situation, your body responds by releasing hormones like adrenaline and cortisol to help you cope with the threat and prepare you for action. However, in the face of no actual physical threat, excess levels of these hormones leave you feeling anxious, to the point that you may even experience a panic attack or the feeling of needing to escape.

This becomes a vicious cycle, in that the hormones cause anxiety, and the anxiety and stress cause the hormones to be released.

2. Sex hormones (testosterone, estrogen)

Changing levels of the sex hormones estrogen and testosterone can also have an effect on your social anxiety. Too little testosterone has been associated with increased anxiety, and there is a relationship to changes in female sex hormones, such as estrogen, and anxiety symptoms.

This is why anxiety often peaks during times of hormonal change such as during puberty, at certain times of the menstrual cycle in women, and during menopause in women.

Stress and sex hormones also interact in their effect on anxiety. For example, when you experience stress, cortisol surges, which inhibits your body's ability to make testosterone.

The combined effect of increased cortisol and lowered testosterone results in increased anxiety. More so, testosterone modulates the release of cortisol, so when testosterone is depleted, cortisol is more likely to surge. You can see why anxiety is a cycle that feeds itself—and that breaking this cycle is key to overcoming your symptoms.

3. Thyroid hormones

An overactive thyroid can also create anxiety in the form of physical symptoms such as increased heart rate, palpitations, shakiness, and increased sweating, among others. If you suffer with a thyroid condition, this may make your social anxiety worse.

Hormones That May Help to Reduce Social Anxiety

1. Testosterone

Just as too little testosterone may increase social anxiety, increased testosterone may help to reduce it. Administration of testosterone, a steroid hormone, has been shown to reduce socially fearful, avoidant, and submissive behavior. Indeed, in general, men have half the reported rate of anxiety disorders as women; this may be partially due to the role of testosterone in moderating levels of anxiety.

Testosterone boosts the action of gamma amino butyric acid (GABA) and serotonin. These two brain chemicals are related to social anxiety disorder.

Testosterone also reduces activity of the amygdala, which is the brain structure related to fear and that initiates the fight or flight reaction. Increased testosterone means an amygdala that responds more like a person without an anxiety disorder.

2. Estrogen

Estrogen is known to calm the fear response in women. Research has shown that women trained on a fear-extinction task do better when the level of estrogen in their blood is higher. As a female, you may have also noticed that your ability to feel calm and relaxed (versus anxious and afraid) is better at certain points during the menstrual cycle.

3. Oxytocin

Oxytocin is a peptide hormone, which acts as both a hormone and a brain neurotransmitter. It is known as the "love" hormone that is release during contact with a loved one. Oxytocin is made in the hypothalamus and transported and secreted by the pituitary gland at the base of the brain. Its release also facilitates childbirth and breastfeeding.

Oxytocin is known to have an anti-anxiety effect and may help to relieve social anxiety. Research shows that oxytocin promotes relaxation, trust and stability, all of which make it easier to manage social situations. Research is ongoing on the role of oxytocin and how it could be used in the treatment of social impairments (including those living with autism).

4. Vasopressin

Vasopressin is a hormone that regulates the body's fluid balance. In addition, it is involved in the regulation of anxiety, stress coping, and social behavior. Vasopressin is released within the hypothalamus and limbic areas of the brain. Some researchers speculate that a balance must be struck between oxytocin and vasopressin for optimal social functioning. Vasopressin is particularly related to social behavior, sexual motivation, pair bonding, and maternal responses to stress.

Steps to Managing Hormones and Relieving Social Anxiety

Although hormonal changes may be related to social anxiety, treatment with hormonal therapy is not currently a common recommendation. Instead, typical treatments for SAD as well as understanding the role of hormones in your anxiety will be most helpful.

What is not helpful is self-medicating—try to avoid temporary "fixes" like sugar, alcohol, smoking cigarettes, or other substances that give you a quick feel-good surge but don't solve the long-term anxiety problem.

1. Increase your levels of testosterone and oxytocin naturally. Increase testosterone by doing the following:

Increase oxytocin by doing the following:

  • cuddling with a loved one
  • listening carefully when others speak
  • being generous toward others (giving gifts)
  • trying "metta" meditation, which involves meditation designed to inspire love and kindness toward others
  • going on social media
  • petting a dog or cat

2. Use cognitive-behavioral therapy (CBT) techniques to learn new patterns of responding to anxiety. Over time, neural pathways in your brain will change, which will help to reduce your anxious response to stressful situations.

3. If you have a thyroid condition that may be affecting your anxiety level, ask your doctor whether the two could be related and how treating your thyroid condition may help.

4. If you are female, learn how variations in hormones over your life and during the course of a month may influence anxious feelings. Just knowing how hormones may be affecting you may help you to stop and think: "This situation is not causing my anxiety; my body is reacting to change in hormones," which may allow you to take a step back and accept your feelings for what they are.

5. Strike a power pose. Research shows that adopting a strong pose (such as the "Wonder Woman" pose, with feet hip width apart and hands on hips) for a few minutes may lead to increased testosterone and feelings of confidence, which in turn will help to lower social anxiety.

6. Take natural supplements that may help to lower stress levels (and cortisol) such as ashwagandha. Note however that these type of supplements are not regulated by the Food and Drug Administration (FDA) and have not been tested by this regulatory body for safety and efficacy.

Is Hormone Therapy for Social Anxiety Possible?

While it may sound fanciful that one day we might treat anxiety disorders with hormone therapy, the truth is that research on this topic is already happening. In one study, it was shown that women exposed to trauma who were administered female sex hormones (in the form of the morning-after pill, after a sexual assault) were less likely to develop post-traumatic stress disorder (PTSD) after the event.

It isn't that much of a stretch to imagine that this new understanding of the role of hormones in anxiety and fear could lead to treatments that relate to hormones.

At present, however, beyond treating an underlying thyroid condition, or hormone replacement therapy (HRT) for problems related to menopause in women, your doctor is not likely to prescribe hormone treatment that will help to improve social anxiety.

A Word From Verywell

The best approach to managing social anxiety in light of the influence of your hormones is to understand natural fluctuations and learn ways to boost hormones that help to reduce anxiety. If severe social anxiety is a problem for you and you have not sought a diagnosis or treatment, it's best to visit your family doctor for a referral to a mental health specialist.

Effective treatments such as medication and CBT can be helpful in managing SAD that has gotten out of control. Remember—your anxiety does not define you and is not who you are. You can move past it with the right help. While hormones may be involved, you are not destined to live with social anxiety for the rest of your life.

Sources:

Harvard Gazette. Estrogen and Female Anxiety. 2012.

Pfaff DW, Kordon C, Chanson P, Christen Y (Eds). Hormones and Social Behavior. London: Springer; 2008.

Sobota R, Mihara T, Forrest A, Featherstone RE, Siegel SJ. Oxytocin reduces amygdala activity, increases social interactions, and reduces anxiety-like behavior irrespective of NMDAR antagonism. Behav Neurosci. 2015;129(4):389-398. doi:10.1037/bne0000074.

Van Honk J, Bos PA, Terburg D, Heany S, Stein DJ. Neuroendocrine models of social anxiety disorder. Dialogues Clin Neurosci. 2015;17(3):287-293.

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