Did you know that that hormones and anxiety are related in certain ways, such that your hormones may have a relation to how anxious you feel? When hormone levels are too high or too low, this 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 related to feelings of increased or decreased social anxiety.
Hormones That May Increase Social Anxiety
There are three categories of hormones that may influence your social anxiety: stress hormones, sex hormones, and thyroid hormones. Learning more about how these hormones affect your body and mind is the first step to managing the impact of hormones on your anxiety levels.
Stress Hormones (Adrenaline, Cortisol)
Stress hormones are released in situations where you feel out of control, overwhelmed, or severe anxiety (such as during the fight-or-flight response), which can increase 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 experience a panic attack or the feeling of needing to escape. This becomes a vicious cycle: your hormones cause anxiety, the anxiety causes more hormones to be released, and so on.
Sex Hormones (Testosterone, Estrogen)
Sex hormones may also play a role in how much anxiety you experience. Changing levels of the sex hormones estrogen and testosterone can affect your social anxiety. Too little testosterone has been linked with increased anxiety, while female sex hormones such as estrogen may also be linked to 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 can also have a combined effect on anxiety. For example, when you experience stress, cortisol increases, which slows your body’s ability to make testosterone. The combined effect of increased cortisol and lowered testosterone means you feel more anxious.
If that isn’t bad enough, testosterone has partial control of the release of cortisol, so when testosterone is lowered, cortisol is more likely to increase. You can see why anxiety is a cycle that feeds itself—and that breaking this cycle is key to overcoming your symptoms.
Finally, there is a third type of hormone that may influence your anxiety: thyroid hormones. An overactive thyroid can create anxiety in the form of physical symptoms such as increased heart rate, palpitations, shakiness, and increased sweating. If you live with a thyroid condition, this may make your social anxiety worse.
Hormones That May Reduce Social Anxiety
If you think hormones are all bad—think again! There are actually some ways in which certain levels of hormones can help to reduce your anxiety.
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 levels of anxiety.
Testosterone boosts the action of gamma aminobutyric acid (GABA) and serotonin. These two brain chemicals are related to social anxiety disorder. Testosterone also reduces the activity of the amygdala, which is the brain structure related to fear and that initiates the fight-or-flight reaction. Increased testosterone means you are working with an amygdala that responds more like a person without an anxiety disorder.
Estrogen is known to calm the fear response in women. Specifically, 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 your menstrual cycle.
You’ve probably heard of the “love” or “bonding” hormone, oxytocin. This is a peptide hormone, which acts as both a hormone and a brain neurotransmitter. It is known as the love hormone because it is released 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 helps with childbirth and breastfeeding.
In terms of its relation to mental health, 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. In fact, studies are ongoing on the role of oxytocin and how it could be used in the treatment of social impairments (including the social implications of autism).
Finally, 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 think 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, your best option is some form of traditional treatment for SAD (e.g., medication or therapy) as well as understanding and adapting to the role of hormones in your anxiety.
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.
Below are six tips to get you started:
1. You can increase your levels of testosterone and oxytocin naturally! These are things that are easy to do, but that you have to make a commitment to following through with.
Increase testosterone by doing the following:
Getting regular exercise
Eating a balanced diet
Minimizing stress (and therefore testosterone-depleting cortisol)
Taking a multivitamin
Get enough sleep each night
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 responses 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. 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.
This fascinating and ground-breaking research is likely to lead to advances in the area of hormone treatment of anxiety. 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.
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. However, if severe social anxiety is a problem for you and you have not sought 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.
Credit: Very Well Mind