What Causes Social Anxiety And What Can Help Sufferers

According to the UK’s National Institute for Health and Care Excellence (NICE), around 12 per cent of people will experience social anxiety disorder at some point in their lives, making it the most prevalent form of anxiety.

If you’re not familiar with the condition, the NHS describes it as: “a long-term and overwhelming fear of social situations.” They add that it usually starts during teenage years and can be very distressing and impact your day-to-day life.

Now, researchers have revealed that the condition which was always thought to be something purely in our minds, it may actually be related to our gut health and changes in our brains, too.

While introversion and social anxiety may sometimes crossover, there is a key difference and it’s perfectly explained by NICE guidelines. NICE says: “Social anxiety disorder (also known as ‘social phobia’) is an overwhelming fear of social
situations…

“Although everyone worries from time to time about coping with a social situation, for people with social anxiety disorder the worry or fear can last a long time and severely affect their lives. They are afraid of doing or saying something that will result in embarrassment, humiliation or rejection by others.”

When it comes to introversion, Psychology Today explains: “Introverts do not fear or dislike others, and they are neither shy nor plagued by loneliness. A crowded cocktail party may be torture for introverts, but they enjoy one-on-one engagement in calm environments, which is more suited to the make-up of their nervous system.”

What’s key to remember here is that social anxiety isn’t about preferring solitude but instead, the brain responding to perceived threat.

Studies as far back as 2016 revealed distinct microbiome profiles in people with depression, suggesting that our mental health may be shaped in part by the organisms living inside us.

With this in mind, Dr Mary Butler at University College Cork, in Ireland, and colleagues analysed the faeces of 31 people with the social anxiety, and 18 without. They found clear differences in the gut bacteria of the two that suggested there may be some weight behind this theory.

Writing for BBC Science Focus, science writer David Robson explains: “To determine whether those differences could have a meaningful impact on people, the team transplanted some of the participants’ faeces into the stomachs of laboratory mice, before putting them through a series of behavioural tests.

“One test analysing ‘social fear conditioning’ proved especially revealing. Here, mice were given a small electric shock whenever they approached another mouse, causing them to learn that social contact led to pain.”

They found that the mice who received faecal transplants from people with social anxiety were more susceptible to the condition and were slower to ‘unlearn’ the association when electric shocks stopped.

Most notably, the mice didn’t experience generalised anxiety but specifically social anxiety around other mice.

“The striking part of our work was the specificity of the transferred phenotype,” said Butler speaking to BBC Science Focus

“The microbiota from donors with social anxiety disorder produced a social-fear-selective effect in otherwise behaviourally normal mice.”

There’s still a long way to go before we fully understand this, but the news is hopeful for future treatment of the condition.

The NHS says: “It’s a good idea to see a GP if you think you have social anxiety, especially if it’s having a big impact on your life. It’s a common problem and there are treatments that can help.

“Asking for help can be difficult, but a GP will be aware that many people struggle with social anxiety and will try to put you at ease. They’ll ask you about your feelings, behaviours and symptoms to find out about your anxiety in social situations.”

You may then be referred to a mental health specialist for treatment and support.

• Mind, open Monday to Friday, 9am-6pm on 0300 123 3393.
• Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI – this number is FREE to call and will not appear on your phone bill).
• CALM (the Campaign Against Living Miserably) offer a helpline open 5pm-midnight, 365 days a year, on 0800 58 58 58, and a webchat service.
• The Mix is a free support service for people under 25. Call 0808 808 4994 or email help@themix.org.uk
• Rethink Mental Illness offers practical help through its advice line which can be reached on 0808 801 0525 (Monday to Friday 10am-4pm). More info can be found on rethink.org.