ALL EYES ON YOU

Social anxiety isn't only psychological. New research is revealing its biological roots – and how to reset them

- Words by DAVID ROBSON Illustrations by SCOTT BALMER

My first signs of social anxiety emerged when I was around six years old. I'd been invited, at the last minute, to the birthday party of a boy in my class. When I arrived, his older brother noticed that I was shaking.

He asked if I was shy. “I’m just cold,” I told him, even though it was the middle of spring. He looked doubtful as he took my arm and led me into their living room.

My parents hoped that those fears would leave me as I grew up, but they continued well into adulthood. The shaking may have stopped, but my mouth would go dry and I'd blush heavily whenever I had to speak in a team meeting.

Such experiences are surprisingly common. The UK’s National Institute for Health and Care Excellence (NICE) estimates that 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.

For a long time, it was seen as something purely in the mind - the anxiety being a reflection of personality, rather than biology. But researchers are starting to see it differently. New studies suggest that the condition may be rooted in changes within the brain, and even the gut, offering clues not just to how social anxiety begins, but how it could be managed or reversed.

ANATOMY OF ANXIETY

Before we begin exploring this new science, it’s worth defining our terms. Almost everyone feels a little shy from time to time, but social anxiety disorder is 'an overwhelming fear of social situations', according to NICE guidelines.

People with social anxiety, these guidelines say, are afraid of doing or saying something that will result in embarrassment, humiliation or rejection by others. They may worry about blushing, sweating, shaking or appearing nervous - or fear seeming boring, foolish or strange. Many also fret about talking too much or too little when anxious.