Social anxiety and Psychedelics

It’s common to experience anxiety in certain social settings. For instance, socializing with a group you never met before or having a work-related meeting can make you feel nervous. But when you have a social anxiety disorder, also known as social phobia, you constantly worry about how other people will react to you and feel self-conscious and embarrassed.

When you have a social anxiety disorder, your life may be disrupted by avoidance caused by fear and anxiety. Your relationships, daily life and routines, work, obligations, and other activities may be negatively impacted by extreme stress. Although taking medication and learning coping mechanisms in psychotherapy can help you gain confidence and enhance your social skills, social anxiety disorder can be a chronic mental health condition.

Social anxiety is a common mental health condition that affects millions of people worldwide. It can be a debilitating disorder that can significantly impact an individual’s quality of life. While traditional treatments such as therapy and medication can be effective, some people may seek alternative approaches to manage their symptoms.

One of these alternative approaches gaining increasing research attention is the use of psychedelics.

Social anxiety is a type of anxiety disorder where an individual experiences significant fear or anxiety in social situations. This can manifest as excessive self-consciousness, fear of being judged, and avoidance of social situations. The severity of symptoms can vary from person to person, with some individuals experiencing mild symptoms while others may have debilitating anxiety that affects their daily life.

Traditional treatments for social anxiety include cognitive-behavioral therapy, exposure therapy, and medication such as antidepressants and anti-anxiety drugs. While these treatments can be effective, they may not work for everyone, and some individuals may experience unwanted side effects.

Psychedelics such as psilocybin (found in magic mushrooms) and LSD have been studied for their potential therapeutic benefits in treating various mental health conditions, including anxiety disorders. These substances work by altering an individual’s perception, thoughts, and emotions, which can lead to a shift in perspective and a new way of looking at things.

Early-phase research has shown preliminary but promising results in the use of psychedelics for anxiety-related conditions. For example, a study conducted at the University of Zurich found that psilocybin-assisted therapy showed potential for reducing social anxiety symptoms in a small group of patients with a life-threatening illness. Another study conducted at the University of California, Los Angeles found that LSD-assisted therapy was effective in reducing anxiety symptoms in patients with terminal illnesses.

Psychedelic-assisted therapy typically involves one or more sessions where the individual ingests a controlled dose of a psychedelic substance and engages in therapy with a trained professional. The therapy session may involve introspection, guided imagery, and other techniques to help the individual explore and process their emotions and experiences.

It’s essential to understand what psychedelics are and how they work. Psychedelics are a class of substances that alter the user’s perception, mood, and cognition. These substances include LSD, psilocybin mushrooms, DMT, ayahuasca, and mescaline. Classic psychedelics work primarily by binding to serotonin 5-HT2A receptors in the brain, triggering changes in neural signaling that can lead to shifts in thinking, mood, and perception. Now, let’s explore which psychedelics may be a good solution for social anxiety.

Psilocybin Psilocybin is the active ingredient in magic mushrooms, and early research suggests it may have therapeutic potential for a variety of mental health conditions (Carhart-Harris & Goodwin, 2017), including social anxiety. In a study conducted by Johns Hopkins University, researchers found that psilocybin-assisted therapy significantly reduced anxiety and depression in cancer patients.

Another study conducted by Imperial College London found that psilocybin-assisted therapy improved symptoms of depression and anxiety in patients with treatment-resistant depression.

The Hopkins and Imperial College studies cited above focused on cancer patients and treatment-resistant depression rather than social anxiety specifically. The UCLA study on LSD did include anxiety reduction. Dedicated trials for social anxiety disorder remain limited.

LSD LSD, or lysergic acid diethylamide, is a potent psychedelic that has been used for decades as a therapeutic tool. In the 1950s and 1960s, researchers conducted studies using LSD to treat various mental health conditions, including anxiety. While LSD is not commonly used in therapy today, some people still turn to it as a way to alleviate symptoms of social anxiety.

One study published in the Journal of Nervous and Mental Disease found that LSD-assisted therapy significantly reduced anxiety and depression in patients with terminal illnesses. However, LSD can be a very powerful substance, and it should only be used under the guidance of a trained professional.

Ayahuasca Ayahuasca is a brew made from the ayahuasca vine and other plant ingredients. It has been used for centuries by indigenous cultures in South America for spiritual and medicinal purposes. In recent years, ayahuasca has gained popularity as a tool for personal growth and healing, and some people with social anxiety have reported positive results from using ayahuasca.

There is limited research on ayahuasca’s potential for treating social anxiety specifically. Several studies have shown therapeutic benefits for depression and addiction, but no dedicated trials exist for social anxiety.

MDMA MDMA, or 3,4-methylenedioxymethamphetamine, is a synthetic entactogen (not a classic psychedelic) that is sometimes referred to as “ecstasy” or “molly.” Unlike classic psychedelics, MDMA works primarily by reversing serotonin transporters (SERT) rather than binding to 5-HT2A receptors. It has shown promise as a therapeutic tool, though in August 2024, the FDA declined to approve MDMA-assisted therapy for PTSD, requesting additional clinical trials. In April 2026, a U.S. executive order directed the FDA to issue priority review vouchers for psychedelic treatments with Breakthrough Therapy designation, aiming to shorten approval timelines from years to weeks. Some researchers have also explored its potential for treating social anxiety.

One study published in the Journal of Psychopharmacology found that MDMA-assisted therapy significantly reduced social anxiety symptoms in adults with autism spectrum disorder. While more research is needed to fully understand the potential of MDMA for social anxiety, early studies suggest that it may

While psychedelics have shown promise in treating social anxiety, they are not without risks. Psychedelics can produce intense and unpredictable effects, which can be overwhelming for some individuals. In rare cases, psychedelics can trigger psychosis or other serious mental health conditions.

Psychedelic-assisted therapy should only be conducted by trained professionals in a controlled setting. Individuals with a history of mental health conditions, including psychosis and bipolar disorder, should avoid using psychedelics as they may worsen symptoms.

Conclusion

Social anxiety is a common mental health condition that can significantly impact an individual’s quality of life. While traditional treatments can be effective, some individuals may seek alternative approaches such as psychedelics. Recent studies have shown promising results in the use of psychedelics for treating social anxiety, but there are risks involved.

Psychedelic-assisted therapy should only be conducted by trained professionals in a controlled setting, and individuals with a history of mental health conditions should avoid using psychedelics. For social anxiety specifically, MDMA-assisted therapy currently has the strongest direct evidence — the 2018 trial in autistic adults showing significant symptom reduction. Psilocybin trials targeting social anxiety disorder are in early stages.