Afraid of Others' Gaze and Hesitant to Attend Gatherings? A Donguibogam Solution for Social Anxiety

The core mental functions that our ancestors attributed to the heart can be explained in modern neuroscience through the coordinated actions of several brain regions. In particular, emotional regulation challenges such as social anxiety disorder are closely tied to interactions among the amygdala, hippocampus, and prefrontal cortex. Acting like the brain's alarm system, the amygdala detects potential threats and initiates fear responses. In individuals with social anxiety, the amygdala tends to become excessively activated even by minor social cues, as though it were repeatedly sounding an errant alarm. In this process, the hypothalamic-pituitary-adrenal axis is overly stimulated, continuously releasing the stress hormone cortisol. This sustained release further sensitizes the amygdala and leads to hypofunction of the prefrontal cortex. The prefrontal cortex manages rational judgment and emotional regulation, so when its function declines, one is easily overwhelmed by anxious feelings. Neurotransmitter imbalances also play an important part. A deficiency of serotonin, which supports mood regulation, affects emotional stability, while hypofunction of gamma-aminobutyric acid, which lowers neural excitability, can amplify anxiety. Conversely, excessive release of norepinephrine triggers heightened sympathetic nervous system activity, causing increased heart rate, sweating, and facial flushing, which worsens the physical discomfort experienced in social situations. These bodily sensations then reinforce the perception that one visibly appears anxious, fueling a self-perpetuating loop of anxiety. This complex brain dysfunction is understood to arise from the combined effects of genetic predisposition, childhood experiences, and ongoing stressors. It is not a matter of being weak-willed, but rather a temporary disruption in delicate neural circuits. Because the brain possesses neuroplasticity and can continuously adapt, appropriate care and consistent strategies can help restore healthy neural balance.