When dealing with fear, the hippocampus receives impulses from the amygdala that allow it to connect the fear with a certain sense, such as a smell or sound. Amygdala
The amygdala is an almond-shaped mass of nuclei located deep in the brains medial temporal lobe. It processes the events associated with fear and is linked to social phobia and other anxiety disorders. The amygdalas ability to respond to fearful stimuli occurs through fear conditioning. Like classical conditioning, the amygdala learns to associate a conditioned stimulus with a negative or avoidant stimulus, creating a conditioned fear response often seen in phobic individuals. The amygdala is responsible for recognizing certain stimuli or cues as dangerous and plays a role in the storage of threatening stimuli to memory. The basolateral nuclei (or basolateral amygdala) and the hippocampus interact with the amygdala in-memory storage. This connection suggests why memories are often remembered more vividly if they have emotional significance.In addition to memory, the amygdala also triggers the secretion of hormones that affect fear and aggression. When the fear or aggression response is initiated, the amygdala releases hormones into the body to put the human body into an "alert" state, which prepares the individual to move, run, fight, etc. This defensive "alert" state and response are known as the fight-or-flight response.However, inside the brain, this stress response can be observed in the hypothalamic-pituitary-adrenal axis (HPA). This circuit incorporates the process of receiving stimuli, interpreting them, and releasing certain hormones into the bloodstream.
Antidepressants
Antidepressant medications such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), or monoamine oxidase inhibitors (MAOIs) may be helpful in some cases. SSRIs / SNRIs act on serotonin, a neurotransmitter in the brain. Because of serotonins positive impacts mood, an antidepressant may be offered and prescribed as a treatment option. For social anxiety, the SSRIs sertraline, paroxetine, fluvoxamine, and the SNRI venlafaxine have FDA approval. Similar medications may be offered for agoraphobia. Benzodiazepines
Sedatives such as benzodiazepines (clonazepam, alprazolam) are another therapeutic option, which can help people relax by reducing the amount of anxiety they feel. Benzodiazepines may be useful in the acute treatment of severe symptoms, but the risk-benefit ratio usually goes against their long-term use in phobic disorders. This class of medication has recently been shown as effective if used with negative behaviours such as excessive alcohol use. Despite this positive finding, benzodiazepines are used with caution due to side effects and risk of developing dependence or withdrawal symptoms. In specific phobia for example if the phobic stimulus is one that is not regularly encountered such as flying a short course may be provided. Beta-blockers
Beta blockers (propranolol) are another therapeutic option, particularly for those with the performance only subtype of social anxiety disorder. They may stop the stimulating effects of adrenaline, such as sweating, increased heart rate, elevated blood pressure, tremors, and the feeling of a pounding heart. By taking beta-blockers before a phobic event, these symptoms are decreased, making the event less frightening. Beta-blockers are not effective for generalized social anxiety disorder.