Social and Performance Anxiety

What It Does & How It Works

Propranolol is a beta-blocker that essentially blocks adrenaline’s effects on your body. Translation? It stops those physical anxiety symptoms that make you want to crawl into a hole: racing heart, shaky hands, sweaty palms—all that fun stuff.

The best part? Unlike most anxiety meds, propranolol doesn’t turn your brain to mush. It calms your body without sedating your mind, so you can still think clearly while giving that presentation or going on that date.

Dosage & Timing

For one-off anxiety situations (interviews, performances, first dates): - Dose: 10-40 mg taken 30-60 minutes before the event - Kicks in: Usually within 20-60 minutes (most people feel calmer around the 30-minute mark) - Lasts: About 3-4 hours, covering most anxiety-inducing events - Pro tip: Try a 10 mg test run at home first. If that’s not enough, your doctor might suggest bumping up to 20 or 30 mg.

You can take it with a small snack to prevent mild nausea. Avoid alcohol around the same time—both lower your blood pressure, and together they can make you dizzy.

As-Needed vs. Daily Use

One of propranolol’s big advantages is you can take it just when you need it. Many people only use it for specific anxiety-triggering situations and not on “normal” days.

This occasional use carries minimal risk of tolerance or dependence—it’s non-habit-forming since beta-blockers don’t create any kind of high or reward cycle.

Some people with frequent anxiety do take it daily (often 10 mg, three times a day), but that requires more medical supervision. If you’ve been using it daily for weeks or months, don’t stop abruptly—taper off under a doctor’s guidance to avoid rebound effects.

Side Effects & Precautions

Most people tolerate propranolol well, especially at low doses for occasional use. But like anything, it’s got some potential side effects:

Common side effects: - Mild fatigue or dizziness as your heart rate/blood pressure drop - Cold fingers and toes from reduced circulation - Possible mild nausea or upset stomach - Sleep disturbances in some people (vivid dreams or insomnia)

Serious concerns (rare but important): - If you have asthma or COPD: Propranolol can constrict airways, causing wheezing or shortness of breath - For diabetics: Can mask symptoms of low blood sugar - People with certain heart conditions (bradycardia, heart block, unmanaged heart failure) should avoid it unless cleared by a cardiologist

Drug interactions: - Be careful combining with other substances that slow heart rate or lower blood pressure - Some antidepressants (like certain SSRIs) can increase propranolol levels - Best practice: Avoid alcohol on days you use it

When used responsibly, propranolol is an excellent tool for managing the physical symptoms of anxiety. It breaks that vicious cycle where feeling your pounding heart makes you even more anxious. It’s especially helpful for stage fright and similar situations.

What It Is & How It Works

Gabapentin is technically an anticonvulsant (originally for epilepsy and nerve pain), but doctors often prescribe it “off-label” for anxiety. It binds to calcium channels in the brain, reducing the release of excitatory neurotransmitters.

The result? A calming effect without the heavy sedation of a tranquilizer. It takes the edge off anxiety without turning you into a zombie.

Dosage & Onset

• Starting dose: Often 100-300 mg, three times a day
• Effective range: Usually 900-2,100 mg daily (split into 2-3 doses)
• For situational use: Some take a single dose of 300-600 mg about 1-2 hours before an anxiety-provoking event

Unlike propranolol, gabapentin isn’t immediate—you’ll generally feel a reduction in nervousness within a couple of hours. Each dose provides about 6-8 hours of relief.

Effectiveness

Gabapentin helps with both physical and mental symptoms of anxiety. It can reduce irritability, racing thoughts, and bodily tension. Research shows it works particularly well for social anxiety—significantly improving symptoms compared to placebo.

Many psychiatrists use it as an add-on therapy—for example, adding gabapentin to an SSRI for someone who still has breakthrough anxiety.

Side Effects

Gabapentin’s side effects are usually mild and dose-dependent:

• Sedation and dizziness are most common—you might feel a bit sleepy or lightheaded
• Some people experience coordination problems or unsteadiness
• Occasionally causes blurred vision or tremor
• Higher doses can cause cognitive slowing or fogginess

On the plus side, it doesn’t cause euphoria (so has lower abuse potential) and typically doesn’t upset the stomach. Any drowsiness often diminishes as your body adjusts.

Dependency & Safety

While gabapentin isn’t classified as addictive, physical dependence can develop with long-term use at high doses. If you’ve been taking it daily for an extended period, don’t stop abruptly—tapering down over a week or two prevents withdrawal symptoms (like agitation, anxiety, insomnia).

The good news: withdrawal from gabapentin is generally much milder than from benzos or alcohol—severe symptoms are rare if tapered properly.

Gabapentin is considered low-risk for addiction. Most anxiety sufferers don’t experience any “high” from it, just relaxation. Still, due to some reports of misuse (especially in combination with opioids), a few regions have started treating it as a controlled substance.

Overall, gabapentin offers a reasonably safe, non-addictive option for anxiety, but it’s best used under a doctor’s supervision. And as with most CNS depressants, avoid heavy alcohol use while taking it.

Overview & Mechanism

Phenibut occupies a unique space in the anti-anxiety world. Developed in Russia (where it’s a medication), it’s sold elsewhere as a supplement. Chemically, it’s closely related to GABA (the brain’s main inhibitory neurotransmitter).

Unlike GABA itself, phenibut crosses the blood-brain barrier and acts primarily on GABA-B receptors, with some effect on GABA-A and dopamine systems. The result? A calming effect somewhat like a gentle tranquilizer.

Users often report feeling relaxed and socially confident without mental fog—one user famously described it as helping “deal with social anxiety without clouding my mind.”

Usage & Onset

• Common dose range: 250-750 mg per dose (first-timers often start around 250 mg)
• Higher doses: 1-1.5 grams produce stronger sedation and can cause euphoria
• Onset: Relatively slow-acting—expect 1-2 hours to feel the full effect
• Duration: Effects typically last 6-10 hours, covering a long evening out or a lengthy flight

The effects are dose-dependent: under 1 gram, you’ll likely feel a smooth calm; at higher doses (1.5g+), sedation deepens, thinking gets fuzzy, and very high doses can cause excessive drowsiness.

Effectiveness

Many find phenibut highly effective for social and performance anxiety. It increases sociability, reduces inhibitions (similar to alcohol’s anxiety relief but without the mental cloudiness), and enhances mood.

In Russia, it’s prescribed for anxiety, PTSD, and even given to cosmonauts for stress reduction. Unlike benzodiazepines, it doesn’t typically impair memory—a big plus if you need to perform or study.

The Big Downside: Tolerance & Dependence

Here’s where phenibut gets tricky: tolerance builds FAST—even after just a few days of continuous use, the same dose will have much less effect. This tempts people to take higher and higher doses, which can lead to a dangerous cycle.

Overuse can result in physical dependence similar to benzodiazepine or alcohol dependence. Stopping suddenly after heavy use can trigger severe withdrawal symptoms:

• Rebound anxiety and insomnia (usually worse than your original anxiety)
• Agitation, tremors, sweating
• In extreme cases (after very high doses), hallucinations or psychosis

There have been reports of people taking massive doses (10+ grams daily, which is way beyond normal use) who ended up hospitalized with delirium during withdrawal.

For this reason, phenibut should be reserved for occasional use. A common guideline in online communities is no more than 1-2 times per week to avoid tolerance. If you find yourself using it daily, you need to taper off slowly rather than quit cold turkey.

Side Effects & Legal Status

At recommended doses (around 500 mg), side effects are usually mild:

• Some drowsiness or a light headache the next day
• Possible numbness or tingling sensations

At higher doses, expect:

• Strong sedation
• Poor coordination (slurred speech, stumbling)
• Nausea
• Possible depression or emotional flatness between uses

Phenibut exists in a legal gray zone. In the US, it’s technically legal to possess but not FDA-approved. Countries like Australia have made it a controlled substance due to addiction concerns.

In summary, phenibut can be extremely effective for anxiety but comes with significant risks. It’s best saved for occasional big events rather than regular use. Stick to moderate doses, don’t redose frequently, and respect its potential for dependence.

Kava (Piper methysticum)

Kava is a plant from the South Pacific whose roots produce a traditional drink with proven anxiolytic effects. The active compounds (kavalactones) act on the brain’s GABA receptors to produce relaxation.

Onset & Usage: - Effects come on relatively quickly—usually within 15-30 minutes on an empty stomach - Peak effects occur about 1-2 hours after consumption - A typical effective dose provides 70-250 mg of kavalactones - Many commercial supplements indicate kavalactone content for accurate dosing

Effects: Kava uniquely reduces anxiety without dulling the mind. Users report feeling relaxed yet clear-headed, with reduced physical tension and worry. Some describe it as providing a bit of “liquid courage” similar to alcohol’s anxiety relief but without the mental impairment. Kava bars have become popular as alcohol-free social venues for this reason.

Safety Considerations: - The most common side effect is drowsiness, especially at higher doses - The major safety concern is potential liver toxicity - Early 2000s reports of severe liver damage led to bans in several countries - Subsequent analyses suggested the liver issues might relate to poor-quality preparations - When high-quality root-only kava is used short-term, the risk appears low - Avoid combining kava with alcohol or other liver-stressing substances - Use intermittently rather than daily for long periods

Kava remains legal in the US as a supplement but is regulated or restricted in some locations. For situational anxiety, it can be very helpful when used responsibly. If you’re otherwise healthy and use kava occasionally, most experts consider it likely safe.

CBD (Cannabidiol)

CBD has exploded in popularity as a natural anxiety remedy. It’s a non-psychoactive compound from cannabis (usually hemp) that interacts with the endocannabinoid system and serotonin receptors. Unlike THC, it won’t get you high.

Effectiveness & Dosing: - Research suggests CBD can reduce anxiety—one study found a single 300 mg dose significantly reduced anxiety during public speaking - Many users take lower doses (20-50 mg) and still report benefits - The onset depends on the form: vaping or sublingual oil works within 15-30 minutes; edibles take 1-2 hours - Effects typically last 4-6 hours

CBD’s anti-anxiety effect isn’t as dramatic as a benzodiazepine—it’s often described as a subtle easing of tension. Many find it improves public speaking performance by reducing pre-speech jitters without causing sedation.

Safety Profile: - CBD is generally considered safe with minimal side effects - Possible effects include dry mouth, drowsiness (at high doses), or diarrhea - One important note: CBD can interact with certain medications by affecting liver enzymes (CYP450) - CBD from hemp (with <0.3% THC) is legal in many countries and US states

For quality control, use reputable brands with third-party lab testing, as the market has many mislabeled products. CBD offers a gentle option for anxiety that can be combined with other approaches.

Ashwagandha (Withania somnifera)

Ashwagandha is an herb used in Ayurvedic medicine as an adaptogen—it helps the body resist stress. It works by multiple mechanisms, including lowering cortisol (a stress hormone) and possibly having indirect GABA-mimicking effects.

Onset & Usage: - Not a fast-acting remedy like kava, but some users report feeling mellower within 1-2 hours - Typically taken daily for cumulative benefits (full effects often emerge after a few weeks) - Standard extracts (usually root extract with 5% withanolides) are taken at 300-600 mg daily - For acute use, 300-500 mg a few hours before a stressor may provide some calming effect

Effectiveness: Studies show ashwagandha can significantly reduce anxiety scores after 4-8 weeks of daily use. It’s particularly good for the “wired and tired” feeling—relaxing you and improving sleep quality. While it may not eliminate a panic attack instantly, it raises your threshold for stress.

Safety: - Generally very safe and well-tolerated, even for long-term use - No dependency or withdrawal issues - Side effects are uncommon, but high doses may cause stomach upset - Avoid during pregnancy (may have abortifacient effects) - Those with thyroid conditions should use under medical supervision

Ashwagandha is sold as an over-the-counter supplement. Look for quality extracts like KSM-66 or Sensoril (patented extracts used in studies). It’s an excellent natural option for taking the edge off anxiety, especially when used regularly.

Kratom (Mitragyna speciosa)—Approach with Extreme Caution

Kratom is an herb that can relieve anxiety but comes with significant risks. It contains alkaloids that act on opioid receptors in the brain—at low doses, it has stimulant effects; at higher doses, opioid-like depressant effects.

Usage & Effects: - Effects begin in 15-30 minutes, with peak effects around 1-2 hours - Typical anxiety-relief doses: 3-5 grams (moderate dose, more calming) - Duration: Usually 2-4 hours

Many report that it eliminates anxiety and produces a calm, positive mood by activating opioid receptors associated with relaxation.

Serious Risks: - High potential for dependence and addiction - Regular use leads to physical dependence with withdrawal syndrome upon cessation - Withdrawal symptoms resemble opioid withdrawal (anxiety spikes, insomnia, muscle aches) - Common side effects: nausea, vomiting, constipation, itching - Reports of seizures with high doses or adulterated products - Potential liver toxicity (cases of liver damage documented) - Extremely dangerous when mixed with other substances

The FDA has warned consumers against using kratom due to these serious risks. While it can act as a quick anxiolytic, it essentially trades one problem (anxiety) for another (opioid dependency).

Medical professionals generally advise against using kratom for anxiety—the risks far outweigh the benefits for most people. If considering it, be fully informed of these issues and explore safer alternatives first.