Social anxiety or socially induced panic can have a huge impact on the general mental state, in my own case, it seems to be at the core of all my issues either directly or indirectly. Even when i am alone, i can feel the pressure of social anxiety churning beneath the surface, creating constant agitation and muscle tension.
The constant muscle tension and physical/mental agitation is exhausting so it is a mixture of total physical and mental exhaustion mixed with muscle tension and agitation. This mixed state leads to decreased exercise and increases time spent in the same position which causes unproductive pain and just makes the situation worse. The worse and more sedentary this state gets, the more depressive my thinking gets and the more motivation is needed to get anything done. Everything complex develops from something less complex.
I've been cycling in and out of this state to varying extents my whole life, in fact everyone does but to different extents. When the highs and lows are out beyond the average margins, its often diagnosed as all kinds of things even though it is really just a manifestation of social anxiety.
It seems to me that fear of embarrasment is at the core of social anxiety and rightly so, because ratio of embarrassment is directly tied to social status. What seems to be out of whack is the extent of embarrasment. Some people handle embarrassment well and others don't. Some people are literally momentarily incapacitated and some people just feel a slight rise in internal temperature or perhaps even get a helpful boost in mental capacity. For those of us who have a profoundly incapacitory reaction to humiliation, there is a very strong aversion toward those experiences and the body over time, develops a hypersensitive state in order to avoid them. This allows us to be more aware of the possibility of getting into one of those experiences, but it is really counterproductive and only makes things worse by increasing self consciousness and obsessive self monitoring.
A proper treatment of the entire manifestation would have to reduce both the constant hypersensitive state and the acute reaction to humiliation. Benzo's seem to be the most effective anxiolytic because they address both states, the problem is, they also reduce cognitive ability which is much needed when attempting to better yourself socially. They also often cause depression and addiction and stop working as soon as you stop taking them.
In order for true remission to be achieved, i think cognitive ability must be at least left intact if not increased along with a decrease in the constant, acute or both, symptoms of anxiety. This would enable you to rewire your thinking patterns and possibly break the cycle of thinking yourself into anxious feelings and the anxious feelings creating anxious thinking. This is why i think so many people have initial success with stimulants even though they also cause anxiety symptoms, they enable you to have better control over your thoughts. Its also why i think social anxiety can appear as ADD and OCD, because part of the avoidance mechanism is to make thoughts harder to consciously control.
So really the best bet is a dual approach aimed at minimizing physical symptoms of anxiety and maximizing cognitive ability. Dexedrine+clonazepam is a crude attempt at this and can achieve very nice states, but because both drugs are addictive and have issues with tolerance as well as not being precise enough, it is not really a viable option.
I would be very interested to hear your opinions or possible substances/stacks which might address the problem in a more precise sustainable way. The quest continues for the illusive anxiolytic/nootropic.
