Anxiety and Brain Fog
Guideline: NICE CG113 Generalised Anxiety Disorder (2011, updated 2020)
What Is Anxiety-Related Brain Fog?
The world looks 2D. Flat. Like you're watching your life through a screen. This isn't regular worry-fog — this is depersonalization/derealization. Your brain's circuit breaker tripped because the anxiety got too high. It dimmed the emotional volume to protect you, but it dimmed EVERYTHING — including your ability to think, remember, and feel present.
What to Do This Week
Seven actionable steps you can start today — free, evidence-based, and designed for when you're foggy.
Body
If dissociating: splash cold water on face, hold ice, do jumping jacks — strong sensory input helps ground you.
Food
Eat regular meals. Blood sugar crashes worsen anxiety. Protein with every meal stabilizes energy.
Water
Stay hydrated. Dehydration can mimic anxiety symptoms.
Environment
Reduce stimulation during high-anxiety periods. Dim lights, reduce noise, limit screens.
Connection
Don't isolate. Even brief social contact helps your brain recalibrate its sense of reality.
Tracking
Track anxiety triggers and dissociation episodes. Note: what were you doing, eating, feeling before?
Avoid
Don't fight dissociation — resistance increases it. Name it, apply grounding, wait for it to pass.
What to Eat: The Mediterranean / MIND Pattern Approach
Anti-inflammatory eating supports brain health and may reduce anxiety symptoms.
Sample Day
- breakfast: 2 eggs scrambled in olive oil + handful spinach + slice sourdough + blueberries
- lunch: Big salad (mixed greens, chickpeas, cucumber, tomato, feta, olive oil + lemon) + water
- snack: Apple + handful walnuts or almonds
- dinner: Salmon or chicken thigh + roasted vegetables (broccoli, sweet potato, red onion) + olive oil
- evening: Herbal tea (chamomile or peppermint)
For Anxiety: Limit caffeine — it mimics fight-or-flight physiology and can worsen anxiety. Avoid alcohol — it disrupts sleep and worsens anxiety long-term despite short-term relief.
This is a PATTERN, not a prescription. Adapt to your budget, culture, preferences, and what's available. The principles matter more than perfection: more plants, good fats, less processed food.
When to Seek Urgent Help
STOP — Seek urgent medical evaluation if: sudden onset of cognitive symptoms (hours/days), new focal neurological symptoms (weakness, numbness, vision or speech changes), seizures, fever with confusion, or rapidly progressive decline. These may indicate a medical emergency requiring immediate care, not lifestyle modification.
Tests and Investigations
Rule Out Medical Causes
- Thyroid panel (TSH, Free T4, Free T3)
- Blood glucose
- Vitamin B12 and D
- Iron studies
- ECG if palpitations present
Anxiety symptoms can be caused by thyroid dysfunction, hypoglycemia, and nutrient deficiencies. Rule these out before assuming primary anxiety disorder.
Evidence-Based Lifestyle Changes
Grounding Techniques
5-4-3-2-1 technique: Name 5 things you see, 4 you hear, 3 you feel, 2 you smell, 1 you taste. Or use cold water/ice to create strong sensory input.
Evidence: Moderate — clinical consensus for dissociative symptoms
Breathing Regulation
Box breathing: inhale 4 seconds, hold 4, exhale 4, hold 4. Repeat 4-6 cycles. Practice daily, not just during panic.
Evidence: Moderate
Screen and Stimulation Reduction
Reduce doom-scrolling and limit news consumption. Set specific times for checking news/social media rather than constant exposure.
Evidence: Moderate — observational studies
Holistic Support
Regular exercise
Strong — reduces anxiety as effectively as medication in some studies
30 minutes most days. Walking counts. Start gentle during high-anxiety periods.
Sleep hygiene
Strong — sleep deprivation worsens anxiety which worsens sleep
Consistent sleep/wake times. No screens 1hr before bed. Dark, cool room.
Medical Treatment Options
Discuss these options with your prescribing physician. This information is educational, not medical advice.
Cognitive Behavioral Therapy (CBT)
12-16 sessions with a trained therapist. Gold standard for anxiety disorders.
Evidence: Strong — NICE recommended first-line treatment
EMDR (for trauma-based dissociation)
6-12 sessions with EMDR-trained therapist. Particularly effective when dissociation is trauma-related.
Evidence: Strong for PTSD; Moderate for anxiety with dissociation
Medication (if indicated)
SSRIs are first-line pharmacological treatment. Discuss with your doctor. Benzodiazepines should be short-term only due to dependence risk.
Evidence: Strong
Supplements — What the Evidence Says
Supplements are adjuncts, not replacements for lifestyle changes. Discuss with your healthcare provider.
Magnesium glycinate
Dose: 200-400mg before bed
Magnesium supports GABA function and may reduce anxiety. Try lifestyle and therapy first.
Psychological Support and Therapy
First-line for anxiety disorders. CBT (12-16 sessions) for generalized anxiety. EMDR (6-12 sessions) for trauma-based dissociation. Seek therapist specializing in anxiety or trauma.
What People With Anxiety Brain Fog Say
What Helped
- • Grounding techniques — cold water on face, holding ice, strong tastes brought me back
- • Naming the dissociation: 'I'm dissociating right now' reduced its power
- • Therapy (specifically trauma-informed) — understanding WHY my brain was doing this changed everything
- • Reducing caffeine — made a noticeable difference in baseline anxiety
What Didn't Help
- • Fighting the dissociation — resistance makes it worse
- • Googling symptoms at 2am — convinced myself I had every serious condition
- • Alcohol or cannabis to cope — cannabis especially can trigger dissociation
Common Mistakes
- • Assuming dissociation means you're 'going crazy' — it's a protective response, not psychosis
- • Isolating yourself — dissociation thrives in isolation
- • Self-medicating — alcohol and cannabis often make anxiety disorders worse long-term
Surprises
- • Depersonalization/derealization is incredibly common — 1-2% have it clinically, many more experience it occasionally
- • Recovery isn't linear — windows of clarity gradually get longer
- • Hyperventilation was making it worse — learning to breathe properly helped
"Dissociation is your brain's circuit breaker. It tripped to protect you from overwhelming anxiety. The goal isn't to fight it — it's to slowly convince your nervous system that you're safe, so it can turn the brightness back up."
Quick Reference
Quick Win
Try grounding: Hold ice cubes, splash cold water on your face, or eat something with a strong taste (lemon, ginger). These sensory inputs help your brain recalibrate its sense of reality. If dissociation is frequent, discuss with a therapist who specializes in anxiety disorders.
NICE CG113 Generalised Anxiety Disorder; APA Practice Guidelines