Ptsd and Brain Fog
Guideline: NICE NG116 PTSD; APA Clinical Practice Guidelines
What Is Ptsd-Related Brain Fog?
Your brain is stuck in threat-detection mode. Hypervigilance consumes the cognitive resources meant for thinking, remembering, and processing. The fog IS the protection — your brain is so busy scanning for danger that there's nothing left for concentration, memory, or clear thinking.
What to Do This Week
Seven actionable steps you can start today — free, evidence-based, and designed for when you're foggy.
Body
Gentle movement helps regulate the nervous system. Walking, stretching, shaking. Avoid intense exercise if it triggers hypervigilance.
Food
Regular meals. Protein for blood sugar stability. Limit caffeine if anxious. Avoid alcohol.
Water
Stay hydrated. Carry water with you — sipping water can be grounding.
Environment
Create a safe space at home. Notice what helps you feel safe and replicate it.
Connection
Trusted people are essential. Tell someone what you're going through. Isolation worsens PTSD.
Tracking
Track triggers and what helps. This information is valuable for therapy.
Avoid
Don't try to process trauma alone or without proper support. Don't use alcohol to cope. Don't isolate.
What to Eat: The Anti-Inflammatory / Stabilizing Approach
Regular meals, blood sugar stability, and anti-inflammatory foods support nervous system regulation.
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 Ptsd: Caffeine can worsen hypervigilance. Alcohol disrupts sleep and nervous system regulation. Regular meals prevent blood sugar crashes that worsen anxiety.
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 help if: suicidal thoughts, self-harm urges, severe dissociation, or inability to function. Crisis lines: 988 (US), Samaritans (UK). PTSD is treatable — you don't have to manage this alone.
Tests and Investigations
Trauma Assessment
- Clinical interview with trauma-informed provider
- PCL-5 (PTSD Checklist for DSM-5) — standardized questionnaire
- Rule out medical causes of symptoms (thyroid, B12, etc.)
PTSD diagnosis requires: exposure to trauma, intrusive symptoms (flashbacks, nightmares), avoidance, negative changes in mood/cognition, and hyperarousal. Symptoms must persist >1 month and cause significant distress.
Evidence-Based Lifestyle Changes
Safety First
Ensure you are in a safe environment. Trauma processing should only begin once current safety is established.
Evidence: Strong — clinical consensus
Grounding Techniques
When triggered or dissociating: 5-4-3-2-1 (name 5 things you see, 4 hear, 3 feel, 2 smell, 1 taste). Cold water on face. Strong sensations.
Evidence: Moderate — clinical consensus
Nervous System Regulation
Practices that activate the parasympathetic nervous system: slow breathing, vagal toning, gentle movement, nature exposure.
Evidence: Moderate
Holistic Support
Trauma-informed therapy
Strong — EMDR and TF-CBT are first-line treatments
Find a therapist trained specifically in trauma. Ask about their approach to trauma work.
Nervous system regulation practices
Moderate — supports therapy work
Breathing exercises, polyvagal-informed practices, gentle yoga, nature exposure.
Medical Treatment Options
Discuss these options with your prescribing physician. This information is educational, not medical advice.
EMDR (Eye Movement Desensitization and Reprocessing)
6-12 sessions with EMDR-trained therapist. Uses bilateral stimulation while processing traumatic memories.
Evidence: Strong — NICE recommended for PTSD
Trauma-Focused CBT
12-16 sessions. Includes exposure therapy and cognitive restructuring.
Evidence: Strong — NICE recommended first-line treatment
Medication (if indicated)
SSRIs (sertraline, paroxetine) are FDA-approved for PTSD. Prazosin for nightmares.
Evidence: Moderate — helpful for some, not curative
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
May support nervous system regulation and sleep. Not a treatment for PTSD, but supportive.
Psychological Support and Therapy
Essential. Seek trauma-trained therapist (EMDR or TF-CBT). Ensure they have specific trauma training, not just general therapy background.
What People With Ptsd Brain Fog Say
What Helped
- • EMDR — finally processed trauma that talk therapy hadn't touched
- • Finding a trauma-informed therapist — not all therapists understand trauma
- • Grounding techniques for acute moments — cold water, strong tastes
- • Understanding the fog was PROTECTIVE — my brain was trying to help
What Didn't Help
- • Trying to 'push through' — avoidance has a function; processing needs safety
- • Non-trauma-specific therapy — talking about trauma without proper techniques can retraumatize
- • Expecting quick results — trauma processing takes time
Common Mistakes
- • Trying to process trauma before establishing safety
- • Seeing a therapist not trained in trauma — trauma requires specific approaches
- • Thinking 'it wasn't bad enough' to be trauma — trauma is defined by your nervous system's response
Surprises
- • The cognitive fog lifted as I processed trauma — they were connected
- • Physical symptoms (fatigue, pain) improved with trauma therapy
- • Hypervigilance was consuming massive cognitive resources
"The fog IS the protection. Your brain is so busy scanning for danger that there's nothing left for thinking. Trauma therapy (EMDR, TF-CBT) helps your nervous system learn it's safe. The fog often lifts naturally as trauma is processed."
Quick Reference
Quick Win
If you suspect trauma is affecting your cognition: seek a trauma-informed therapist. EMDR (6-12 sessions) or trauma-focused CBT (12-16 sessions) are evidence-based treatments. The fog often lifts as the trauma is processed.
NICE NG116 PTSD; APA Clinical Practice Guidelines