Confusion and Anxiety

Causes: Why Anxiety Causes Mental Confusion

1. Anxiety-Activated Stress Response

Anxious behavior activates the stress response, also known as the fight or flight response,[1][2] which prepares the body for immediate emergency action.

Part of the body-wide changes include:

• Rushing blood to the brain so that we are more keenly aware of danger.
• Stimulates the fear center of the brain (amygdala and others) so that we are more aware of and reactive to danger.
• Stimulates the body, especially the nervous system.
• Heightens most of the body’s senses.

To name a few.

Visit our “Stress Response” article for all of the ways stress responses prepare the body.

This sudden change can cause temporary confusion as the body and brain adjust to the emergency readiness.

Temporary episodes of confusion are commonly caused by anxiousness and how the body prepares for emergency action.

2. Hyperstimulation

When stress responses occur infrequently, the body can recover relatively quickly. When they occur too frequently, however, such as from frequent apprehensive behavior, the body can’t complete recovery.

Incomplete recovery can keep the body in emergency readiness, which we call “stress-response hyperstimulation” since stress hormones are stimulants.

Hyperstimulation is also often referred to as chronic stress, “hyperarousal,” “HPA axis dysfunction,” or “nervous system dysregulation.”[3][4]

Hyperstimulation can keep the body stimulated and symptomatic. Chronic confusion and cognitive impairment are common indications of hyperstimulation.

Visit our “Hyperstimulation” article for more information about how it can affect the body.

3. Chronic stress

Anxiety stresses the body due to the many body-wide changes caused by the stress response.

Research has found chronic stress can cause thinking and memory problems, including mental confusion and cognitive impairment.[5][6][7][8][9][10]

There are many reasons why. Here are four:

1. Chronic stress suppresses the hippocampus

The hippocampus is thought to be the learning and memory area of the brain. Chronic stress (hyperstimulation) suppresses the hippocampus. Hippocampus suppression can make it more difficult to store and retrieve information.[10]

Not only can stress suppress the hippocampus, but research has found that chronic stress has a deleterious effect on the hippocampus, such as alters synaptic plasticity and reduces volume.[11][12][13]

Reduced hippocampal function can impair thinking, causing mental confusion and cognitive impairment.

2. Stress-induced fatigue

Chronic stress taxes the body’s energy resources harder and faster than normal, which can lead to fatigue. Fatigue can impair thinking,[14][15] which can cause mental confusion and cognitive impairment.

3. Chronic stress affects schema processing

Research has found that prior knowledge, represented as a schema, facilitates memory encoding. Stress can impair the brain regions responsible for this encoding, which can cause memory problems, especially with new or recent information.[16]

Memory problems can contribute to mental confusion and cognitive impairment.

4. Sleep deprivation

Chronic stress can cause sleep disruption. Sleep disruption affects cognitive performance and working memory.

If anxiety, stress, or hyperstimulation are affecting the quality of your sleep, research shows sleep disruption (acute or chronic) can harm cognitive performance and memory (both short- and long-term memory).[17] As the degree, frequency, and duration of sleep disruption increases, cognitive and memory performance decrease.

Sleep disruption can cause mental confusion and cognitive impairment.

4. Inward Focused Thinking

Many anxious people develop a habit of being internally focused:

• Ruminate about their health.
• Ruminate about how they feel.
• Worry about the implications of anxiety and how it might affect their future.
• Worry about their recovery.
• Wonder if they will recover from anxiety.
• Worry about what others will think of them because of their struggle with anxiety.
• Worry about how their struggle with anxiety might affect their loved ones and livelihood.

And so on.

Inward Focused Thinking distracts our attention by all of the “what if” scenarios and implications of long-term suffering. Distracted thinking can also contribute to mental confusion and cognitive impairment.

Internally focused and “what if” thinking can become so habituated and automatic that many sufferers aren’t even aware that they are doing it.

Recovery Support members can read more about “Inward Focused Thinking” and how to overcome it in chapter 6.

Unfortunately, when thinking problems occur, such as mental confusion, cognitive impairment, and muddled thinking, many anxious people fear they may be losing their mind or that they are on the verge of a complete mental breakdown.

Many also fear their thinking and memory problems are an indication of a serious mental or biological illness, such as Alzheimer’s disease or some other form of dementia.

These anxieties can aggravate an already hyperstimulated body making confusion and cognitive impairment worse.

5. Other factors

Associated with anxiety, there are other factors that can cause and contribute to mental confusion and cognitive impairment, including:

• Medication
• Recreational drugs
• Stimulants
• Hyper and hypoventilation
• Low blood sugar
• Nutritional deficiencies
• Dehydration
• Hormone changes
• Pain

Select the relevant link for more information.