Confusion Anxiety Disorder Symptoms

Written by Jim Folk
Medically reviewed by Marilyn Folk, BScN.
Last updated May 19, 2021

confusion anxiety disorder symptoms

Confusion, mental confusion, and bewilderment are common anxiety disorder symptoms often associated with Anxiety Attacks, Generalized Anxiety Disorder, Social Anxiety Disorder, Obsessive Compulsive disorder, and others.

This article explains the relationship between anxiety and mental confusion.

Common descriptions of the anxiety disorder mental confusion symptoms include:

  • You have difficulty thinking clearly and arriving at conclusions.
  • You are having some cognitive impairment.
  • Your thinking is muddled, impaired, confused, and disconnected.
  • It can feel as if your mind is in a fog.
  • Your thinking can seem slow, disjointed, and mixed up.
  • You have difficulty finishing your thoughts.
  • You find you are uncharacteristically bewildered, perplexed, puzzled, or stumped.
  • It seems as though your thoughts are elusive, and things that you once knew seem hard to comprehend or recall.
  • You are having unusual difficulty in making decisions.
  • You often find yourself unsure of your thinking.
  • Because of the confusion, it’s difficult to focus and carry on conversations.
  • You might also start something and uncharacteristically forget what you were going to do.
  • It feels like your thoughts are all mixed up.
  • Your thinking seems uncharacteristically convoluted.
  • It can also feel like you have too many things demanding your attention and you are having difficulty sorting them out.
  • It can seem like you’ve lost confidence in your thinking.
  • It feels like you have serious mental confusion and cognitive impairment.

To name a few.

Mental confusion can come and go rarely, occur frequently, or persist 24/7 day after day. For example, you have episodes of confusion once in a while and not that often, have episodes of confusion off and on, or feel confused all the time.

The confusion anxiety symptom can precede, accompany, or follow an escalation of other anxiety sensations and symptoms, or occur by itself.

Confusion and cognitive impairment can precede, accompany, or follow an episode of nervousness, anxiety, fear, and stress, or occur “out of the blue” and for no apparent reason.

Confusion and cognitive impairment can range in intensity from slight, to moderate, to severe.

Confusion can also come in waves where you feel confused one moment but not the next.

Mental confusion and impairment can change from day to day and from moment to moment.

All of the above combinations and variations are common.

This confusion and cognitive impairment symptom can seem more prevalent and bothersome when undistracted.

To see if anxiety might be playing a role in your symptoms, rate your level of anxiety using our free one-minute instant results Anxiety Test, Anxiety Disorder Test, or Hyperstimulation Test.

The higher the rating, the more likely anxiety could be contributing to or causing your anxiety symptoms, including confusion and feeling confused.

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Why anxiety disorder causes mental confusion

Medical Advisory

1. Anxiety and the 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:

Select the relevant link for more information.

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How to get rid of anxiety disorder mental confusion symptoms

When mental confusion and cognitive impairment are caused by anxiety and the stress response changes, calming yourself down will bring an end to anxiety and these changes. As your body recovers, confusion and cognitive impairment should subside.

It can take up to 20 minutes or more for the body to recover from a major stress response, such as a panic attack. This is normal and needn’t be a cause for concern.

When confusion is caused by hyperstimulation, it can take much longer for the body to recover.

Nevertheless, as the body recovers, anxiety caused mental confusion and cognitive impairment subside.

Consequently, confusion and cognitive impairment anxiety symptoms needn’t be a cause for concern. They are merely symptoms of acute or chronic stress.

You can speed up the recovery process by containing anxious behavior and reducing stress.

Visit our article “60 Ways To Reduce Stress And Anxiety” for natural ways to reduce and eliminate anxiety symptoms.

If you’d like to learn more about containment, learn how to contain, or are having difficulty with troublesome worry, we recommend connecting with one of our recommended anxiety disorder therapists.

Working with an experienced therapist is the most effective way to overcome problematic anxiety and its symptoms, including mental confusion, cognitive impairment, and what seems like uncontrollable worry.

For more in-depth information about anxiety, anxiety disorder, anxiety symptoms, why anxiety symptoms can persist long after we think they should, common barriers to recovery and symptom elimination, and much more, the Recovery Support area has many chapters that address anxiety and recovery.

The combination of good self-help information and working with an experienced anxiety disorder therapist, coach, or counselor is the most effective way to address anxiety and its many symptoms. Until the core causes of anxiety are addressed – which we call the underlying factors of anxiety – a struggle with anxiety unwellness can return again and again. Dealing with the underlying factors of anxiety is the best way to address problematic anxiety.

Additional Resources

Return to our anxiety disorders signs and symptoms page. Information, support, and therapy for anxiety disorder and its symptoms, including Confusion Anxiety Disorder Symptoms.


1. Folk, Jim. “The Stress Response.” Anxiety Attacks,, 2020,

2. "Understanding the Stress Response - Harvard Health." Harvard Health. N.p., n.d. Web. 23 May 2016.

3. Elbers, Jorina, et al. "Wired for Threat: Clinical Features of Nervous System Dysregulation in 80 Children." Pediatric Neurology, Dec 2018,

4. Teixeira, Renata Roland, et al. “Chronic Stress Induces a Hyporeactivity of the Autonomic Nervous System in Response to Acute Mental Stressor and Impairs Cognitive Performance in Business Executives.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 2015,

5. Liston et al. “Psychosocial stress reversibly disrupts prefrontal processing and attentional control.” Proceedings of the National Academy of Sciences, 2009; 106 (3): 912 DOI: 10.1073/pnas.0807041106

6. Luethi, Mathias, et al. “Stress Effects on Working Memory, Explicit Memory, and Implicit Memory for Neutral and Emotional Stimuli in Healthy Men.” Advances in Pediatrics., U.S. National Library of Medicine, 2008,

7. McKim, Daniel B., et al. “Neuroinflammatory Dynamics Underlie Memory Impairments after Repeated Social Defeat.” Journal of Neuroscience, Society for Neuroscience, 2 Mar. 2016,

8. “Chapter 18 – Effects of Stress on Learning and Memory.” Egyptian Journal of Medical Human Genetics, Elsevier,

9. Rossman, Marni, “Effects of Stress on Short-Term and Long-Term Memory"(2010). University of Tennessee Honors Thesis Projects.

10. “Short-Term Stress Can Affect Learning And Memory.” ScienceDaily, ScienceDaily, 13 Mar. 2008,

11. Krystal, John H. “Stress, the Aging Brain, and the Mechanisms of Neuron Death.” Advances in Pediatrics., U.S. National Library of Medicine, 1993,

12. Osborne, Danielle, et al. "The neuroenergetics of stress hormones in the hippocampus and implications for memory." Frontiers in Neuroscience, 6 May 2015,

13. Kim, Eun Joo, Pellman, Blake, and Kim, Jeansok J. "Stress effects on the hippocampus: a critical review." Learning & Memory, 22 Sep 2015,

14. Abd-Elfattah Hoda M., et al. "Physical and cognitive consequences of fatigue: A review." Journal of Advanced Research, May 2015,

15. Harrington, Mary. "Neurobiological studies of fatigue." Progress In Neurobiology, 24 July 2012,

16. Vogel, S, et al. “Stress Affects the Neural Ensemble for Integrating New Information and Prior Knowledge.” Advances in Pediatrics., U.S. National Library of Medicine, June 2018,

17. Alhola, Paula, and Päivi Polo-Kantola. “Sleep Deprivation: Impact on Cognitive Performance.” NCBI PubMed, U.S. National Library of Medicine, Oct. 2007,