How Does Anxiety Affect Cognitive Ability?

Cognitive Ability

Are you an anxious person who struggles to remember directions, appointments, or what your spouse asked you to get at the supermarket? Do you have trouble concentrating, and processing information, or seem to lack mental sharpness? Do you find it hard to make decisions? These hallmark symptoms of brain fog may result from any number of factors such as a bad night’s sleep, hormonal shifts, or simply doing too much. Brain fog can also occur after recovering from an illness like COVID. But for some people there’s another, often overlooked driver of brain fog: anxiety.


Threat-related anxiety monopolizes neural resources, leaving the brain with a reduced capacity to handle other mental tasks. Click To Tweet

A mounting body of evidence has revealed a link between anxiety and impaired brain structure and function. While a little anxiety is normal and even necessary at times, too much is not good for your brain!

For the roughly 19.1% of Americans estimated to have struggled with an anxiety disorder in the past year—especially women, teens, and those with ADD/ADHD—knowing the negative impact anxiety can have on cognitive function is critical to getting help for both conditions.


Anyone who has struggled with anxiety knows how debilitating it can be. Common symptoms such as racing thoughts, worry, rumination, nervousness, restlessness, panic, rapid breathing or heart rate, gastrointestinal distress, tense muscles, trembling, chest pain, sweating, dizziness, and difficulty sleeping can feel unbearable at times. Yet, still, many who suffer from anxiety don’t seek accurate diagnosis and treatment. Untreated anxiety can get worse over time, and it can be very dangerous to your cognitive health.

In today’s world of myriad anxiety-stoking stressors, the body’s fight-or-flight stress response, which is supposed to kick in on the occasion of a real or perceived threat, is engaged nearly all the time. This high-alert state causes the stress hormone cortisol to stay elevated, fueling anxiety.

When cortisol levels remain high over time, it can adversely impact the hippocampus, an area of the brain critical to learning and memory, research has found. Additionally, it appears that threat-related anxiety monopolizes neural resources, according to research, leaving the brain with a reduced capacity to handle other mental tasks.


It’s not surprising then that a study published in the Journal of Neuroscience found significantly reduced hippocampal size associated with participants who suffered from anxiety. Another more recently published scientific review paper observed a similar association and warned that untreated pathological anxiety and chronic stress could potentially cause structural degeneration and impaired functioning of the hippocampus, as well as the prefrontal cortex—resulting in an increased risk of dementia.

Indeed, researchers have discovered a strong association between anxiety, chronic stress, and impaired memory function—including increased risk of Alzheimer’s disease, according to one 38-year longitudinal study published in Neurology.

Also very concerning is anxiety’s apparent detrimental influence on working memory. A 2019 meta-analysis involving more than 500 participants found that increased anxiety was associated with impaired measures of verbal and visuospatial working memory.

A strong working memory is at the core of healthy cognition. Your working memory allows you to receive information and engage with it temporarily, kind of like a mental notepad or workspace. It facilitates planning, comprehension, reasoning, and problem-solving. You use your working memory when you do mental arithmetic, follow instructions, or rehearse.


Anxiety appears to adversely affect more than memory; it disrupts executive functions of your brain’s prefrontal cortex as well. A 2017 study found that stress and anxiety affected attention and cognitive abilities. Specifically, they were observed to considerably impair decision-making and sustained attention.

Impaired decision-making and associated activity in the prefrontal cortex were observed in an additional study that examined anxiety and “selection” among options. Examples of this type of cognitive function might include making selections at the grocery store or choosing a word to fittingly express a thought of feeling.

Regarding attention, a study found that in high-anxiety people, there’s a visual narrowing of the scope of attention to a central point—while compromising attention on stimuli in the periphery of one’s visual field. Additionally, research has linked anxiety with delayed processing (sluggish cognition) of tasks requiring concentration in the prefrontal cortex.


On a brighter note, brain SPECT imaging at Amen Clinics has shown that there are 7 brain patterns associated with anxiety, and all of them can be managed once properly diagnosed. You can also facilitate healing and better functioning of your brain’s hippocampus and prefrontal cortex by practicing brain healthy habits. Below are 5 tips for managing anxiety and supporting better brain function.


1. Try Psychotherapy

There are many causes of anxiety. To identify what’s driving your own anxiety, psychotherapy can help. But there are many therapeutic options to help address anxiety including EMDR (Eye Movement Desensitization and Reprocessing), cognitive behavioral therapy, hypnotherapy, and more.

2. Kill Your ANTs

Automatic negative thoughts, or ANTs, fuel anxious thinking. Hallmark signs of false negative thinking include all-or-nothing thinking, blaming others, and catastrophic thinking. Writing down the negative thought, asking if it is absolutely true, and imagining how you would feel without the thought is one easy way to reduce ANTs. When practiced consistently over time, your thinking can improve.

3. Practice Diaphragmatic Breathing

In as little as 2 minutes, you can calm anxiety with diaphragmatic breathing.  Simply lie down on your back and place a book on your stomach (the belly, not the chest, should rise and fall with the breath). For 4 seconds take in a slow, deep breath, hold for a second, and breathe out for 8 seconds. Practice this a couple of times every day until it feels natural. Use it when anxiety surfaces in response to a sudden stressor.

4. Exercise Regularly

Moving your body doing exercise you love will boost your mood while helping to lower cortisol levels, which tend to be high in anxious people. Exercise also increases blood flow to the brain, which is one of the best things you can do for improved brain function.

5. Eat Brain-Healthy Foods

Sugar and refined carbohydrates may soothe anxiety in the short term, but they tend to increase anxiety levels in the long run. Avoid them. Artificial sweeteners can elevate cortisol levels, which may trigger anxiety. These foods are also associated with blood sugar spikes and reduced blood flow to the brain, which compromises brain function.

Eating brain-healthy foods—such as fresh fruits (especially berries) and vegetables, loaded with vitamins, antioxidants, and phytonutrients, as well as whole grains, lean protein, and healthy fats—truly fuels your brain and helps to optimize brain function.


This information is not intended to increase anxiety, but rather to inspire you to take care of your brain health every day. If anxious feelings or brain fog symptoms are troubling you, be sure to reach out to a mental health professional for help.

Anxiety, brain fog, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.


  1. Can you refer me to a specialist in the AnnArbor,MI area who can help me with MDD,anxiety, MCI and CPTD since infancy?l’m 75 and desperate for help that I can get to in the area. Your help is most appreciated. Thank you.

    Comment by Diane Lynn Evans — December 28, 2022 @ 12:47 PM

  2. How do you help your teen with ADHD and severe anxiety who is on a destructive path and won’t accept help

    Comment by Leah — January 3, 2023 @ 10:39 AM

  3. I've had very bad anxiety for years now , my psychiatrist has tried every medication you can think of and I've had to many side affects even on the lowest doses, I'm 34 years old and desperate for help 🙏

    Comment by Jaimie — January 13, 2023 @ 3:10 AM

  4. My wife has been suffering with depression and anxiety for many years now. Medicine has not worked, TMS, Ketamine and ECT also did not work. Brain fog all the time. What do we do?!

    Comment by Walter Kalinoski — January 13, 2023 @ 6:02 AM

  5. I haven’t left the house for 3 years except for doctor appointments . I take 12 medication‘s and I have no idea if any of them are for anxiety. I feel like I’m just been in my wheels here. I have been trying for 12 years to figure out why I can’t think straight. I have been referred to the EMDR Therapy but I am unable to find anyone in my area who offers it. My doctor orders all these tests and then they never follows up with anything. I’m a patient at UC health in Northern Colorado. I spent 2022 thinking these people could somehow figure something out, but I was wrong.

    Comment by Bobbi — January 13, 2023 @ 7:33 AM

  6. Please stop the "artificial sweetner" bashing. I am an RDN (Registered Dietitian Nutritionist) and know you are making statements about "sugar substitutes" (better name) and you cannot group them together as all bad and don't back up what you say with research on humans. Much of what you say has been debunked. There's much more to the "other side" you do not balance it with. The American Academy of Nutrition and Dietetics (AND) does not share your view and has published a position paper on it, although it needs updating.

    Comment by Janet DaPrato — January 13, 2023 @ 7:50 AM

  7. Hello, I have been diagnosed with Vascular Dementia, I am 76 years old female wt 144 lbs 5'6". I feel extreme anxiety 90% of my awake time. I am well educated, however, I can't read a book for more than 1/2 page and I need to put it down. My family is supportive of me, sometimes they forget I cannot process my thoughts and decisions quickly. I feel as if I am out on a string floating around, afraid I will get lost or in general fail on a task. I feel as if my anxiety can be controlled, my mind will follow. TY

    Comment by Sondra Wheeley Myers — January 13, 2023 @ 9:55 AM

  8. Are there any clinics near the west coast of Fla as I live in Sarasota?

    Comment by Doreen Holstein — January 13, 2023 @ 10:18 AM

  9. What supplements can help with generalized anxiety?

    Comment by Brenda — January 15, 2023 @ 2:42 PM

  10. Hello Brenda, thank you for reaching out. For more information about Dr. Daniel Amen's recommended, brain-directed supplements, please visit:

    Comment by Amen Clinics — January 19, 2023 @ 8:11 PM

  11. Hello Doreen, thank you for reaching out. Amen Clinics currently has 11 locations nationwide. Our closest clinic to the west coast of Florida is in Hollywood, FL:

    Comment by Amen Clinics — January 19, 2023 @ 8:14 PM

  12. Hello Bobbi, thank you for reaching out. For more information about SPECT scans and our services, please contact our Care Coordinators:

    Comment by Amen Clinics — January 19, 2023 @ 8:16 PM

  13. Hello Walter, thank you for reaching out. For more information about SPECT scans and our services, please contact our Care Coordinators:

    Comment by Amen Clinics — January 19, 2023 @ 8:17 PM

  14. Hello Jaimie, thank you for reaching out. For more information about SPECT scans and our services, please contact our Care Coordinators:

    Comment by Amen Clinics — January 19, 2023 @ 8:17 PM

  15. Hello Sondra, thank you for reaching out. For more information about SPECT scans and our services, please contact our Care Coordinators: Here are some additional resources:

    Comment by Amen Clinics — January 19, 2023 @ 8:20 PM

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