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Clinician handoff

Trauma

Designed for a 60-second scan in primary care. Use this to explain why this theory fits, what would weaken it, and which tests are most worth discussing.

Why this still fits

I want to evaluate whether trauma-related nervous-system activation or shutdown is contributing to my brain fog and how to distinguish that from depression, anxiety, or PTSD overlap.

What would weaken it

  • -No trauma history, no trigger-linked worsening, and no shutdown or hypervigilance pattern around the fog.
  • -The symptoms behave more like depression, sleep apnea, or another medical cause than a threat-state nervous system pattern.
  • -The fog doesn't meaningfully change with safety, triggers, or trauma-state shifts.

Key points to communicate

  • I want to know whether this is trauma-state brain fog itself or another cause layered on top of trauma history.
  • Please separate shutdown, dissociation, and hypervigilance from depression, anxiety, and sleep disruption.
  • If trauma is central, I want to know which trauma-focused treatments are most likely to help cognition.
  • Could any of my current medications be contributing to cognitive symptoms?
  • Would neuropsychological testing help clarify whether this is trauma-related or something else?

Bring this to the visit

  • A timeline of when cognitive symptoms started relative to traumatic events.
  • Current coping strategies and any substance use.
  • Sleep quality data: nightmares, insomnia, hypervigilance at night.
  • Current therapy and medication details.

Useful screening structure

  • -ACE questionnaire (Adverse Childhood Experiences) for developmental trauma.
  • -PCL-5 if PTSD is a possibility.
  • -PHQ-9 for depression and GAD-7 for anxiety screening.

Tests and measurements to discuss

Trauma Assessment

PTSD Screening (PCL-5)

What this helps clarify: Patient-facing PTSD Checklist route used when trauma symptoms may be driving the cognitive picture.

Range context

0-80 score bands

How to use the result

Save the result with date and symptoms from the same week.

ACE Questionnaire

What this helps clarify: The ACE questionnaire counts types of childhood adversity: abuse, neglect, and household dysfunction before age 18.

Range context

0-10 (count of adverse childhood experience types)

How to use the result

Save the result with date and symptoms from the same week.

Sleep Assessment

What this helps clarify: This is here to make sure the story is not being driven by sleep-disordered breathing or chronic sleep disruption that could mimic or amplify the primary cognitive pattern.

Questions to ask directly

  • Is the fog from trauma itself (dissociation, hypervigilance exhaustion) or from co-occurring depression/anxiety?
  • Should we screen for medical causes alongside trauma-informed care?
  • Would somatic-based therapy (EMDR, somatic experiencing) be more effective than talk therapy for cognitive symptoms?
  • Are my current medications contributing to the fog?

Functional impact snapshot

  • -Track fog against stress levels, sleep quality, and dissociation episodes.
  • -Rate whether therapy sessions temporarily worsen or improve cognitive function.
  • -Note whether body-based regulation (exercise, breathing, grounding) shifts the fog.

Escalate instead of self-managing if

  • Suicidal ideation, self-harm, or safety concerns.
  • Severe dissociation causing dangerous situations.
  • Substance use escalation as a coping mechanism.

Peer-reviewed references

  1. 1. Felitti et al., Am J Prev Med 1998 - ACE Study [DOI]
  2. 2. Scott et al., Psychol Bull 2015 - Neurocognitive functioning in PTSD meta-analysis [DOI]
  3. 3. HTTPS://WWW.PSYCHIATRY.ORG/PSYCHIATRISTS/PRACTICE/DSM [DOI]
  4. 4. HTTPS://WWW.NICE.ORG.UK/GUIDANCE/NG116 [DOI]