What causes brain fog? How to overcome the struggles
Brain fog is a word that was created by patients to describe the cognitive effects of chronic illness; for many, the causes are unclear and it is hard to cope with.
The COVID-19 pandemic led to more people experiencing chronic fatigue and other persistent symptoms. Consequently, the term “brain fog” spiked in popularity. But, what causes brain fog?
This article will explore what brain fog is, what researchers believe may lead to brain fog, and how people are coping with it.
What is brain fog?
Brain fog is a cognitive experience described by folks living with chronic conditions like chronic pain, long-COVID, and chronic fatigue syndrome.
People with brain fog describe the symptoms as:
- Difficulty thinking and focusing
- Forgetfulness, short-term memory loss and confusion
- Slow or hazy thought processes
- Variable in severity, but worsened by difficult physical or mental tasks
Due to the COVID-19 pandemic, there is a lot of recent research on brain fog. Unfortunately, brain fog is one of the most common symptoms of long-COVID or, formally, Post-Acute Sequelae of COVID-19 (PASC).
However, brain fog is not new. Brain fog is a term that patients with chronic pain, chronic fatigue syndrome, and other chronic conditions have been using for years.
The next section describes some theories from research that may explain these challenging cognitive symptoms.
What researchers think may cause brain fog
One recent paper from February 2022 proposed three possible causes of brain fog for long-COVID patients. Although they are specific for long-COVID, they can absolutely be applicable to other conditions, too.
The first cause was neuroinflammation. They proposed that a COVID-19 infection may lead to an inflammatory response. It was described as a “cytokine storm”, where inflammatory proteins (cytokines) were overproduced. The researchers thought this could affect the brain, causing neuroinflammation. This inflammatory response could disrupt typical brain function, leading to brain fog symptoms. Often, folks with chronic pain or chronic fatigue syndrome have chronic inflammation; therefore, this theory may be applicable beyond long-COVID.
The second proposed cause is sleep disturbances. Folks with long-COVID often have trouble sleeping. Poor sleep impacts cognition, especially attention and processing speed. Likewise, sleep is a big issue for many people living with chronic pain or chronic fatigue syndrome. This is termed “painsomnia” by pain patients.
Psychological factors are the final cause discussed in the paper. Many people with long-COVID reported associated mood disorders like depression and anxiety. Indeed, poor mental health could cause cognitive symptoms like trouble focusing or poor memory. However, it’s unclear whether these long-COVID patients had poor mental health as a result of their brain fog, or if they had brain fog as a result of their mental health.
Further, mood disorders are often linked with chronic pain and chronic fatigue syndrome. This could be another possible cause for brain fog in folks with pain and/or fatigue.
In several studies looking at neurological differences in patients with chronic fatigue syndrome, researchers found decreased cerebral blood flow in several brain regions when compared to healthy controls. When given mental tasks, patients with chronic fatigue syndrome performed the same as healthy controls but reported greater mental fatigue afterwards. Researchers proposed that this fatigue may come from the brain having to compensate for the lowered cerebral blood flow to achieve the task.
In summary, some proposed causes of brain fog are:
- Neuroinflammation
- Sleep disturbances
- Psychological conditions (e.g., depression)
- Decreased cerebral blood flow
How to cope with brain fog
Coping with brain fog will differ from person to person, depending on the cause or condition. When considering the first three theorized causes, there are a few lifestyle modifications that could address each. These habits would aim to improve inflammation, poor mental health, and sleep.
Lifestyle Factors:
- Stress Management
- Prioritize Better Sleep
- Exercise
- Anti-Inflammatory Diet
- Treating Untreated Mood Disorders
It’s important to note that some forms of exercise can be harmful to folks with chronic fatigue syndrome, causing post-exertional malaise. In this case, exercise would most likely increase brain fog symptoms.
One strategy that might help is to take note of when your brain fog worsens. Can you identify your triggers? Understanding what causes your brain fog can help you figure out what will help.
Other folks with chronic illness have said they use the following tools to help with their brain fog:
- Taking regular breaks
- Prioritizing the to-do list everyday (cutting down excess)
- Making lists and leaving notes
- Making time for creativity
- Going for walks
- Reducing distractions
- Avoiding caffeine, drugs, and alcohol.
If you’re interested in how to stay productive and prioritize your tasks with chronic illness, check out this awesome blog post by WorkBrighter. Further, if you want to learn more about energy management strategies, like pacing, check out our Managing Pain with Cognitive Behavioral Therapy course.
In conclusion…
Brain fog is mysterious, stressful, and debilitating, but fortunately there is a lot that could improve the distressing symptoms. It is a matter of finding what works for you!
References
Callan, C., Ladds, E., Husain, L., et al. (2022). “I can’t cope with multiple inputs: a qualitative study of lived experience of ‘brain fog’ after COVID-19. BMJ, 12. DOI: 10.1136/bmjopen-2021-056366
Ocon, A.J. (2013). Caught in the thickness of brain fog: exploring the cognitive symptoms of Chronic Fatigue Syndrome. Frontiers in Physiology, 4(63). DOI: 10.3389/fphys.2013.00063
Krishnan, K., Lun, Y., Prewitt, K.M., et al. (2022). Multidisciplinary Approach to Brain Fog & Related Persisting Symptoms of Post COVID-19. Journal of Health Service Psychology, (48). DOI: https://doi.org/10.1007/s42843-022-00056-7