Difficulty concentrating can be a sign of brain fog; see how to take care

I have trouble remembering things, and I often feel exhausted, as if I can’t “clear” my head. Is this brain fog? And what can I do to solve it?

Mental “white”, when it appears, can be confusing. What did you just say? Did you need to buy chicken and carrots on the way home, or was it just chicken? Why is it suddenly so hard to focus on what you’re doing, and why does your brain feel 30 years older than you are?

If you’re feeling sluggish and forgetful, get easily distracted, or become completely overwhelmed by mundane tasks, you may be experiencing a common phenomenon known as brain fog.

While not an official clinical diagnosis that would end up on a medical record, brain fog can arise after several sleepless nights, when taking certain medications, such as antihistamines, or as a result of “jet lag,” among many other scenarios.

Some people experience brain fog after a big meal, during particularly stressful times in life, or when they go through major hormonal changes, such as during pregnancy or menopause.

The condition can also be a symptom of illness like lyme, lupus and multiple sclerosis, after cancer treatment or even during a particularly bad cold.

In recent years, the term has also started to be associated with the cognitive impairment that many people experience during or after Covid-19.

Approximately 20% to 30% of Covid patients have brain fog that persists or develops during the three months after the initial infection, and more than 65% of those with long-term Covid also report neurological symptoms.

“It’s becoming a neurological health crisis,” said Michelle Monje, a Stanford University neurologist who has studied cognitive impairment related to chemotherapy and the coronavirus.

When should you see a doctor?

Brain fog can be frustrating and worrying, no matter when or how you feel it. Cognitive problems can wax and wane, both in Covid-19 and other types, said Jacqueline Becker, a clinical neuropsychologist at Mount Sinai Hospital in New York.

But if symptoms persist for several weeks or make life extremely difficult, you should seek medical evaluation.

“Some people are able to continue their work and their normal lives, but may need to take more frequent breaks between tasks,” Becker said. “And there are others who are completely crippled by it.”

How is it diagnosed?

While brain fog seems vague and temporary like bad weather that gets better with time, research is starting to show that it can affect some people for months and dominate many aspects of life compared to the usual sluggishness or forgetfulness.

It tends to affect executive function — a set of skills essential for planning, organizing information, following instructions and practicing various tasks, among other things.

“When executive function is impaired, it often affects multiple domains of cognitive ability,” Becker said.

Many doctors prefer to use the term “cognitive impairment” to give more medical legitimacy to what patients go through, and begin the diagnostic process with cognitive tests used to measure function in serious conditions like dementia, Becker added.

The main difference is that brain fog doesn’t get progressively worse, the way mental abilities degenerate with dementia. You may have some days worse than others, but brain fog tends to impair your cognitive function to the same degree each time.

A variety of blood tests can also help pinpoint some causes of cognitive impairment, such as sleep apnea, vitamin B deficiency, or other hormonal and thyroid problems, said Joanna Hellmuth, a neurologist at the University of California, San Francisco.

But because brain fog can present itself in so many different ways, and because it has so many diverse causes, diagnostic tests have limitations, she added.

Sometimes the condition can be difficult to diagnose because it is caused by many factors, even for a patient who has a comprehensive condition.

Someone with lupus or multiple sclerosis, for example, may have cognitive impairment because of direct damage to brain cells — but they also may not be getting enough sleep, may have extensive fatigue or take medications that contribute to brain fog.

How do you get rid of brain fog?

Even if doctors can’t find a physical cause for brain fog, there are steps you can take to manage it, Hellmuth said. Start with short-term adaptive strategies for everyday tasks. Write notes and set alarms so you don’t miss appointments.

Take regular breaks during long projects to stay focused and get things done. You can also try tracking your daily activities using an app on your phone or laptop to find out what times of day you feel most energetic and clear-headed. So set aside that time to do more difficult or complicated tasks.

Your doctor may also suggest lifestyle changes to improve your overall health and energy. “We try to encourage cardiovascular exercise, a good diet, sleep and social activities that are known to be beneficial for the brain,” said Hellmuth.

Physical activity can help improve your ability to focus, as well as increase neural connectivity and memory formation in the brain. If you don’t like rigorous workouts, try doing them in small chunks so you can slowly build up your aerobic fitness.

Stay hydrated and eat a variety of foods rich in vitamins and antioxidants. And seek support from friends and family. Studies have shown that maintaining a good social network not only helps reduce stress in difficult times, but can also increase intellectual stimulation and improve brain health.

Rest better, which of course is easier said than done for patients with long-term Covid, those undergoing chemotherapy or undergoing life changes such as pregnancy or menopause. Take steps to relax your mind at night. Unplug your electronics and create a peaceful environment.

Translated by Luiz Roberto M. Gonçalves