I Live With a Host of Conditions That Trigger Brain Fog—Here’s How I’ve Learned to Deal With It

I experienced brain fog for a long time before finding out it had a name. Indeed, struggling to find the right word, an inability to focus, and unfeasibly short concentration spans have been familiar challenges throughout my adult life.

Now, experts recognize that people with a wide range of health conditions and circumstances can experience brain fog, which Irish neuroscientist and psychologist Sabina Brennan, PhD, defines as a collection of symptoms that affect cognitive domains like attention, memory, learning, processing speed, language, spatial navigation (aka, finding your way around the world), and executive function.

“Essentially, it leads to a loss of mental clarity and mental fatigue,” says Brennan, who’s author of the book Beating Brain Fog: Your 30-Day Plan to Think Faster, Sharper, Better.

Brennan explains that brain fog is not a disease or a diagnosis of its own. Rather, “it is a sign that something is amiss.”

My brain fog triggers

Because I have several health problems, it can be difficult to pinpoint which of them is causing brain fog. I have endometriosis, for instance (which wasn’t diagnosed until I was 21, though my symptoms had been glaringly obvious for seven years by that point). I was diagnosed with polycystic ovary syndrome (PCOS) at the same time, and later with post-traumatic stress disorder (PTSD) and a rare neurological condition called sensory ganglionopathy that affects me in myriad unusual ways.

Sometimes I know why my brain is foggy. If my period has just started and everything hurts, then it’s fairly clear that I can’t concentrate because I’m either in too much pain or because I’ve taken painkillers that mute my thinking as much as they dull the gnawing agony. If I’ve just watched a documentary about a trauma similar to my own, it seems obvious that it’s a PTSD flare-up that’s interrupting my ability to remember the right words in a Zoom meeting at work. If I’ve been kept awake all night with electric-shock pains in my legs from my sensory disorder, it’s the pain and lack of sleep that affect my capacity to excel in my tasks the next morning.

Sometimes it’s not that clear. If I’m having low-level symptoms of several conditions and I can’t remember my PIN to pay by card at the supermarket, it’s impossible to identify which diagnosis is affecting my cognitive abilities at that particular moment. But trying to work it out just adds to the mental exhaustion and doesn’t usually serve a useful purpose.

On a good day, I can think, I can function, I can speak coherently, and I can remember what I’m doing. On a bad day, though, I struggle through meetings, assignments, and life in general.

What else causes brain fog?

Most people have experienced brain fog at some point. Whether you can’t function for a few days when you have jet lag, or you feel extra forgetful while caring for a new baby, that fuzzy feeling of not quite being able to pin down your thoughts or stay focused on a task is familiar to many.

It only becomes a true problem, though, when your cognitive and memory difficulties are prolonged.

Reliable statistics are difficult to come by, because brain fog isn’t a medical diagnosis in itself, but March 2022 research in the Journal of the Neurological Sciences¹ suggests that, three months after getting COVID, 20 to 30 percent of people have symptoms that could be described as brain fog. Of those diagnosed with long COVID, up to 85 percent² experience these thinking issues.

Other conditions that can be associated with brain fog include perimenopause, diabetes, fibromyalgia, chronic fatigue syndrome, traumatic brain injury, mental health problems like anxiety and depression, autoimmune diseases, neurological conditions like multiple sclerosis, and the side effects of chemotherapy, Brennan says.

A further cause of brain fog can be medications, including painkillers and anti-histamines, though Brennan points out that if you believe a medicine is causing your problem, you should never stop taking it without first talking to your doctor. She is also keen to highlight the role of lifestyle factors in causing symptoms of brain fog, naming nutritional and dietary deficiencies, poor sleep, chronic stress, and lack of exercise as key contributors to the problem.

How I cope with brain fog

It would be nice to be able to stop and rest every time brain fog attacks, but, like most people, sometimes I have to struggle through. If I don’t work, I can’t pay my rent. If I don’t go out and socialize even when I’m tired and sore, I become miserable. If I don’t engage in hobbies, I become somebody who does nothing but work and sleep, and that leaves me bored—and boring.

But there are better approaches to dealing with brain fog than mainlining caffeine and trying to bully myself into thinking clearly.

Brad Merker, PhD, a neuropsychologist with Henry Ford Health in Michigan, tells me that resolving the underlying issues is vital to getting on top of foggy brains and blurry thinking.

“You treat your sleep problems, you resolve the fatigue, you hopefully resolve the brain fog,” he says. “You treat your underlying depression or anxiety, you no longer feel that fog or the difficulties with attention and memory.”

Addressing the lifestyle factors Brennan identifies as triggers, including nutritional and dietary deficiencies, poor sleep, lack of exercise, and chronic stress, is also a great place to start. And while that may feel like a tall order, it honestly feels more appealing than forcing myself through the blur day after day.

At the same time, daily life has to continue so, ultimately, I have learned to push through and find workarounds. For example:

• It hurts to stand up? I can work in bed to reduce the need for painkillers.
• I can’t think of the right word when I’m speaking? I can send an email instead of making a call.
• I forget what I’m doing? I can create endless to-do lists and write everything down, even the stuff that seems obvious.

I’ve had years of brain fog, and I’m still learning about what helps and what doesn’t. Some of the more positive approaches I take include:

• Flexi-time: Being able to work, as much as possible, on my own timetable helps me manage fatigue, reducing how debilitating symptoms are.
• Knowing my patterns: I know that early mornings and mid-afternoons are not times I can think efficiently. I delegate mindless-but-necessary tasks to these slots, to avoid wasting my more productive hours with busy work.
• “Outsourcing” my brain: If I have to do it, it’s on a list or in my calendar. If the list is complex, it may become a diagram or a timetable. Reducing the load on my working memory frees up my capacity to concentrate.
• Not beating myself up: Yelling at myself when I can’t focus on an important task does not help. It risks creating a vicious cycle where self-recrimination makes me more miserable and thus even more prone to brain fog.

Merker agrees that self-blame is not “a helpful way to conceptualize things” when we are dealing with brain fog, telling me, “You may not be able to think your way out of it, and having that belief tends to lead to low self-concept,” as well as irritability, frustration, and low mood.

Merker recommends paced activity schedules for people who are struggling with fatigue, such as “taking frequent breaks, doing things early in the morning or after a nap, and spreading things out over a longer period of time.”

For those with memory difficulties, he adds alarm clocks and memory books as more ways to “outsource” our brains.

Brennan, who studies brain fog and also experiences it herself, has more suggestions that can help people to manage their limited mental energy in the most efficient and pain-free way possible.

She highlights the importance of prioritizing and insists that we stop trying to multitask.

“We’re brought up [believing] that females are brilliant at multitasking. It’s an absolute myth because your brain can’t multitask. So what you’re doing is task-switching at millisecond levels. And all the research shows that if you multitask, it comes at a cost. And that cost is more errors and taking a longer time.”

Brennan is also a fan of a restorative nap, but only with a strict, 15-minute limit, “to avoid becoming sleep-drunk” by waking up during the deep-sleep stage of the sleep cycle.

Removing distractions can also help. Brennan tells me she struggles with the overwhelming visual stimulation of clutter and that clearing her space helps her to focus and concentrate.

When to get help for brain fog

If we wait until we’re completely burned out by pushing through symptoms of brain fog, it is harder to recover than if we address the problem early on. On the other hand, we don’t want to bother the doctor every time we’re a bit sleepy in a morning meeting.

I asked Merker when the best time to seek help was: “I wouldn’t wait extended periods of time, but if it’s been present for a few days, definitely start the process with a primary care doctor, who can then do a basic workup and refer you to whatever specialist might be needed.”

He also recommends using a journal to track symptoms and any factors that might influence them, to help you understand your condition more clearly, and to help the doctor, too. This is especially the case if one aspect of your woolly thinking is that your memory is impaired; it will help you to communicate the things you need to say that you might not be able to recall on the spot.

Brennan agrees, comparing the vagueness of saying “I have brain fog” as similar to saying “I have pain”—the doctor needs to know the details to work out what you need.

A hazy “I just can’t think!” won’t guide your health care professional to the conditions she should screen for, whereas “I struggle to find the right words and I keep forgetting what I’m supposed to be doing, and it’s worse just before my period” might give her a head start.

When Merker starts working with a patient who has brain fog, he begins with “a good thorough clinical interview and a review of medical records,” explaining that “because it’s such a vague term, we’re trying to get a better understanding of the medical causes of their brain fog.” He may then conduct testing to assess a person’s cognitive dysfunction to truly understand what’s going on with them, so that he can “offer better recommendations if it’s actually a problem with attention or memory or processing speed, or maybe we find that’s that there’s some psychological issues.”

Specific treatments for the underlying cause of the brain fog can then be undertaken.

So while brain fog can be utterly debilitating and demoralizing, the situation is not hopeless. There are ways to mitigate the difficulties, and addressing the underlying causes can go a long way to help us function.

It can also be a sign that we’ve simply got too much on our plates. Brennan finds that lists can help us realize which tasks are not, in fact, important after all: “One real bonus of lists is that, actually, after a period of time, you will find there’s a bunch of tasks that are frequently at the bottom of the list. And the world hasn’t fallen apart because you didn’t do them. Maybe you just need to knock them off your to-do list and say, ‘They’re just adding to my brain fog.’”

Isn’t that a message we all needed to hear?

—reviewed by Smita Holden, MD