Brain
fog, characterized by difficulty focusing, sluggish thinking, and memory lapses, is a common symptom
of long COVID-the complex condition that sometimes emerges after a case of
COVID-19. But brain fog is not unique to
long COVID. Chronic insomnia and other
consistent sleep troubles, as well as head injury, stroke, depression, cancer
therapies, and drug side effects, can lead to a similar, often troubling mental
cloudiness.
There is no perfect treatment for brain fog, but doctors may be able to treat some of the conditions that can cause it, says Zaldy Tan, MD, director of the Bernard and Maxine Platzer Lynn Family Memory and Healthy Aging Program at Cedars-Sinai Medical Center in Los Angeles. It is unlikely you will be able to clear up brain fog instantly. But here is what we know about it, and what experts say you should do if you are experiencing brain fog.
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UNDERSTANDING BRAIN FOG
People who report brain fog describe it as “the sense they cannot do cognitively what they could before…. they do not feel as mentally sharp,” says Steven Flanagan, MD, chair of rehabilitation medicine at the New York University Grossman School of Medicine. People may report problems multitasking, articulating words, or finding things around the house, Tan says.
Brain fog differs from cognitive changes that can occur with age, Flanagan and other experts say. While it is not uncommon for the retrieval of information to get slower with age—taking longer to recall a name, for example—what doctors consider brain fog tends to come on more abruptly and is often linked to a specific event, such as a head injury or COVID-19. But factors associated with aging could increase the risk of brain fog, such as taking multiple meds. And brain fog is distinct form dementia, which is a progressive condition.
The exact biological causes of brain fog are not clear, says Ramon Diaz-Arrastia, MD, PhD, director of the Traumatic Brain Injury Clinical Research Center at the University of Pennsylvania in Philadelphia and a member of the American Neurological Association. Damage to the small blood vessels or to the neuronal connections within the brain could potentially play a role, he says. And in many cases, stress or anxiety could exacerbate symptoms. Many experts think the cause could also be inflammation lingering in the brain after COVID-19 or head trauma, Flanagan says.
WHAT YOU CAN DO TO CLEAR UP BRAIN FOG
Diaz-Arrastia says that potential solutions will depend on the exact nature of someone’s brain fog and how it is affecting their daily life. So, your initial step should be consulting a physician and explaining your symptoms. Your provider may refer you to a neuropsychologist for a formal cognitive assessment. That might lead to therapy to identify cognitive strengths that can compensate for impairment. Here are some other strategies that doctors might suggest that can help to ease brain fog.
LIMIT MEDS & ALCOHOL: Tan says one of the first things to do is cut back on alcohol and try to eliminate unnecessary medications, especially any drugs known to leave people feeling foggy. Those can include tranquilizers, as well as pills used to treat insomnia. But ask your doctor before stopping meds.
IMPROVE SLEEP: An episode of jet lag can cause short-lived brain fog, but people with chronic sleep problems can experience this consistently. Practicing good sleep hygiene may help, Flanagan says. That means having a consistent bedtime, sleeping in a cool, dark room’ and avoiding screens for an hour before bed. “Sufficient and particularly regular sleep is important….to maintain healthy brain functioning,” Diaz-Arrastia says.
EXERCISE: For those who can do aerobic exercise, there’s good evidence that it may help clear mental fogginess. Someone with severe brain fog should work with a physical therapist, however. Trying to exercise solo can be risky in this case, Diaz-Arrastia says. Getting the correct dosage of exercise is important, and too much can exacerbate long COVID symptoms.
REDUCE YOUR COGNITIVE LOAD: Take steps to put less stress on your memory, Tan says. Consider relying on lists instead of your memory, for example, and try to avoid multitasking until you feel better.
ADDRESS MENTAL HEALTH: People who have depression can develop brain fog that affects memory and lasts for months or years, Tan says. Therapy or antidepressants may help ease brain fog, a well as other symptoms.
Editor’s Note: This article also appeared in the August 2022 issue of Consumer Reports on Health.
