Thursday 18 February 2021

Here’s Why You’re Dealing With Brain Fog—and What You Can Do to Fight It

 Safe to say we’re all feeling more than a bit overwhelmed with the state of the world right now. And that can lead to some fuzzy-brain moments, says Jessica Caldwell, Ph.D., a neuropsychologist and the director of the Women’s Alzheimer’s Movement Prevention Center at Cleveland Clinic. “It’s tempting to think that brain fog won’t happen until you’re much older, but I see it in so many patients at every age—and stress is a known trigger,” she says.

Take Delia Lewis*, a marketing strategist from Manalapan Township, NJ. Three months into the COVID-19 pandemic, Delia started feeling a little foggier than usual. She’d sit down at her desk in her new home office and begin doom-scrolling instead of answering emails. Tasks she used to rip through in 10 minutes started taking an hour. On calls with her manager, she had to type madly as they talked so she could remember her to-do’s. “Usually I can keep all the balls in the air,” says Delia. “Now I’m like, ‘What did you want me to do?’ ”

Stress is certainly a big factor behind that fuzzy feeling, experts say: In fact, being frazzled creates toxins that can build up in your brain and impact your ability to focus, concentrate, and remember multiple things, according to Sandra Bond Chapman, Ph.D., chief director of the Center for BrainHealth at the University of Texas at Dallas. “We all do things that wear out the brain, and then we wonder why we’re not as clearheaded as we used to be,” she says. “When our bodies are fatigued, we recognize that we need to rest. But when our brains are tired, we tend to slog through.” Yet the more you ignore brain fog, the more it builds up—and the more likely it is that you’ll keep having unproductive days and many “it’s on the tip of my tongue” moments.

On the flip side, if you start implementing simple strategies that will give your gray matter a rest, you’ll start feeling clearer—quickly. “Science has revealed the surprising truth that you can actually do more to make your brain healthy than any other part of your body,” says Chapman. Here’s how.

What is brain fog, exactly?

When Delia started feeling a little less sharp and a lot more distracted than usual, she chalked it up to Zoom meeting fatigue, not being able to blow off steam at the gym, and the sudden lack of socializing with friends. She figured some extra sleep and a little time would help her adjust to our collective new normal. But when her symptoms persisted, she saw her doctor, who told her she was likely dealing with brain fog—not a technical diagnosis exactly, but a term many people use when they feel absentminded or not as sharp as they used to be or have difficulty focusing. Other symptoms include being more forgetful than usual or sluggish when you’re trying to remember things—almost as if you can feel your brain chugging but not firing on all cylinders, says Caldwell.

There’s actually a physiological reason why it’s so common, adds Gayatri Devi, M.D., a clinical professor of neurology at SUNY Downstate Medical Center and an attending physician at Lenox Hill Hospital in New York City. Of the trillions of neurons in your brain, just 10,000 to 20,000 secrete a neuropeptide called orexin, which research shows is one of several circuits that keep us awake and alert. “It’s astounding that our wakefulness and arousal is controlled by such a small number of nerve cells—and easy to see how this part of the brain system might be easily impacted,” says Dr. Devi. The good news is that our brains are hard-wired to be alert. That’s what helps us react so quickly to our environment. Yet the fact that such clarity is our brain’s go-to mode helps explain why brain fog can feel so disorienting—and stressful.

“When my brain fog is bad, I feel totally overwhelmed way sooner than I otherwise would,” says Lila Jones*, a wellness coordinator for a nonprofit who has been dealing with brain fog for a few years. “Everything just gets harder—driving is more stressful, multitasking at work is nearly impossible, and I’m not as with it in conversation. It just feels like my brain is in molasses, which is no fun.”

What causes brain fog?

There are a number of reasons your mind may feel foggy, says Chapman. When Delia’s brain fog settled in and nothing she tried—extra sleep, meditation, even a week off from work—seemed to help, she got a little nervous: “I started wondering if I was really sick.”

Though brain fog isn’t on the official list of symptoms of COVID-19, Delia’s doc made sure to rule it out, as some infections—including the novel coronavirus—can present with brain fog. “It’s especially common in infections that affect the upper respiratory system, because reduced oxygen flow to the brain and fever can lead to mental impairment,” Dr. Devi says. “While brain fog isn’t a common symptom of COVID, it can happen—and we’re seeing it as an ongoing complication for those who are recovering.”

The most likely causes of brain fog, it turns out, are things that many of us are dealing with right now (or will at some point), including:

✔️ Stress

The human body is amazing at adapting in the face of tension. When we perceive that we’re in danger, the brain releases a cascade of neurochemicals and hormones to help us mobilize (hello, fight-or-flight mode!). But this cocktail is only meant to pump through our bodies for a limited time, Caldwell says, and these substances exhaust our brains when they stick around longer than they should. “That’s why there’s a feedback loop built into the system,” she says, “where your brain eventually gets a message that says, Let’s shut this stress hormone release down—there’s no acute threat anymore.

One part of the brain that gets this shutoff signal is the hippocampus, which is responsible for taking in new information and consolidating it into long-term memory storage. Unfortunately, when stress becomes chronic (say, when you’re trying to work from home, homeschool your kids, and navigate the world during a global health pandemic), the brain stays in protection mode and doesn’t get the message to turn off that stress hormone cascade. The result: The hippocampus gets tired out, and over time its cells start to die, this important area of the brain begins to shrink, and brain fog can set in.

✔️ Not enough sleep

This is one of the biggest culprits behind brain fog simply because it makes you feel less alert. Not getting enough zzz’s also means you miss out on important brain cleansing that happens when you’re snoozing soundly, adds Caldwell.

For example, research in the journal Science found that the ebb and flow of blood and electrical activity that takes place during sleep actually triggers cleansing waves of blood and cerebrospinal fluid—prompting scientists to call sleep the brain’s “rinse cycle.” “Sleep is when your brain reviews new information and consolidates it, helping you form more stable, long-term memory,” Caldwell says. “It’s a time when unneeded stuff is cleared from the brain.” (Bonus: This cycle also clears amyloid, the substance involved in Alzheimer’s, from the brain, research shows.)

✔️ Menopause

Yes, mood swings and night sweats often show up during perimenopause, but Dr. Devi says brain fog is a major symptom that’s too often overlooked. “I’ve actually had patients misdiagnosed with dementia and Alzheimer’s disease when really it was menopause-related brain fog,” she says.

Before this hormonal transition, estrogen gives the female brain a big advantage in a number of ways. Remember the hippocampus, the part of the brain important for memory and speech? It’s also home to a slew of estrogen receptors. “Think of those receptors as being like little docking sites for estrogen that are spread out across the hippocampus,” says Dr. Devi. When estrogen takes a dip during perimenopause, those sites don’t get what they’ve long relied on, and as a result, the brain has to adjust, which can feel like brain fog, adds Caldwell. “It’s your brain figuring out how to work without as much estrogen as it’s used to.”

✔️ Medication side effects

A number of medications can cause brain fog, from migraine and antiseizure prescriptions to over-the-counter drugs for sleep or allergies. Add alcohol to any of these drugs—even a moderate single glass of wine per night—and you might feel even less clear, says Caldwell.

✔️ Medical conditions

There are times when brain fog might be the result of a health issue such as a head injury, thyroid problems, or the early stages of multiple sclerosis. These cases are much more rare, but it’s important to pay attention to signs that your muddled mind might be due to something more critical. (See “When Is Brain Fog a Sign of Something Serious?” below.)

How to treat and prevent brain fog

When you’re in the thick of brain fog, you might convince yourself it’ll go away on its own. “It’s really important not to just say, Oh, well, I’m a little foggy today—tomorrow will be better,” says Chapman. “The brain is an amazing machine that will rebound, but the question is, will it return to the same level? It’s important to do something proactively to help.” Try these tips:

Take control of  your stress reaction

“It’s easy to get into a mindset in which everything is negative and it feels like there’s nothing you can do about stress,” says Caldwell. “But if you really look at what’s making you feel the most anxious, you may see things you can take off your plate or different ways to cope.” Even simply acknowledging what’s stressing you out can help you refine the way you cope with the tough stuff life will inevitably throw at you. Even better, it’ll help your brain turn off that cascade of stress hormones that tires out your hippocampus.

Nail your sleep routine

“Too many of us think of our brain like a motor that can be switched on and off, but the brain is more like a plant that’s growing and changing all the time,” says Dr. Devi. “And nothing is more elegant than or as powerful as sleep to feed that plant and keep it healthy.” While a night or two of poor zzz’s won’t have a huge impact, consistent sleep trouble is worth fixing. “There are many proven ways to treat insomnia these days,” says Dr. Devi. “You can train yourself back into a good sleep routine.”

Move your body

What’s good for your heart (read: exercise!) is good for your brain. That’s because upward of 40% of blood from your heart ends up circulating to your noggin, says Dr. Devi. “It’s proof of how much energy your brain requires, and how much it relies on your heart to get that energy.” If your heart isn’t pumping blood properly, your brain won’t get the oxygen-rich blood it needs to support memory function and alertness. Plus, exercise improves your mood and reduces stress. “If you can do one thing to get multiple benefits when it comes to preventing or treating brain fog, exercise is a great choice,” says Caldwell.

Check in with your brain

Try an exercise Chapman prescribes to all her patients, which she calls “five by five”: Set an alarm to go off at five intervals throughout the day and spend five minutes stopping all brain activity (don’t even meditate!) and just being in the moment. You might close your eyes and take a rest or sit outside and look at trees. Go for a walk (without listening to a podcast!) and zone out. “Just five minutes with no major input is the best way to reset your brain,” says Chapman.

Stop multi-tasking

It may make you feel super productive, but multitasking actually irritates your brain, ultimately slowing it down, says Chapman. Instead of trying to juggle multiple things at once, focus on one goal at a time—and make it doable in a 30-minute chunk of time.

Overthink one thing every day

“Thinking deeply is like push-ups for your brain,” Chapman says. When you read an interesting article online, spend 15 minutes thinking about it and how you might apply it to your life. If you and your partner watch a movie, talk about its message and how it connects with your life rather than just rehashing the plot. Chapman’s research has found that when people engage in deeper levels of thinking, they increase the speed of connectivity across the brain’s central executive network, which is where decision-making, planning, goal-setting, and clear thinking happen, by 30%. “That’s like regaining almost two decades of neural function,” says Chapman.

Excite your brain

Your brain actually hates the same old thinking and ways of doing things. That means the best way to give your gray matter a shot of excitement is to innovate, says Chapman: “This prompts the brain to produce norepinephrine, a brain chemical that makes us excited to learn.” Even simple things can help. At work, try a different approach to a task you’ve done a thousand times. In your downtime, take a new route to the grocery store or listen to different music as you walk around your neighborhood.

Delia Lewis joined the quarantined masses in starting to bake banana bread when her brain fog got really bad, and she says spending time in the kitchen gave her a surprising shot of joy—and a chance to turn her brain away from the worry and stress.

“Baking has become a chance to give my brain a break,” she says. “Plus, it has the added bonus of helping me feel like I’ve accomplished something on days I don’t get enough done on the work front.” And that has helped her feel sharper all around.

When is brain fog a sign of something serious?

If you’re experiencing any of these four symptoms, see your doctor to get a sense of what might be causing them:

  • You have felt foggy for months and nothing (more sleep, less stress) makes it go away.
  • Your brain fog prompts you to make big mistakes at work, with your finances, or in other ways that have significant negative impacts.
  • You have other symptoms in addition to brain fog, like a change in balance or new pain.
  • You don’t remember conversations you've had with family and friends (though they say you were perfectly coherent). 

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