Brain fog: what it is and how to get rid of it

What is brain fog?

Brain fog is a symptom rather than a medical condition. That means treatment will be aimed at the underlying condition that's leading to it. The symptoms of brain fog include fuzzy thoughts, forgetfulness, poor concentration, feeling tired, getting confused and thinking more slowly than usual. You may forget words you use regularly or just feel mentally exhausted.

What does brain fog feel like?

It can feel a bit like being really sleep deprived. Patients who are depressed or under severe stress often describe the same sensations. Some medications - particularly strong painkillers (so-called opioid-based medication) and medicines used for mental health conditions - can also lead to brain fog.

However, it's very different from 'normal' tiredness - a good night's sleep often gets rid of sluggish thinking. But if you have long COVID or ME/CFS, no amount of sleep will perk you up. You may feel just bone weary - even getting dressed can feel like climbing a mountain. Women often describe the same symptoms of brain fog around the menopause, and the symptoms can last for years.

Can menopause cause brain fog?

Yes it can. However, you may be less likely to feel physically exhausted if your symptoms are down to the menopause. In addition, the menopause and the 'perimenopause' (the years leading up to the menopause, before your periods stop completely) are often also accompanied by other symptoms.

While hot flushes, night sweats and vaginal dryness are perhaps the best known, many women also experience joint pains, headaches, skin and hair changes, palpitations and more alongside menopause brain fog.

Is brain fog a symptom of long COVID?

There are about 1.8 million people in the UK with long COVID - symptoms which have persisted for at least four weeks after COVID-19 infection. Of these, about 1.3 million say their ability to carry out their usual day-to-day activities is affected. For almost 400,000 people, the effect on their daily lives is major. Tiredness is the number one symptom of long COVID, affecting about half of sufferers, with shortness of breath affecting 1 in 3, muscle ache causing issues for almost 1 in 4 and about half a million people experiencing problems concentrating.

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Why do we get brain fog and what can we do about it?

We've all been there: you leave the supermarket after doing your weekly shop and take a minute or two to remember where you parked the car. Or you go over the same passage of a book several times, yet absorb nothing of what you've read. These momentary lapses in memory or concentration are normal for most people. We all get a little bit hazy of mind when we're tired, overwhelmed or stressed. When experienced now and then, these instances aren't quite considered to constitute brain fog.

by Allie Anderson

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Encephalitis

Encephalitis is inflammation of the brain. It is usually caused by a viral infection. In the UK, the most common virus to cause encephalitis is herpes simplex virus. Symptoms usually start with the common symptoms of a viral infection such as high temperature (fever), headache, muscle aches, feeling tired and feeing sick (nausea). Confusion, drowsiness and eventually coma can develop. Encephalitis can be difficult to diagnose. Treatment includes antiviral medication such as aciclovir. However, this is not effective against all viruses that can cause encephalitis. Some people can recover from encephalitis and have few, or no, long-term problems. In other people, encephalitis can be life-threatening. Also, after encephalitis, some people are left with permanent brain damage.

by Dr Rachel Hudson, MRCGP

How to get rid of brain fog

So how can you battle brain fog and take control of your life again? There are no medicines that can 'cure' brain fog - although HRT (if the symptoms are due to menopause) can significantly improve many symptoms. Otherwise, simple lifestyle changes can make a real difference.

Don't exert yourself too much

The first key step is not to push yourself too hard. It can be tempting, if you have a 'good day', to make up for lost time. But experiences of people with ME/CFS show that this often leads to being even more exhausted if you overdo it. Instead, divide activities into small, bite-sized chunks, and take regular breaks. Plan what you need to do each day, prioritise the important activities and pace yourself. This can help conserve energy and leave your brain feeling more active.

Too much screen time can cause brain fog

Too much time staring at a computer or mobile phone screen can also make things worse. You tend to concentrate very intently, even blinking much less often than normal. As well as making you prone to eye strain, this can leave your brain feeling overworked.

Practise good sleep hygiene

Conditions that lead to brain fog can also disrupt your sleep, leading to a vicious cycle of overtiredness. But it's important to do everything you can to ensure you sleep well. Getting into a regular sleeping routine can help - try to go to bed, and get up, at about the same time. Make sure your bedroom is quiet and dark, and keep your bedroom for sleeping, not watching television or eating.

If your bed is old, it may be uncomfortable and leading to disturbed sleep, so it's worth thinking about investing in a new bed. Keep the temperature comfortable - layers of bedclothes will let you adapt to feeling too hot or cold. Avoid ticking alarm clocks or digital clocks in the bedroom - the blue light from digital devices can disrupt your sleep. Wind down for an hour or two before bed with a warm bath, a milky drink (without caffeine) and a good book. But avoid adventure or horror stories, which can leave your mind whirring.

Exercise and a healthy diet

Regular exercise, ideally outside, can boost your overall energy levels and concentration. If you're also suffering from fatigue, it's important not to overdo exercise - this can lead to a rebound effect with worsening symptoms for several days.

A healthy diet, with lots of veg, fruit, nuts, beans and whole grains, has been shown to improve brain health. Yoga or country walks can help you relax and reduce your stress levels too, doubling the benefits. Avoid exercising too close to bedtime, though.

Keep hydrated but avoid alcohol if possible - if you do drink, stick to the recommended limits of not more than 14 units a week, spread over several days and with at least a couple of alcohol-free days each week. Pregnant women should avoid alcohol entirely.

Some people are sensitive to caffeine. While it's well recognised that caffeine can increase alertness, you may find that this is followed by a drop in energy. It's worth a trial of a couple of weeks off caffeine (found in energy drinks, some colas and tea as well as coffee) to see if it helps.

With thanks to 'My Weekly' magazine where this article was originally published.