Published on: August 17, 2015
by Sarah Kline for Livestrong:
It starts with something you can brush off: the standard where in this enormous mall parking lot did I leave the damn car?! Happens to everyone, no big deal, a brain fart. Until you realize it wasn’t just today at the mall; you’ve somehow spent most of your week feeling as if you’ve made major decisions behind a smokescreen. As if those brain farts were fogging up the place.
“Brain fog is an inability to really punch through,” says Mady Hornig, MD, associate professor of epidemiology at the Columbia University Medical Center. “It’s a vague sense of what you’re trying to retrieve, but you can’t focus in on it,” she says, “and the effort to harness the thought can be as draining as physical activity.”
Remember how impossibly exhausting it was to run your board meeting the last time you came to work sick (please, please, stop doing that, by the way)? Brain fog is a lot like that, except it persists. A fog can linger for several days, sometimes even weeks.
Its impermanence is the big difference between what we know as brain fog and actual dementia, says rheumatologist Robert Lahita, MD, PhD, chairman of medicine at Newark Beth Israel Medical Center and professor of medicine at Rutgers in New Jersey. Brain fog might cause you to forget where you parked that car at the mall, but dementia might make it impossible to get there in the first place, he says.
There’s not a lot of scientific evidence to explain what’s going on when the clouds roll in. Researchers haven’t really found a way to measure or test for brain fog like they have dementia. “Everybody knows what it is,” Lahita says, “but at the same time, it is so unknown.”
If you’re sure you’ve been getting enough sleep—because who isn’t in a daze when sleep deprived; it’s probably a good idea to bring up brain fog with your doctor if you start to feel seriously off. “If you’re not feeling like your normal self, that might suggest something’s going on,” says neuropsychologist Kelly Ryan, PhD, clinical assistant professor of psychiatry at the University of Michigan, especially if it lasts for a week or two, Lahita says. At the very least, your doctor can perform tests to reassure you it’s not dementia.
People facing a wide variety of diagnoses describe foggy days, as do people who don’t seem to have anything physically wrong. Here are a few things brain fog might be telling you.
You won’t be tampon-shopping for long.
And here you thought only your hormones would change! A series of hazy days in the mental forecast could be a sign menopause is near. Midlife brain fog is very real: A University of Rochester and University of Illinois study showed women between the ages of 40 and 60 have trouble staying focused on tricky tasks and stumble with something called working memory, which helps you do things like adding up a bunch of numbers in your head.
Hormones shape the brain, Lahita says, so it would make sense for vascillating estrogen levels to cause shifts in cognition, too. Which likely sounds familiar to anyone who not-so-fondly recalls “pregnancy brain.” In one small study, researchers found having a bun in the oven makes what’s called spatial memory, which helps you do things like remember where your glasses are (hint: probably on your head), a challenge, possibly because of the impact high levels of hormones have on neurons in the memory-focused part of the brain called the hippocampus.
Your mood swings are actually a big deal.
Ryan’s recent research found that the fuzzy thinking cited by people with depression or bipolar disorder actually shows up on brain scans. In the study, women with these conditions struggled more with a cognitive test than healthy women. The same area of the brain was active in all the women (since it’s known to pitch in when you’re taking a test), but women with depression or bipolar disorder had unusual amounts of activity (either too much or too little) going on in that region, she says. Not only does that mean bipolar disorder and depression may not be as different as science once thought, she says, but also “at a neurobiological level, it could be that the brain works differently” in mental health patients.
With the assistance of certain meds or therapies, you might be able to address some of this difficulty focusing or concentrating, Ryan says, although some people with depression or bipolar do still report they don’t feel as sharp even when their mood feels stable, she says.
You’re stressing your brain into a frenzy.
Freaking out about your brain fog won’t do you any good, considering worrying could be what got you here in the first place. When life gives you lemons—you’re going through a divorce, you’ve lost a dear friend—it will probably also give you confusion and forgetfulness, simply because of the mental energy it takes to crank out the lemonade. “Stress impairs performance, physically and mentally,” Lahita says.
At the very least, know what really sets you off, whether it’s the overflowing laundry hamper or your oversharing co-worker, because zeroing in on what triggers stress could help you curb the fog, Hornig says. “Identify potential patterns, then eliminate certain factors causing issues to feel more stressful.” If that sounds daunting itself, talking it through with a therapist might help you put the pieces together, Hornig says.
You filled a new script.
Is it just us or are those lists of possible side effects getting longer and longer with every new prescription we fill? Chances are you haven’t read to the bottom, so allow us to offer a spoiler: Certain antibiotics, incontinence meds, and even blood pressure pills can cause mental clouding, especially in older patients. Of course, there are also some obvious ones to keep in mind, including antidepressants, painkillers, and allergy meds. If you think one of yours is causing detrimental fog, talk to the doc who prescribed it about your alternatives.
You’re eating for your belly, not your brain.
Foods like fatty fish, leafy greens, and (hooray!) dark chocolate are all known for building some mental muscle. If only it were as easy as grabbing a chocolate bar whenever you’re feeling foggy and watching the clouds suddenly lift! But there is some evidence, Lahita says, that obesity ups risk of cognitive decline, meaning you can add “preventing brain fog” to your list of reasons to stick to eating clean.
If you want to get specific, make sure you’re not skimping on iron, an essential nutrient for memory and attention. In a small study of college-aged women, eating a protein-rich lunch for 4 months upped levels of iron in their blood and improved their brainpower. And quit with the binges already—there’s a reason it’s called a food coma.
Cancer treatment is taking its toll.
Some cancer patients report feeling a mental cloudiness in response to chemotherapy treatment, not-so-affectionately dubbed “chemo brain”. It might result in forgetfulness, trouble concentrating, disorganization, and a hard time finding the right words to finish a thought, according to the American Cancer Society.
The ACS recommends the same old memory tricks you’ve heard countless times: Eat a balance of nutritious foods, exercise as regularly as you can during treatment, establish daily routines, leave all sorts of handwritten and iPhone notes and reminders for yourself, and, perhaps most importantly, ask for help. Of course, that’s only so comforting, considering chemo brain was shown to linger for as long as 5 years in a small study of blood cancer patients. Luckily, in most cases, Lahita says, it’s likely to lift after a few weeks.
You’ve got an undiagnosed health concern to address.
From the autoimmune to the neurological, brain fog crops up in people with a wide range of diseases, like fibromyalgia, lupus, multiple sclerosis, and more. If you’ve been battling prolonged brain fog and it’s not related to your sleep schedule or your last feeding frenzy, talk to your doctor about what other symptoms you might have overlooked, like joint or muscle pain, numbness or tingling, headaches, and loss of coordination.
Chronic fatigue syndrome—now called myalgic encephalomyelitis, so we’ll go with ME/CFS—is a highly misunderstood condition, but one in which people often complain of feelings of brain fog. Earlier this year, Hornig’s study found differences in brain fluid of people with ME/CFS that might help explain the mental cloudiness so common in the disease.
Immune-system proteins called cytokines were reduced in ME/CFS patients, she says, “almost like the immune system has exhausted itself.” Science isn’t totally clear on why these changes might lead to brain fog, but Hornig, also the director of translational research at the Center for Infection and Immunity at Columbia’s Mailman School of Public Health, says there are receptors in the brain for the cytokines, which are closely related to some of the receptors for hormones and other brain chemicals. This complex interplay between all of our wiring up there could be making ME/CFS patients foggy, she says.
It’s time to say goodbye to gluten (sorry).
There’s a lot more to celiac disease than belly bloat after eating a bagel. People with the autoimmune disease can do lasting damage to their small intestines by eating gluten—and accumulate dense brain fog in the process. The good news for people with an actual celiac diagnosis (aka people who aren’t ditching gluten to be trendy) is that going gluten-free really does help, and not just by keeping you out of the bathroom.
In a small study of celiac patients who went G-free, brain fog lifted significantly. Before adopting the new diet, they scored as poorly on certain cognitive tests as if they had been jetlagged or legally drunk. A year later, things were blissfully back to normal.
You have 23—or is that 24?—browser tabs open right now.
You’ve already heard multitasking only makes you less productive, but maybe you haven’t listened. (Probably because you were in a meeting, texting under the table, and reading about how multitasking hurts attention, productivity, and memory all at the same time, right?) Let’s try an experiment: Right now, close, say, 75% of those tabs, and, for a few moments, practice the art of focusing. Maybe you’re just rusty!
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