Mental cloudiness may arise with long COVID but can also be caused by meds, depression, insomnia, and more
By Kevin Loria
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 isn’t unique to long COVID. Chronic insomnia, a head injury, stroke, depression, cancer therapies, and drug side effects can all lead to a similar, often troubling mental cloudiness.
There’s 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. Here’s what we know about brain fog, and what experts say you should do if you are experiencing it.
Understanding Brain Fog
People who report brain fog describe it as “the sense they can’t do cognitively what they could before . . . they don’t 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’s not uncommon for the retrieval of information to get a bit 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 from dementia, which is a progressive condition.
The exact biological causes of brain fog aren’t 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 around 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’s 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 to help ease brain fog.
Limit meds and 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.
Exercise. For those who are able to 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, and 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, as well as other symptoms.
Editor’s Note: This article also appeared in the August 2022 issue of Consumer Reports On Health.
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