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Brain Fog

For some patients, COVID infection can lead to neurological symptoms, meaning those that affect your brain and nervous system, including brain fog. Brain fog is a general term that can refer to having difficulty thinking clearly and trouble with focus, memory, word finding, logic, or problem solving. Most people will experience brain fog at some point in their lives, for example, after a poor night’s sleep or during periods of elevated stress.

Some with PASC have reported brain fog lasting weeks or months, even after other symptoms from their COVID infection have gone away. If your infection was mild, the continued experience of brain fog is most likely related, at least in large part, to factors that that have co-occurred with your infection, but perhaps not the infection itself. These can include the following:

  • Feeling anxious, overwhelmed, or distressed
  • Depression or grief
  • The spotlight effect (discussed below)
  • Pain experience
  • Medication effects
  • Poor sleep and fatigue
  • Increased substance use
  • Decreased activity
  • Expectancy effects

The blood-brain barrier refers to cells that prevent disease, inflammation, pathogens, and toxins from entering the central nervous system from the blood. However, COVID-19 can affect the brain directly by crossing the blood-brain barrier. COVID-19 may cause blood clots in the brain, nervous system inflammation, and brain vascular injuries. The effects of COVID-19 on the brain can lead to brain fog and other cognitive symptoms.

Being diagnosed with COVID-19 is also stressful, especially because we know so little about it. On top of that, recovering from COVID-19 often includes periods of isolation. Feelings of uncertainty and lower levels of social support makes it difficult to focus and get things done. Runaway thoughts and worries also make it harder to sleep, which is important for all brain functions including memory and concentration.

As it gets harder and harder to concentrate and get things done, it’s natural to focus your attention “spotlight” on your PASC symptoms and the ways you are different than before getting sick. But a greater focus on your symptoms means there is less focus on the things that are most important to you. While it can take some practice, shifting your spotlight back to the things you value will help you feel like you are living a productive and purposeful life. In time, these feelings can improve your mood, physical functioning, and ability to think clearly. Another helpful strategy is to understand that our thoughts, emotions, and behaviors are all connected. Treating yourself kindly can help you recover since your energy isn’t being spent on unhelpful thoughts, like wishing you could “go back to normal” immediately.

Seeing a Doctor for Brain Fog

If you are experiencing cognitive change, this could be reason to see your doctor, particularly if the change is impacting your daily functioning. Your doctor will likely consider a range of factors that may be contributing to your problems. While PASC may be one source of brain fog, others include poor sleep, nutritional deficiencies, hormonal changes, stress, prescription medications, and other illnesses like autoimmune disorders or anemia.

No matter the cause of brain fog, there are some strategies that can help you manage your symptoms. For example, it may be useful to start carrying a notebook with you to write things down that you want to remember later. Using your phone or calendar to set reminders and organize your day may also be helpful. Making sure to schedule values-based activities every day to keep your spotlight focused on what is important and meaningful, despite symptoms. And practicing self-compassion, to decrease stress that we can unintentionally place on ourselves, which will free up “bandwidth” to better focus and concentrate. Listed below, there are self-care strategies that can help prevent further declines in memory and brain function.

Self-Care for Brain Fog