Did you know?
According to Vinnidhy Dave, DO, director of medical pain management at the Hospital for Special Surgery in New York City – between 15 and 40% of patients with chronic pain can have brain fog.
Living with brain fog is a unique challenge. It comes hand-in-hand with many chronic illnesses, but isn’t always so apparent to those around you.
So what is Brain Fog?
A study published in the Frontiers of Neuroscience describes brain “fog” as a constellation of symptoms that include reduced cognition, inability to concentrate and multitask, as well as a loss of short and long term memory. It can be accompanied by a variety of other symptoms, such as fatigue, irritability, and difficulty completing tasks. Brain fog can be caused by a variety of factors, and it can have a significant impact on an individual’s quality of life.
Brain Fog often arrives with pain, fatigue, and new medications.
Brain fog is harder to diagnose and treat because there is no medical consensus around it, it isn’t recognized as a medical or psychological condition and there is no test or measurement for it, although there are tests to measure the cognitive impairment that is associated with it.
So it isn’t a medical condition per se, rather a symptom of other medical conditions.
What causes Brain Fog
The cause of brain fog and mild cognitive impairment is not always straight forward, just like pain it can range from mild to severe, and vary day by day. It is important to identify any potential underlying medical causes and look at the whole picture, taking into account your prescribed medications, mental and emotional health, lifestyle, exercise and diet.
There are a number of reasons why brain fog co-occurs with chronic pain. If the person experiences brain fog only after starting a medication, it is likely medication related. In this case, the medication itself or its dose should be adjusted by a medical professional.
Sleeping pills, antacids, antidepressants, stimulants, antipsychotics, antihistamines, chemotherapy, and blood pressure medication. Side effects from many of these medications can produce symptoms of brain fog and may trigger brain inflammation.
Brain fog is a common symptom of depression. Depression affects people physically and psychologically and this can include effects on cognition, memory, slow thinking, and indecision.
Chronic pain and depression can be intertwined, with depression being one of the most common mental health problems facing people with chronic pain.
If the brain fog is a symptom of depression, it can be treated by treating the underlying depression. The ideal treatment approach is a combination of psychological counseling, medication, diet and exercise.
Pain makes sleeping difficult and not getting enough sleep can exacerbate pain.
Quality sleep is so important, and one of the most common effects of sleeping too little is that it can rob you of clearheadedness.
A research study found sleep deprivation disrupts our brain cells ability to communicate with each other.
“If I had to recommend just one thing for you to heal your brain body generally and brain fog specifically, it would be to rest more.” . . . “When you cut sleep short, inflammation rises and pokes holes in the blood-brain barrier. That translates into less attention, stamina, strength, and performance because you’re less effective at repairing and rebuilding your brain body.”
~ Gottfried, M.D., Sara. Brain Body Diet (p. 159). HarperOne.
My personal experience of Brain Fog
Like the foggy weather, it seemed to blow in from nowhere.
I couldn’t think of words I wanted to say. I knew what I wanted to say, but it felt like there was a disconnect from my brain to my mouth. I found it difficult to concentrate, multitask and I was easily distracted. I traced my “fuzzy thinking” back to the time when Nortriptyline was added to my pain medications. I suspected this medication was most probably the culprit.
I was so frustrated by this ‘zoned out’ feeling, after discussing it with my doctor, I decided to taper this medication down, and then I came off it completely. Sure enough to my mental acuity has returned. However, the tradeoff is that I am now experiencing more pain, Hobson’s choice! I’m prepared to accept this because sounding incoherent and confused is not something I can live with.
Do you think you might have Brain Fog?
If you are experiencing brain fog, it is important to see your doctor to rule out any underlying medical conditions.
Start by paying attention to whether there are certain triggers for your brain fog.
I recommend that you consult your doctor or treating specialist, who can help you trace the root cause of your brain fog by looking at the whole picture.
For example, if brain fog is caused by a medication side-effect, switching to a different medication may be necessary. If it’s caused by a chronic condition, treating the underlying condition may help to alleviate symptoms.
What is brain fog? An evaluation of the symptom in postural tachycardia syndrome
McCracken L, Iverson G. Predicting complaints of impaired cognitive functioning in patients with chronic pain. JPSM. 2001;21(5):392-396.
Berryman C, Stanton T, Bowering KJ, et al. Evidence for working memory deficits in chronic pain: A systematic review and meta-analysis. PAIN. 2013;154(8):1181 – 1196.
Gottfried, M.D., Sara. Brain Body Diet (p. 159). HarperOne