Mental fatigue, or ‘brain fog’ as it’s often known, isn’t a specific medical condition – it’s simply that feeling of your brain not serving you as well as you know it can. This can affect you in many ways, because your brain has such a vast range of functions. It could mean that you have trouble with your memory – easy to notice when you forget to complete a routine task,  go blank trying to remember a familiar person’s name, or remember words in a sentence (we all know this feeling!). Or maybe you find yourself struggling with simple calculations, like counting loose change when you’re paying for a coffee.

The causes of brain fog are as diverse as the symptoms. So if you’ve got that foggy feeling, it’s best to work out what’s behind it before it gets too frustrating.

Lack of sleep – your brain needs both quality and quantity when it comes to sleep. Without enough good sleep, you’re likely to feel a little fuzzy headed, and have trouble concentrating.

Stress – when stress becomes an ongoing issue, it can tire your brain out to the point where thinking, reasoning and focusing become harder.

Hormonal changes can have an impact on your memory and ability to think clearly.

Diet – your brain needs energy and nutrition, much like other parts of your body. Getting enough vitamin B-12 and iron are particularly important.

Physical inactivity – your brain works very closely with your body, and it doesn’t operate well when you sit all day and don’t take the time to keep physically fit.

Since brain fog is not recognized as a medical condition on its own, there are no formal diagnostic criteria for it. However, Tests of verbal fluency evaluate an individual’s ability to retrieve specific information within restricted search parameters (Lezak, Howieson, Loring, Hannay, & Fischer, 2004). The two most common parameters are

(1) semantic fluency, tested by asking the examinee to generate semantic category exemplars (most commonly names of animals)

(2) phonemic fluency, assessed by asking the examinee to generate words beginning with a single letter, most commonly F, A, and S.

When you’re feeling mentally fatigued, it’s a good idea to get a few simple strategies in place that can often get your brain back to its normal self.

Improve your sleeping habits – aim for 8 to 9 hours of sleep per night

Manage your stress levels – take time out to do things that make you happy

Give your diet a boost – with more protein, fruit, vegetables, and sources of healthy fats such as nuts, avocados and olive oil

Keep your alcohol and caffeine intake low – tough but worth it

Exercise more – getting regular exercise and becoming physically fit is great for brain fitness

If these hacks aren’t helpful, then it’s best to speak with your health professional. It might be a good idea to get your iron levels checked if you suspect that these could be low, especially if you feel physically fatigued too.

Once you have cleared the fog, you might even consider strategies for enhancing your mental clarity further. Meditation is a great option for boosting mental performance, and has other great health benefits. Or you could consider introducing a natural plant-based supplement  to your routine, for some extra brain support.

What is BrainFog?

Recently I received an email from a man who described how he is still struggling with “cognitive challenges” since recovering from the virus in the spring of 2020. His doctor ran him through a checkup and a battery of tests. Everything was normal, yet his cognitive challenges remain. Like this man, many people who have recovered from the acute, life-threatening effects of COVID-19, but still don’t feel that their thinking and memory are back to normal.

There are many ways that COVID-19 can damage the brain. Some can be devastating, such as encephalitis, strokes, and lack of oxygen to the brain. But other effects may be more subtle, such as the persistent impairment in sustained attention noted by Chinese researchers.

In addition to direct effects on the brain, COVID-19 can also have long-term effects on other organ systems. So-called long haulers can have other lingering symptoms including fatigue, body aches, inability to exercise, headache, and difficulty sleeping. Some of these problems may be due to permanent damage to their lungs, heart, kidneys, or other organs. Damage to these organs — or even just the symptoms by themselves — can impair thinking and memory and cause brain fog. For example, how can you think clearly if you’re feeling fatigued and your body is aching? How can you concentrate if you were up half the night and awoke with a headache?

What should you do if you may be experiencing COVID-19 brain fog?

The first and most important thing to do is to see your doctor and share with them all of the lingering symptoms you are experiencing. These should include your brain fog and other neurologic symptoms (such as weakness, numbness, tingling, loss of smell or taste), and also problems such as shortness of breath, palpitations, and abnormal urine or stool.

To help clear the brain fog, I recommend pursuing all of the activities that we know help everyone’s thinking and memory.

Perform aerobic exercise. You may need to start slow, perhaps just two to three minutes a few times a day. While there is no established “dose” of exercise to improve brain health, it’s generally recommended you work toward 30 minutes a day, five days a week.

Eat Mediterranean-style meals. A healthy diet including olive oil, fruits and vegetables, nuts and beans, and whole grains has been proven to improve thinking, memory. and brain health.

Avoid alcohol and drugs. Give your brain the best chance to heal by avoiding substances which can adversely affect it.

Sleep well. Sleep is a time when the brain and body can clear out toxins and work toward healing. Make sure you give your body the sleep it needs.

Participate in social activities. We are social animals. Not only do social activities benefit our moods, but they help our thinking and memory as well.

Pursue other beneficial activities, including engaging in novel, cognitively stimulating activities; listening to music; practicing mindfulness; and keeping a positive mental attitude.

What is COVID-19 brain fog — and how can you clear it?

Anxiety takes up mental resourcesTrusted Source. A person may have to use more energy to focus on something other than their anxiety. They may feel that their anxious thoughts constantly intrude on their thought process. This can make it more difficult to concentrate and think clearly. The effects of anxiety on various tasks and on brain fog may depend on the specific task a person is doing.

In a 2012 studyTrusted Source, researchers gave people various tasks that induced feelings of anxiety. The researchers noted that anxiety made relatively easy tasks difficult, because the tasks required more effort. However, the effects of anxiety on more challenging tasks were less obvious.

The study’s authors speculate that this may be because the difficult task used up more cognitive resources, leaving less space for anxiety. It is unclear if a similar phenomenon might happen in actual-world cases of anxiety.

Anxiety may also undermine a person’s thought process, intensifying brain fog. The tasks a person must perform may trigger further anxious thoughts. For example, a person cleaning their house or filing their taxes may find additional things to be anxious about. This may lead to more anxiety, more brain fog, and greater difficulty completing their tasks.

Some mental health conditions that may cause anxiety and brain fog include:

anxiety disorders such as generalized anxiety and post-traumatic stress disorder (PTSD)

attention deficit hyperactivity disorder (ADHD)

Physical health issues may also cause anxiety and brain fog.

A 2021 studyTrusted Source found that COVID-19 survivors, especially those who had to use a ventilator, had a higher risk of PTSD. This also elevated their risk of brain fog. People with long COVID may also experience brain fog and PTSD.

Brain fog is a symptom, not a medical diagnosis. It can feel different to different people, and they might use the same term to refer to a range of symptoms. Some characteristics of brain fog include:

thinking more slowly than usual, and needing more time to complete simple tasks

having trouble organizing thoughts or activities

forgetfulness, such as forgetting daily tasks or losing a train of thought

Since brain fog is a symptom rather than a medical diagnosis in itself, there is no specific treatment for it. However, managing the anxiety, or the condition causing it, may help.

medication, including anti-anxiety medication, antidepressants, or stimulants for ADHD

psychotherapy to talk about anxiety and develop coping skills

time management systems to help a person remain focused

adjustments at school or work, such as extra test-taking time

Getting enough sleep, drinking plenty of water, and remaining nourished may also help reduce the risk of brain fog. This is especially helpful for people with anxiety that distracts them from self-care.

Some people find that specific self-care strategies may also help. These could include following a schedule, using a reminder app, or taking frequent breaks from whatever could be heightening anxiety. 

Chronic fatigue syndrome, which can cause a person to feel frequently exhausted, may cause both anxiety and brain fog.

Symptoms of brain fog

Treatment and prevention&nbsp;

antidepressants

What to know about anxiety and brain fog

At the beginning of 2020, Carol Andersen was busy enjoying life.

The 67-year-old had a job she loved in the results department of a clinical lab and was looking forward to a holiday on a cruise.

Even though Ms Andersen's infection wasn't severe, she has been stuck with lingering neurological symptoms such as nerve pain, fatigue, "brain fog" and smell issues ever since.

The Blacktown resident has been unable to work due to her symptoms.

“I don’t feel the way I felt before COVID. It’s really quite confronting," Ms Andersen said.

"Even doing my 'survival' jobs at home like showering, washing up, putting the garbage out ... I feel like I’ve done a 10-page essay."

An emerging body of research on the long-lasting neurological effects of COVID-19 suggests Ms Andersen is not alone.

A recent analysis of the health records of more than 230,000 people with COVID-19 found that around one-third experienced a neurological or psychiatric condition up to six months after infection.

Roughly 13 per cent of those patients had not been diagnosed with those types of conditions previously.LIVE UPDATES: Read our blog for the latest news on the COVID-19 pandemic

"It's more than a psychological thing," said Craig Anderson, a neurologist at the George Institute for Global Health.

"This is really a physical fatigue that people are trying to recover from."

And while it's early days, researchers are beginning to unravel how COVID-19 affects the brain and leads to brain fog and other neurological issues. 

How does COVID-19 actually affect the brain? 

In the early days of the pandemic, researchers wondered whether the SARS-CoV-2 virus could break into the brain and infect neurons, the cells that send and receive information.

But most studies have failed to track down the virus hiding out in the brain. 

For instance, a recent US study that analysed brain tissue from eight patients who died from COVID-19 found no traces of the virus in the samples.

But the research did find more signs of inflammation in the brain tissue of COVID-19 patients than the control group, suggesting that inflammatory responses triggered by the virus in other parts of the body can kickstart inflammation in the brain.

Tissa Wijeratne, a neurologist at the University of Melbourne, has also found inflammatory markers linked with the immune response in the blood of patients who experience neurological issues months after they were first infected with the virus.

“The virus doesn't have to go to the brain to make an impact,” said Professor Wijeratne, who is currently investigating the long-term neurological effects of COVID-19.

“My hypothesis is that this is largely driven by a maladaptive, persistent low-grade immune reaction.” 

And while it's too early to know for sure, there's a strong possibility that inflammation could be one of the main culprits behind lingering neurological symptoms, said the George Institute's Professor Anderson. 

“We know that [other] severe viral infections can cause inflammation in the brain,” he said.

But it’s difficult to pin down the exact mechanism of how the virus affects the brain, because symptoms such as brain fog and memory problems can be caused by other things, said Anthony Hannan, a neuroscientist at the Florey Institute of Neuroscience and Mental Health.

For instance, the stress of having the infection itself could also have an effect on the brain and cognition, particularly for those who have been in hospital, said Professor Hannan.

“We need much more research,” he said.

“The complexity of the way the body interacts with the brain raises a whole range of possibilities as to how COVID-19 as an acute disease could then persist in the long-term and affect brain and cognitive function.” 

A recent international survey of more than 3,700 hospitalised COVID-19 patients found 82 per cent had neurological symptoms.

Headaches and loss of taste or smell were the most common symptoms patients reported, while confusion and delirium, coma and strokes were the most frequent neurological abnormalities bedside clinicians saw in their patients. 

Another recent survey of almost 13,000 people in Norway found that 11 per cent of participants experienced memory problems up to eight months after infection.

Professor Anderson said poor concentration and fatigue were also in the mix.

“It can be quite hard to concentrate and keep your mind focused on things,” he said.

Ms Andersen has experienced this firsthand and often struggles to keep track of conversations. 

"Sometimes I’ll be talking and I just stop and I forget what I’m about to say," she said. 

Professor Wijeratne added that the most common symptoms he is seeing in his patients look familiar. 

“They’re very similar to the patients that I used to see after an acute event of stroke.

“[The patients] say that their life is not the same. Most of them have a significant amount of anxiety and have disrupted sleep." 

Studies have shown that people who have had severe COVID-19 infections aren’t the only ones with lasting neurological and cognitive issues.

A recent study found that people who had recovered from COVID-19 performed less well on a cognitive test than they did before infection, even if their initial infection wasn't severe enough to go to hospital.

The study controlled for other factors such as age, pre-existing medical conditions, depression and anxiety. 

And preliminary research presented at the Alzheimer’s Association Annual Conference in Denver last month found that persistent forgetfulness, language problems and cognitive issues experienced by older adults from Argentina who had recovered from COVID-19 were not associated with the severity of the original disease.

While more research is needed, Professor Anderson suspects genetic factors could be playing a role.

“The major theory behind susceptibility to a lot of diseases is that you’ve got a genetic predisposition,” he said. 

"That programs your body, either by strength or weakness, and will determine how you respond to COVID and how you will eventually recover from it."

Professor Hannan said looking at the genetic makeup of people who have neurological symptoms after a COVID-19 infection could help uncover whether the disease accelerated the onset of brain disorders that they were already predisposed to.

“It could provide a trigger that's overlaid on their already susceptible brain and body that's affected by genetics and environmental factors,” Professor Hannan said.

For instance, another preliminary study presented at the Denver conference found an uptick in biomarkers associated with Alzheimer’s disease in the blood of older patients who were hospitalised with COVID-19.

“It's a major concern, because Alzheimer’s disease and dementia are some of the biggest disorders, so if this pandemic is going to increase the incidence and prevalence, it's going to have enormous public health implications,” Professor Hannan said. 

While there is no specific treatment yet for brain fog and other post-COVID neurological symptoms, early trials are underway.

Professor Anderson and his team are exploring whether atorvastatin, a common medication used to lower cholesterol and the risk of heart disease, could help reduce brain-related symptoms after COVID-19.

“We want to evaluate it rigorously as to whether it might be able to suppress the inflammation in the brain that’s giving rise to brain fog and thinking problems,” Professor Anderson said.

In the meantime, Professor Wijeratne said doing things that were beneficial for brain health in general, such as getting enough sleep, managing stress and exercising, were good approaches for managing symptoms. 

"Even doing a few things around the house or putting on your favourite song and dancing for a few minutes is better than nothing," Professor Wijeratne said.

For Ms Andersen, online support groups for people experiencing long COVID have helped reassure her she’s not alone.

“When I joined, I was gobsmacked and relieved at the same time, because there were other people exactly like me,” she said.  

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LIVE UPDATES: Read our blog for the latest news on the COVID-19 pandemic

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SpeechTherapy is a global organization on the lookout for solutions for people who are suffering from their day to day speech problems as a result of having Brain Fog.

© Copyright by Shaznan Fairoze, do not claim as your own

Get Rid of BrainFog And Elevate YourVerbal Fluency

Try out our tests in order to discover if you are a victim of brain fog, and join our community to fight BrainFog together!

What BrainFog feels like?

Why Speech Therapy?

Was looking for a book regarding brainFog, finally managed to find it here!

Speech Therapy has made me a better public speaker

I was not aware that i was a victim of BrainFog until I came here

Was looking for a book regarding brainFog, finally managed to find it here!

Speech Therapy has made me a better public speaker

About

SpeechTherapy is a global organization on the lookout for solutions for people who are suffering from their day to day speech problems as a result of having Brain Fog.

© Copyright by Shaznan Fairoze, do not claim as your own

Get Rid of BrainFog
And Elevate Your
Verbal Fluency