"Where did I leave my keys?"
"Why did I come into this room?"
"Why can't I seem to keep my thoughts together?"
If you've ever experienced any of these moments, you're not alone. And though such mental lapses are sometimes jokingly called "senior moments," they don't only happen in older adults. Anyone can experience a momentary lapse in cognition or mental capacity, and in some cases, a lingering sensation of fuzziness can develop. Anytime you experience such a sensation, particularly if it's ongoing, is pervasive or worsens, it may be an indication that you've had an encounter with an amorphous symptom called brain fog.
What Is Brain Fog?
Brain fog is not a condition in itself, but "is very likely to be a sign or symptom of another issue," says Dr. Freda C. Lewis-Hall, chief patient officer at Pfizer and co-editor of the book "Psychiatric Illness in Women: Emerging Treatments and Research." People who experience brain fog often describe it as a sense of confusion or disorganization, disorientation or feeling scattered. A diminished ability to react and difficulty thinking, expressing your thoughts or thinking through complex situations or calculations can all be considered brain fog.
Dr. Emily Huang, physical medicine and rehabilitation specialist with Santa Clara Valley Medical Center in San Jose, California, says that "while the term 'brain fog' is not a phrase we use medically to define a specific condition, the term can be used to describe an experience associated with mental fatigue, memory issues and decreased focus throughout the day."
Laura Boxley, director of clinical neuropsychology training in the department of psychiatry and behavioral health at The Ohio State University Wexner Medical Center, says that patients who are experiencing brain fog describe it as "not being as mentally sharp or having a slower processing speed, loss of attention and memory lapses."
What Causes Brain Fog?
"There is no specific cause of brain fog as there is relative ambiguity regarding this symptom, and it is typically a result of other medical conditions," Huang says. These conditions can be wide-ranging, not just related to the brain itself, and brain fog can be a side effect of many medications.
"It can be from early Alzheimer's disease," a common form of dementia, Lewis-Hall says. "It can be physical illnesses – high blood pressure can be accompanied by dizziness and other cognitive impairments." Autoimmune conditions can also cause cognitive issues. "Patients with lupus talk about brain fog as one of the symptoms that they're experiencing." And in some cases, it can be triggered by normal life experiences. "Even very common developmental experiences like menopause can present it," she says.
Huang agrees that the symptom can be associated with many factors. "There are numerous causes of brain fog, including sleep deprivation, poor nutritional habits, mental health issues, stress, depression, endocrine changes, lack of exercise and dehydration."
"One of the most common contexts that I see people come in with brain fog is chemotherapy and cancer treatments," Boxley says. "But that's just one of many different medications that can cause brain fog as a side effect. There's entire classes of medicines that can contribute to people feeling mentally fuzzy." In fact, poly-pharmacy, or the taking of several medications at once, can also be a source of brain fog as those different medications interact with one another, she adds.
Some of the more common reasons for brain fog include:
What Should You Do if You Feel Foggy?
Lewis-Hall says that if you experience brain fog, "even if you think it's easily explained by something that's happening in your life, talk to your health care provider about it." She says that sometimes, this recognition that something is a little off may come from a loved one or a co-worker. "Have someone help you identify periods when you feel foggy, or appear foggy. Having someone to tell you, 'Yes, you kind of lost yourself in that sentence,' or 'You seem more forgetful to me than you usually do,'" might help you identify the source of the brain fog.
Boxley agrees that relieving feelings of brain fog starts with a "good working relationship with your physician. There's no substitute for having a close relationship with your doctor." Together, you can identify what exactly is causing your feelings and then treat it appropriately. The key is figuring out what is causing the issue, because "brain fog related to multiple sclerosis has a very different set of treatments than brain fog caused by stress and anxiety. That's why you have to have a professional really work you up and make sure the symptom is attributed to the right thing."
Lewis-Hall agrees: "Figuring out what we are trying to treat is critically important. I would encourage a solid diagnostic work up." To do this, your health care provider "might ask about prescriptions and medications, order blood scans and lab work or conduct a CT scan or MRI of the brain," Boxley says. Your doctor will also likely ask about the timeline of symptoms – when did they emerge and was there a triggering event that you can recall? Have symptoms changed significantly over time? To that end, it helps to keep a journal of your symptoms so you can recall details of past episodes when you meet with your doctor.
All that detail is important because the more information you can provide about your symptoms, the more likely your doctor will be able to pinpoint the problem and offer you helpful treatment. "It really depends on what you're dealing with," she says, so start with your primary care doctor for answers. You may also be referred on to a neurologist or another specialist who handles the specific cause of your symptoms for further evaluation and treatment.
And Boxley adds that if your brain fog changes, it's even more important to talk to your doctor. Brain fog often "ebbs and flows, so if there's been a recent change or shift, or if it seems like it doesn't let up or it's progressive and gets worse, that might be a different category of health problems than just feeling fatigued." Plus the specific way you're experiencing brain fog may point to one cause over another. "Not having as good recall as usual is different from a situation where, 'I'm retired and I'm leaving the stove on.' There's a real distinction between cognitive impairment versus brain fog," and it's a good idea to get it checked out in any instance.
How Is Brain Fog Treated?
Depending on what's causing your symptoms, your doctor may be able to help alleviate them. Boxley says that although not every case of brain fog can be easily cleared up with a prescription, there are still some changes you can make to improve your situation. "We tend to focus on helping patients learn cognitive compensatory strategies," or simple ways to improve memory and attention. "What are some of these things you can do to buttress performance as you go about your day, especially if you're used to making things happen and planning things out?" This means finding ways to reinforce your cognitive powers in your environment. "For example, whereas previously you'd just remember something, now you might have to write it down." Carrying a notebook with you at all times and getting in the habit of using it can make a world of difference.
In this digital age, there are all sorts of technological tools that can also aid in improving your situation. Whether it's a programmable timer set to remind you to take your medications at a certain time, a digital calendar that reminds you of when and where you need to be next, an app that helps you shut off distractions when you're working or a note-taking app on your phone that helps you organize your day, the key is to build in fail-safes that can support you as you go about your regular activities. Baxley calls these tool "external memory," and they can make a big difference in how you navigate the world when dealing with brain fog. She says it's also helpful to "avoid too many distractions and recognize when you're getting overwhelmed."
Huang cautions that though it may seem like a lot of work, it's better to change your approach than just reach for a quick fix. "One of the most common ways people address the symptoms associated with brain fog is by drinking fluids high in caffeine like coffee or energy drinks to stay alert." Ingesting too much caffeine can cause other problems, such as a racing heart or increased blood pressure. Plus, most energy drinks are loaded with sugar and lots of chemicals that can pose health risks. "Preferable recommendations include incorporating more activity into your daily routines – it can seem counterintuitive, but often the more we move, stretch and find ways to be active, the more energy we feel overall," she says. And, "of course, ensuring you are getting adequate levels of sleep would be one of the best recommendations I could give."
Though you may come across many so-called "natural remedies" for brain fog online, it's best to confer with your doctor before you add any over-the-counter or herbal supplements or vitamins to your diet to make sure they won't cause further problems or interact negatively with other medications you may already by taking, Boxley says. "I don't know that there's anything in the cupboard that can cure it," she says.
That said, focusing on improving your diet by "ensuring that you're getting adequate nutrition and hydration" is a smart place to start in tackling most any medical condition or symptoms you may be experiencing. "We love exercise," Boxley says, noting that getting plenty of physical activity can help you feel more focused and alert.
Also, making sure that you're getting enough high-quality sleep and controlling stress levels as best you can will also likely go a long way to alleviating feelings of brain fog. "Countless published studies and research have shown that improved duration and quality of sleep have a myriad of benefits for your well-being, including cognitive function and alertness. Regular exercise, eating a healthy and balanced diet, drinking plenty of water and decreasing caffeine intake are additional recommendations that will not only help with symptoms associated with brain fog, but provide a plethora of other benefits that will help individuals to stay committed to their positive changes," Huang says.