I realised very quickly following encephalitis and acquired brain injury that cognition encompass of many aspects such as memory, concentration, attention, processing speed, problem solving, thinking processes and of how a brain injury can easily disrupt the very fragile equilibrium under which it operates. All those aspects of cognition rarely operate as a standalone process either. They continuously bounce off each other and rely on one another for us to make sense of the life that unravels in front of our eyes every day. But what happens when brain fog creeps its way in?
At times, I literally feel the brain fog creeping in. It's as if all aspects of cognition start to deteriorate one by one right in front of my eyes. I always find this heartbreaking. It feels awful and can often drag me down physically and mentally too.
What is Brain Fog?
Firstly, I think it's important to mention that you don't need to have a brain injury to experience brain fog. Brain fog can indeed be experienced by many of us. Some of the root cause of brain fog can include hormonal changes, lack of sleep, food sensitivities and depression. However, it's also important to note that brain fog linked to brain injury slightly differs from other common causes of brain fog.
Following a brain injury, inflammation, bruising and damage can disrupt how the brain functions. In order to get from point A to B, an input may now need to go through a series of detours which can in turn slow down the transfer and processing of information. When old pathways can no longer be accessed, your brain will re-route the information either by using other existing pathways which role differ from the original ones or by creating new pathways. In either case, this tends to tire the brain quite quickly. Other times, a pathway will keep working overtime...as if there is no on/off switch. The effect of having a part of the brain working even when not required will result in the same effect which is, the brain will tire more quickly than it should. That’s often when people recovering from a brain injury will experience concentration difficulties, slow thinking, trouble remembering stuff, struggle to process information and so on. If you are or know of a person recovering from brain injury, that's when you may have heard them use the term brain fog to describe what they are experiencing.
Commonly, people can describe it as being stuck in a think fog, as a dark cloud coming over them, feeling fuzzy, feeling as though they are there but not quite there or that their brain struggles to keep with what’s happening around them.
People recovering from brain injury rarely
experience brain fog on its own. Their brain fog can be triggered by another symptom such as fatigue or a headache, but they can also occur concurrently with a range of other symptoms. These can include: memory loss, visual disturbances, depression/anxiety, dizziness, nausea, physical pain, hormonal disorders and as previously mentioned fatigue and headaches. The brain energy spent on trying to manage those other symptoms means that the energy tank drains at a much quicker rate and that the brain energy available to run the cognitive functions is now being used to try to manage other symptoms. That's when brain fog can significantly affect a person's cognitive functions.
Tips for brain fog
In order to help reduce brain fog when recovering from a brain injury, we really need to look at the brain fog itself, but also at the concurrent symptoms as alleviating those may help reduce the severity of the brain fog experienced. As a rule of thumb, the following areas can trigger or increase the severity of some of your symptoms so it's worth exploring which part of your lifestyle could be tweaked:
Sleep hygiene: Having good sleep routine (avoiding overstimulation, consistent bed time, 7-8 hours sleep, eliminating blue lights, avoiding caffeinated drinks, avoiding strenuous exercise when close to bed time, etc.)
Nutrition: Many research claim the benefit of Mediterranean diet to reduce inflammation, so this may be something to explore. If shopping triggers some of your symptoms, you may need to think of ways in which you can tweak your shopping habits (e.g.: online shopping, off-peak shopping time, etc.)
Exercise: Regular exercise has clear benefits on a person's health. Exercise allows for oxygen-rich blood to reach the brain and regulate the production of chemicals that can assist healing. Remember to exercise at levels that aren't increasing your symptoms else it is counter-productive and can have the opposite effect i.e. increase your brain fog. This may mean opting for a gentle walk one day and for a higher intensity form of exercise on a day where your symptoms allow for it.
Medication: Some medication can help clear the brain fog temporarily, but as they wear off, they can cause you to crash. On other hand, some medication can trigger brain fog as well so if you are on medication, talk to your GP to find out how they could be a contributing factor.
Relaxation: There are several relaxation techniques out there that can help reduce stress and consequently help calm your nervous system. Explore several of those techniques and see which ones tend to work better for you. Examples include deep breathing exercises, visualization, meditation, yoga, spending time in nature, mindfulness, listening to music or using the creative part of your brain. Once you find something that works for you, try to incorporate them in your daily routine.
You don't have to implement these tips all at once. Doing it gradually can be a more realistic and sustainable approach. If you come out remembering one tip from this blog, please let it be not to push through your brain fog. Brain fog is likely to creep in once you've gone above your current limits so it's important to stop and take five. Those limits will move in time, but by pushing through, you are likely to increase your brain injury symptoms and experience those dreadful set-backs. Stop what you are doing, take a little break, try one of your relaxing technique or have a rest. Try some of those tips and be consistent in your approach, hopefully it can translate in an improvement of your overall health.