Brain Fog: “We will see an increase in this symptom”

What is the name of the colleague who has been working at the same office for 5 years? And where did I leave my Postiwagen again? And why can’t I come up with this word that I use all the time?

If these unpleasant questions sound familiar to you, you are probably suffering from brain fog. The complaints are numerous: in addition to forgetfulness and a lack of concentration, those affected also complain of difficulty finding words and a lack of mental clarity. But what are the causes of brain fog? Unfortunately, the answer is not that simple. In many cases, however, adjustments in daily behavior already help.

Mrs. Dr. Diem, what exactly is Brain Fog?
Dr Diem: Brain fog is a symptom – a complaint. We do not use the term in medical reports. We are talking about cognitive or mental fatigue – mental exhaustion. Colloquially, one can also say that one feels “as if foggy”.

A little Google research shows: there are many reasons for this…
You have to distinguish between conditions and diseases: the conditions include stress, lack of sleep, medication, hormonal changes such as pregnancy – it is also popularly referred to as pregnancy dementia. However, the same symptoms can also occur during menopause. Any of us can be affected.

And then there are the diseases?
Precisely. Again, the range of diseases that brain fog can cause is huge. It starts with such banal things as iron deficiency, anemia, vitamin deficiency, for example B12. But diabetes, hypothyroidism can also be a cause, as well as serious diseases, autoimmune diseases such as multiple sclerosis (MS). This is where cognitive fatigue is common. Or in the case of rheumatological autoimmune diseases, migraines, mental illnesses such as depression or post-viral conditions, for example after COVID.

What are the most common causes?
Currently it is Post-Covid. Between 6 and 9.9 percent of all people infected with Covid develop a post-Covid disease. More than 90 percent of them complain of cognitive fatigue syndrome. Add to that the physical exhaustion. However, fatigue is also common in MS – also in about 90 percent of all those affected. Vitamin and iron deficiencies are also among the most common causes, especially in young women. Depression is a common cause. We are currently seeing an increase in these cases. In short, mental illnesses are on the rise after the Covid pandemic. Finally, I mention migraines. In migraine, the symptoms are felt for a shorter period of time, ie only between 24 and 72 hours.

In my area, mostly working parents in mentally demanding jobs complain about brain fog…
Then the cause is usually lack of sleep and stress. Brain fog is a sign of mental exhaustion. Lack of sleep, children, stress and then a job that demands a lot from the gray brain cells – it is clear that they get tired. You need to take this seriously because you are at risk of developing depression – or even chronic headaches.

What do you advise in such “mild” cases?
Something that the entire population should really pay attention to: the lifestyle. Even when the work is stressful. Take time to unwind, relax. Watch your sleep hygiene. The last point in particular is often underestimated. At best, our sleep rhythm should be like a Swiss watch. We should always go to bed at the same time and get up at the same time. Otherwise, the system will go haywire and sleep will lose its effectiveness.

So it’s not just the amount of sleep that matters?
The rhythm is extremely important. We know this from sleep research, also from the Inselspital. There are people who hardly have REM sleep phases despite six hours of sleep. So, of course, sleeping is not effective.

What else helps to increase sleep effectiveness?
Avoid watching TV in bed, or checking your phone, tablet, or computer. The light from the screens wakes up the brain and later prevents the deep sleep phase from collapsing as soon as possible. However, caffeine consumption before bed should also be avoided.

But in the evening it is precisely the time to relax and relax with a series.
But please, not in bed, but on the couch. And make sure they spend some time doing their evening routine, brushing their teeth or reading a book afterwards. Or listen to a podcast. But just don’t go to bed right after screen time.

What do you recommend for people with “mild” brain fog?
I recommend reducing stress with sports, exercise, relaxation techniques – and of course: diet plays an important role. Eating only burgers and fries, fatty meals high in nitrates, promotes cognitive fatigue. That is why we recommend a protein-rich diet to patients with fatigue.

At what level of brain fog do you recommend seeing a doctor?
As soon as you experience any problems in your life and work, you should consult a doctor. But it is important to do some introspection beforehand and think about whether there could be reasons why this state has arisen. I mainly mean that you critically question your own lifestyle – and adjust it if necessary. You have to be really strict and disciplined with yourself to make a change. If you notice that it doesn’t get better, maybe even worse, you need to see a doctor.

A first step would then be to create a blood test. You don’t have to immediately think of the worst – everyday things like iron or vitamin deficiencies are common and correcting them will already get better.

How do you explain the advance of Brain Fog apart from the Covid cases?
I think people talk more about this symptom now because our lifestyle is simply not healthy: we work too much, eat too little healthy, and then the pandemic also left its mark. There are also psychological factors. Wars, the pandemic and climate change can be stressors in the subconscious. I think we will see an increase in this symptom in the future. Especially if we don’t pay attention to our lifestyle.