Brain fog. Of all the many symptoms that accompany chronic illness, it can be the thing that frustrates and isolates us more than anything! Ironically as I write this, I’m finding myself in a particularly “foggy” day. It doesn’t take much, does it? A few crazy hours at work, a little increased stress, poor sleep, pain… Or sometimes there’s no reason at all! We look for the word on the tip of our tongue and just can’t seem to find it. We walk into a room and have no idea why we went there in the first place. We forget important things, like medications, appointments, or tasks we need to do. We feel overwhelmed and unable to sift through the murkiness to think clearly.
If you suffer from brain fog, know that you are not alone. In fact, it’s a common denominator in many illnesses, and for many reasons. The good news is, there are some strategies and habits that might give you the help you need to function on your foggiest days. Here are the things I rely on the most.
I have always been a list person, mostly for the sheer joy of crossing finished items off of my list. But since my health took a trip south, I’ve become a List Person, with capital letters. I have lists for everything: things to do, groceries, gift ideas, books I want to read, posts I’d like to write in the future… On my worst days, I literally map out my day a list at a time to make sure I’m not missing anything. In my work as a phone nurse in a busy clinic, I keep lists of patients I need to follow up with, their symptoms or questions, and where to reach them. The beauty of all of the lists is that they unload and unclutter my brain. Instead of juggling all of the things I need to remember in addition to what I’m saying and doing, I can put them down on paper and release them. It’s like closing unused tabs on my computer, and it frees my brain to focus on the tasks at hand. It’s also super satisfying to cross items off the list and know they’ve been taken care of! Even on my most unproductive days, I can feel like I’ve accomplished something.
2. Phone Notes
Many of my lists, like I said, are comprised of things I need to take care of that day. I usually scribble them on scraps of paper that can later be crossed off and recycled. But for those long-term things I need to remember, I rely on phone notes. There are some great apps out there that are free and user-friendly. I like ColorNote, because it lets me create text or checklist notes, and set a color for each note. That means I can choose a color for every type of note I create: to do lists, gift ideas, home improvement projects, shopping lists, restaurants to try–whatever it may be! I can look at a glance and know that all my shopping lists are purple, for example, so that I don’t have to sift through endless notes to find what I’m looking for. If I choose to create a checklist, I can cross items off on my device. And because they’re on my phone, they’re always with me and can be stored long-term. I even have lists for future trips we hope to take in several years, detailing all the things we’d like to do! And, again, they’re out of my mind and in a safe place so that I can free up mental space for other things.
3. Calendar Events
Another way I stay ahead of the fog is to use my calendar to the max. Of course I add important events, meetings, birthdays, and the usual things to my calendar. But I also add reminders to increase medication dosages, call to schedule follow-up visits, pick kids up from school, or do routine tasks around the house. It helps me stay organized and ensures I don’t forget anything important. I also use it to track certain things with my health. I make calendar events for my menstrual cycle, migraine days, rescue medications I take, and onset of new symptoms. I have a search function on my calendar, so by using the same wording each time for these things, I can easily pull up all the dates that I had a migraine, for example, to update my provider.
4. Setting Alarms
In addition to my calendar reminders, I use a lot of alarms. I can tend to get focused on a task (or take a lot of naps), and having alarms keeps me from worrying that I’ll miss something important. I have an alarm set for when I need to leave for work, when I need to wake up from my afternoon nap to be ready for my kids to get home, and when I need to pick my high schoolers up from school. I can set them to go off on certain days, such as Monday through Friday, and can easily turn them off on days when I don’t need to use them (such as over the holidays). They allow me to fully engage in what I’m doing without having to watch the clock or worry about the time. It’s all about freeing up mental space…
5. Single Tasking
I often think of my poor brain as an old computer that’s running low on memory and hasn’t been restarted in months. When I have multiple tabs open, or ask the computer to do more than one thing at a time, the whole system bogs down. It can be painfully slow, or crash altogether. I think you can probably see the parallels… The more things I attempt at once, the more I’m risking bogging the whole system down or crashing. And this is true of cumulative activities throughout the day as much as multitasking in the moment. For example, if I’ve had a particularly challenging morning at work and jumped from phone call to phone call, or from patient to patient, I find that by afternoon, I’m just incapable of focusing on more than one thing at a time. If I’m trying to talk to my husband while cooking supper, for example, I’ll stumble often in the middle of sentences and struggle to find my words. Like many things with chronic illness, my brain seems to keep the score, and if I’ve pushed it too hard at any time recently, it will struggle to keep up. The more I can focus on just one thing at a time, the more smoothly my brain can manage, and the less likely I am to overwhelm it.
6. Pill Sorter
I will confess that I don’t personally use a pill sorter, only because I don’t have a large number of medications right at the moment (that’s not always been the case, and likely won’t always be the case). That being said, I’ve recommended this to my own patients, as well as to friends and family members, as a great way to remember what and when to take medications. There are all sorts of pill boxes available, from single colored ones, to ones that allow you to keep pills for morning, afternoon, and night in multiple colors. The key is to choose something that makes sense to you and won’t confuse you any further. Create a routine (and put a reminder to do it in your calendar!) on the same day each week to refill the pill box. Put in exactly what you need for each day. The beauty is that, in addition to keeping you organized, a pill sorter lets you see clearly whether you’ve taken your medications or not. I can’t tell you how often I’ve walked away from a meal wondering if I actually remembered to take my medication. There’s no confusion when you look in the pill sorter and find that the medications for the day are still in there! It also lets you see well in advance when you need to request a refill, so that you’re never caught without your medication.
7. Taking Breaks
Breaks are non-negotiable for me. I’ve talked before about how naps are a necessity for me, and how we’ve learned to schedule things around my rest times. As much as I need the rest for my physical symptoms, I notice the need even more in my mental status. Or, more accurately, when I don’t rest, my brain fog is almost unbearable! I hit a mental wall by mid-day, and I struggle to think, process what’s being said to me, formulate my words, or function in any way. The only reset I’ve found is to take a break and nap.
If naps aren’t an option for you, find other ways to take your break and allow your mind to reset. Put down any kind of electronic device. Look out the window. Close your eyes and take a few deep breaths. Do something that you do just for fun, like reading a children’s book or doodling. Take a few minutes to not be productive, engaged, or entertained and let your brain recover from all you’ve asked it to do. We all need a little reset from time to time!
As hard as it can sometimes be, I’m a firm believer that laughing is the thing that most often makes chronic illness livable. I learned a long time ago that it was easier to laugh at the frustrating moments than to cry (not that I don’t shed my share of tears too, mind you). So when my words come out jumbled, when I can’t finish a thought, or when I forget what I was doing for the umpteenth time, my family and I have learned to poke fun and laugh. We joke about how my brain is “buffeting,” like an old program loading on a streaming service. We laugh at the crazy scrambled words I come out with. We treat it lightly as often as we can.
One of the keys to navigating brain fog, I think, is finding systems that work for you. Systems can remain in place and function without your input even on bad days: alarms, calendar reminders, pill sorters, etc., all take the burden off of your memory, and act as a safety net to help you remember the things that are important. Whatever your preferred system, find something that works consistently for you, that allows you to “put down” some of the things you carry in your mind, and frees you up to be fully present and as clear-minded as possible in the moment. I’d love to hear what works well for you!