Patient Blogs | Multiple Sclerosis
Dealing With Brain Fog
photo of note on kitchen counter

What was I saying? What am I looking for? What’s your name? What’s that called? Does this sound familiar? I bet you’ve been in this position before. It’s called brain fog or cog fog (cognitive fog). More than half of the people living with multiple sclerosis struggle with brain fog. It can affect many aspects of our lives.

When cog fog strikes, you can feel embarrassed and frustrated when you lose your train of thought, or you can’t remember somebody’s name, or you can’t find the words to describe something you know very well, but the right words just won’t come out.

Although there’s no current medical treatment for brain fog, aerobic exercise and a healthy diet are some of the ways to manage this common MS symptom. Fatigue and lack of sleep can trigger brain fog, so not overdoing it and napping throughout the day can help prevent it.

Most MSers stop working or retire early, not because they can’t walk or move around, but because they can’t think, and they feel overwhelmed at work. Retaining information, learning new skills, using language, concentrating, calculating, processing, problem-solving, become more challenging over time. Especially during an MS exacerbation, cog fog is very likely to happen.

I was a medical interpreter for many years. My job depended on my memory 100%. Once I was diagnosed with MS and I was forced to stay away from work for 4 months to recover, my memory started to decline. Once I returned to work, it was like magic. I was sharp, on point, and I could think and process faster. It didn’t happen from one day to the next, but I could definitely see a big change in my cognitive functions.

My point is that if we keep our brain “in check” or busy, we can overcome brain fog. Learning a new skill -- a new language, for instance -- challenges your brain to process and retain new information. It also requires that you associate images with the new words you’re learning to remember their meaning. This only can retrain areas of your brain in charge of memory.

There are also brain games that you can play online, puzzles, crosswords, or something so simple as reading a book. Invest your spare time in yourself and your brain health. Take on a new hobby that challenges your creativity, like painting or playing an instrument.

Stress is another factor that contributes to brain fog. Life alone brings a lot of stressful situations, but it’s how we deal with stress that makes the difference. I know, it’s easier said than done. Be wise and choose your battles.  Let others solve their own problems. The world won’t end if you take care of it tomorrow.

When you are in the midst of stress, repeat to yourself: “All is well” and “It shall pass.” Meditation is one of the best tools you can incorporate to your lifestyle. It’s been researched and proven through imaging testing that breathing exercises done during a meditation session show positive changes in the brain. It releases the primary driver of the brain’s reward system, the “happy hormone” dopamine, in charge of feelings of well-being.

Also, don’t saturate yourself with too many things to do, much less try to do them all at once. Try your best to organize your day by priorities. Do the most important things or the things that require immediate attention early during the day, when your levels of energy and alertness are higher. This way, if you forget to do something, at least it’s not one of the very important things.

Of course, not everyone is the same. The more lesions you have in the brain, the more acute the cognitive dysfunction could be. Sometimes certain medications can also contribute to the worsening of the symptoms, as well as relapses and the level of demyelination of the brain cells. There are many factors that play a role in the severity of cognitive impairment.

Your verbal abilities can also be affected by cog fog. Some people slur or stutter, and their pronunciation of words changes. I remember one of my group members saying that people thought she was drunk all the time because her words were slurred. Many can fall into depression, anxiety, and isolation because of this.

I sometimes catch myself slurring, and so, I stand in front of the mirror and do facial exercises using an exaggerated pronunciation of the vowels (a, e, i, o, u) one by one. I learned this in acting school. It’s an exercise that actors do to improve their articulation of words while on stage. These exercises stimulate the muscles around your mouth and seem to increase the blood circulation to them. Therefore, your speech is clearer.

Misplacing objects around the house is very common, too. Have you found the butter in the pantry instead of the fridge? I know I have! At this point, I just laugh about it. I mean, what else can I do? I tried taking supplements that helped with memory, but then I would forget to take the supplements. Not a plan well-thought.

Fortunately, we live in the digital era and there are self-help strategies you can use, like keeping a calendar on your smartphone, tablet, smartwatch, or computer where you can set up reminders of your appointments, to-do-list, birthdays, etc. You can set up alarms for when you must take your medications too. Alexa, Siri, and Google have become essential assistants for all of us nowadays. Cheers to technology!

I was the type of person that didn’t have to write anything down. I didn’t have a written to-do-list. I didn’t have to take notes in college. I could do mental math like no other. Now, I’m on a different stage of my life and of my disease. I’m older, too, which doesn’t help either. But hey, I have lesions! I’m doing my best to make the best out of each day.

Just don’t be so hard on yourself. This is not like you are just being distracted or that you’re not productive anymore. It’s MS causing this to you. It’s hard to cope with it, especially when your work demands attention to details, fast thinking, problem-solving, following instructions, or your household is very busy and loud, and you just can’t function amid the responsibilities of family life. But it’s not your fault, just know that.


To connect with other people living with multiple sclerosis join our MS Facebook Support Group.



Photo Credit: Jeffrey Coolidge / Stone via Getty Images

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Mayteé Ramos

Mayteé Ramos

Diagnosed since 2015

Mayteé Ramos was diagnosed with relapsing-remitting multiple sclerosis in 2015. She is a support group leader for the National Multiple Sclerosis Society, a member of the Buddy Network for, and has participated in programs such as the “Ask an MS Expert” series and the PBS American Portrait project. She enjoys traveling, watching tennis, collecting jewelry, and spending time with her three sons. Connect with her here.

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