Understanding and Managing Brain Fog: for Young people Living with Fatigue Conditions

What is Brain fog?

Brain fog is a term used to describe cognitive symptoms that impact on daily functioning, including: 

• Memory difficulties – particularly immediate memory. 
• Trouble finding and generating words. 
• Problems with attention & feeling overwhelmed by simple everyday tasks. 
• Executive function difficulties such as planning, organising and multi-tasking. 
• Speed of processing. 

Some young people describe:  

• having difficulties concentrating in class and managing the school environment 
• that brain fog has an impact on managing exams 
• immediately forgetting thoughts and ideas 
• Having difficulty managing friendships/socialising. 

What causes brain fog?

We don’t yet know what causes brain fog. Theories include low level inflammation, chemical or blood flow changes, for example. We do know that some factors are linked to it and can make it worse. For example: 

• Fatigue – feeling very tired makes it harder to concentrate, think quickly and remember information.  
• Pain – being in pain makes it harder to pay attention and think quickly.  
• Feeling anxious or low – this can impact our motivation, make our brains feel scrambled and make us more distracted.  

The good news is, we also know some ways to help you manage your brain fog! 

Day-to-day:  

• Get enough sleep and rest. (See 'Sleeping Better: for Young People Living with Fatigue Conditions') 
• Have a healthy, balanced diet and stay hydrated to keep your energy levels up. 
• Regular exercise or activity - applying a pacing approach to your activities (see 'Activity Management: for Young People Living with Fatigue Conditions'). 
• Do something you enjoy and find motivating.  
• Take regular breaks as and when needed.  
• Notice any triggers or patterns to your brain fog – e.g. do you feel more tired at certain times of day, or after certain activities? Does your brain fog increase when doing certain types of activities?   

Stress management – relaxation and grounding techniques

• Progressive muscle relaxation – starting with your hands, clench your left hand and hold it tightly for five seconds, then release. Repeat with your right hand. Move to your arms, your legs, your feet etc. Try and notice how your body feels when you relax.  
• Grounding – try a grounding strategy such as the 54321 technique. Can you name: 5 things you can see. 4 things you can hear. 3 things you can feel. 2 things you can smell. 1 thing you can taste.  
• Mindfulness – mindfulness improves attention and can help us to be less caught up in our thoughts. Apps such as ’Insight Timer’, ‘Headspace’ and ’Smiling Mind’ can teach and guide mindfulness. Mindfulness is not just about meditation - you can also practice mindfulness while doing everyday activities; for example: going for a walk where you really focus on what you can see, hear and feel as you walk, gently bringing your attention back to the present whenever your mind wanders; or having a snack slowly, paying close attention to the food’s taste, smell and texture. 

Cognitive strategies

• Work out when you are feeling more alert or relaxed and when you are most distracted and try to optimise your learning around this. Do you feel less tired in the mornings? Maybe this would be a good time to do some studying!  
• Slow things down – if you find your processing or thinking speed is slow, take your time and go back over information if needed. Simplify things to make them easier to understand. 
  • Switch between study materials – use a computer, read a book, listen to an audio, find what works best for you. Some people work best listening to an audiobook and others prefer to read it from a screen.  
• Memory retrieval – use cues, diagrams, key words, or to-do lists. This can be helpful to look back on and remind us of important information and can also help us to prioritise what’s most important in the moment. 
• Writing important or ideas thoughts down as soon as you have them e.g. using a notes app. 
• Whilst it is recommended to manage sensory overload (see below), sometimes it might be helpful to apply a multi-sensory learning approach to specific cognitive/learning tasks e.g. audio book to complement a reading task, drawing diagrams or pictures when revising Biology, creating Mnemonics to the tune of a catchy song, or using a flow diagram with a story to learn science formulas etc.  
• See if you can be given extra time in exams and extensions for assignments. 

Managing sensory overload

• Understand how the school, classroom, and social environment might be impacting you - is it too noisy or bright? See if you can have some support in lessons and with your timetable to make this manageable.  
• Take movement breaks – get up and move around as and when needed. 
• See if you have access to any quiet spaces in school to use when necessary if you need a break or are starting to feel overwhelmed. 
• Try to reduce how much sensory input you’re getting at the same time e.g. if you want to enjoy being with friends you may need to be in a comfortable or quieter place. 
• Sensory toys – using fidget toys like magnets or stress balls can be helpful when feeling tired, stressed or you feel your concentration reducing. 
• Try noise cancelling headphones or earbuds if you find the noise around you overwhelming.  
• Other strategies that young people have found helpful include colouring, art, reading or spending time with pets. 

Resources

For Cognitive Dysfunction:

Use Home Hubs/Smart watches (Alexa, Siri, Google Play) to your advantage: 

• Set reminders for specific days/times/dates  
• Timetable your day with prompts  
• Set timers during an activity Initiate 'sleep' routines  
• Add 'to-do' lists  
• Link audiobooks to your device  
• Link music 'beats per minute' playlists (e.g. 60-80 BPM can be calming, 155 BPM can aid focus 

Try out some different apps, eg:

• Daylio - self-care bullet journal with Goals Mood Diary & Happiness Tracker  
• Structured – daily planner.  
• Forest - focus on activities and goals 
• WaterDo – to do list and schedule 
• ME+  
• 'The Pacing Pack' and/or 'My Recharging Ladder' Resources  
• 'Request for help' discreet wristbands - can be worn in school/college.  
• 'Mood Bands' - Green 'I'm okay', Red 'I need support' 

For reducing visual overload:

Use the accessibility settings in your phone/tablet/laptop:  

• Set time limits on your apps.  
• Use coloured tints  
• Increase the text size  
• Invert colours  
• Set weekly reports to monitor your screen time use. 
• Try using coloured overlays, reading rules or extraneous text blockers (https://www.crossboweducation.com)  
• Try wearing sunglasses if the light is bothering you. 

For reducing auditory overload:

• Noise cancelling headphones or earbuds  
• Set volume warnings and alerts on your devices  
• Decibel reducing earbuds - 'Flare Audio' calmer range, or 'Loops' 

Books containing useful advice for managing brain fog: 

• The Fatigue Book: Chronic Fatigue Syndrome and Long COVID fatigue: practical tips for recovery. By Lydia Roller (2022).  
• Smart but Scattered Teens: The "Executive Skills' Program for Helping Teens Reach Their Potential. By Richard Guare, Peg Dawson & Colin Guare (2013).  
• Executive Functioning Skills for Teens: Super Easy to Use Strategies, Games, Tools, and Activities That Work! By Gail A. McHugh (2022)  
• Anxiety is Really Strange. By Steve Haines (2018).