12 Tips for MS Brain Fog

For decades, people were told that MS didn’t impact their thinking and memory – but now we know better. About 65% of people with MS will experience changes in their cognition at some point in their disease course.   

If you struggle with feelings of MS brain fog–or a slow, fogginess in your thinking–then you know how frustrating it can be. These cognitive symptoms can end up affecting your self-confidence, your productivity, and your relationships.   

Thankfully, there are plenty of ways to manage cognitive changes, whether it’s forgetfulness, slowed thinking, or trouble focusing. This article has 12 tips to help you with changes in your thinking, attention, and memory.  

Identify Your Cognitive Strengths and Weaknesses 

1.  Seek a cognitive screening.  

Like any other MS symptom, a good starting point is talking to your doctor. Write down your concerns (so you don’t forget!) and then bring them up during your next visit with your MS provider.   

They will likely recommend a cognitive screening. (If they don’t, ask for one!)  

A cognitive screening is a brief test, typically done at the time of diagnosis and every 6-12 months thereafter. It can alert you to changes that may be occurring before they cause a significant disruption in your life.  

If the brief screen indicates a problem, you may be referred for more in-depth evaluation by a neuropsychologist or speech/language pathologist. This can identify your specific areas of difficulty as well as your cognitive strengths.  

2.  Consider Cognitive Remediation Therapy  

From there, you may be offered cognitive remediation, which means you work with a speech-language pathologist, occupational therapist, or another care provider to develop compensatory strategies. Together, you’ll work on your thinking skills and come up with ways to stay on top of things.   

PS – If remediation hasn’t been offered to you, ask for it!  

In the meantime, there are plenty of tips and tricks to help yourself work around cognitive challenges.  

Stay Organized So You Don’t Need to Rely On Your Memory

3.  Have a place for everything; keep everything in its place.  

When you organize your home and workspace this way, you eliminate the need to look for things like glasses, keys, TV remote, or mail.   

Select your organization strategy and stick with it! Consistency is key.  

4.  Stop using sticky notes.  

When it comes to your reminders and lists, stick to one calendar and one notebook. Sticky notes have a way of getting lost and mixed up. 

Use Mindfulness to Make Memories Stick 

5.  Lock in the memory using multiple channels.  

Memories are created when you pay attention. So, give important items extra attention: say it aloud, say it silently to yourself, visualize it, write it down.  

6.  Associate something you’re trying to remember with something else that’s familiar.  

Let’s say you can’t think of a word mid-sentence. The best way to try to find the word, and carry on the conversation, is to describe its meaning and context. (“The actress from Friends! She was blonde…”)   

7.  Set up space and time for yourself to create memories.  

A great way to remember meaningful moments is to reflect on them. List your activities from the day and ask yourself “What happened today that I want to remember?”  

Set Yourself Up for Success in Everyday Life

8.  Schedule reminders.  

Maintain a daily schedule in a handy place and refer to it throughout the day. Use your smart phone or other device to ping you when it’s time to do something. This can be anything, from taking your medications, to meeting a friend for lunch, to driving to an appointment.  

9.  Keep a family calendar.  

If you have always been the person who keeps their whole family on-the-go, you may want to share the responsibility going forward. Create a family calendar and post it in a place where everyone can use it and see it.   

10.  Minimize distractions.  

For conversations and tasks requiring your attention, minimize distractions around you. (For example, put your phone away, pause computer notifications, close the door, turn off the TV)   

To improve your driving safety, minimize distractions like the radio and conversations.  

11.  Try task templates.  

For tasks with multiple steps, create or search online for a template. Similar to a recipe for cooking, you break down the project into its simplest steps, and check them off as you go.   

If breaking down the steps of a task seems daunting, you can ask for help with creating the template. With a little support at the start, you’ll be able to work through the list on your own from there!  

Ask for Help 

12.  Let others know how they can assist you.  

It might be vulnerable to ask for help, but it can be a huge relief for everyone when you receive the right support. Here are a few ways to seek it:  

• Ask the person to speak more slowly so that you can keep up and respond.  

• Ask for patience as you formulate your thoughts.   
• Ask not to be interrupted while you take the time you need to complete your sentences.  
• When someone’s done speaking, confirm what you’ve heard from them.  
• If you share your home or workspace with others, ask them to honor your organizational strategies and return things to their designated places.  
• Ask for your family to post their activities and appointments on the family calendar.  

• If you can’t find a word, describe it, and see if the other person can help.   
• Ask for a break when you’re feeling overloaded by tasks or distractions.   

Cognitive changes can be challenging, but with the right strategies and the right support, they are manageable!