Getting a Handle on Brain Fog

MS Can Come With Cognitive Changes

If you’re living with MS and feeling as though your head is in the clouds – but not in a good way – you may be experiencing MS-related cognitive changes. These changes may:

• slow your thinking
• challenge your ability to learn and remember new information
• cause word-finding problems
• interfere with attention and concentration
• make organization, planning, prioritizing, and decision-making particularly difficult

Any or all of these changes can occur at any point in the disease, even as the very first MS symptom. However, foggy thinking can be caused by many different things. Just think about the many terms people use to describe their problems with brain fog – cog fog, chemo brain, pregnancy brain, mommy brain, menopause brain, losing it, and many more. The good news – particularly if you’re a perimenopausal women, a new mom, a male or female undergoing chemotherapy, or someone who is aging – is that the strategies for managing cognitive changes are the same. That means that you don’t need to spend time worrying whether it’s MS or menopause, or chemo that’s causing it – you just need to take steps to manage it!

Management starts with a screening evaluation to determine what kinds of changes are occurring. The simplest screening tool evaluates how quickly you are able to process incoming information. Slowed information processing speed is the hallmark of MS-related cognitive change. When your brain is processing information more slowly than it used to, it feels as though the world around you is moving too fast. It takes longer to understand what others are saying, to figure out the meaning of something you are reading, to make a decision or a plan, or to come up with the words you want to say. People describe feeling as though their head is filled with molasses – that is slowing everything down and gumming up the works. This slowing also contributes to problems with learning and remembering new information, to finding your way when you’re driving, to planning and preparing a meal, or to completing a project at work on time.

If your initial (baseline) cognitive screening test indicates a change or slowing, you will likely be referred for a more in-depth evaluation to determine the specific types of challenges you are experiencing as well as your areas of cognitive strength. Armed with this information, you can work with a speech-language pathologist (SLP), occupational therapist (OT) or a psychologist to create a toolchest of strategies for managing cognitive changes in your everyday life. Some of the tolls and strategies you might use include:

• Posting a Family calendar (or using an app on your phones) that allows everyone in the family to see each other’s schedules will cut down on repeated questions.
• Organizing your home and office so that everything has its place will reduce the amount of time you spend hunting for glasses, keys, TV remotes, and other pesky items.
• Using a smart watch or phone to give you prompts – for taking meds, getting ready to go out, leaving the house, starting meal prep, taking a rest, or doing some physical activity, will help you stay on track with your day.
• Using a Task Template for multi-step tasks (similar to a recipe for cooking) helps you follow the necessary steps to complete a task successfully.
• Using a Problem-Solving Flow Chart to identify the steps you need to take from identifying a problem to arriving at a solution will save to time and reduce stress.
• Using the 4 P’s – Planning, Prioritizing, Pacing, Positioning helps cognitive functioning as well as energy conservation – by providing structure and organization to your thinking, highlight your options and priorities, and reducing the cognitive fatigue that comes with prolonged and intense concentration.
• Downloading a Grocery Checklist, or creating one that aligns with the aisles in your grocery store (and making multiple copies), allows you to plan your shopping trips, conserve energy, and cut down on impulse buying.
• Using a free Meal Planner app such as Mealime, AnyList, Pepperplate, Prepear, can save your time and money and help reduce your stress!
• Creating a Decision-Making Tool for yourself can help you s the specify the decision you are trying to make as well as the plusses and minuses you want to take into account in making your decision.

The beauty of this toolchest is that it can be tailored to your needs and lifestyle – and it can be modified over time if and when your needs change.