Unlike a hangover or depression, brain fog is not a similar condition. It is a dysfunction of executive function that renders even the most basic cognitive tasks incredibly challenging.
Hannah Davis realized she had COVID-19 on March 25, 2020, while texting with two friends and struggling to understand one of their messages. This was her first encounter with “brain fog,” a misunderstood symptom of Long COVID that has become one of her worst. Hannah used to work with artificial intelligence and analyzed complex systems with ease, but now finds simple tasks like filling out forms challenging.
Her memory is no longer sharp, and former mundane activities like buying food and cleaning have become agonizingly difficult. She has lost her ability to daydream, make plans, and imagine, and the fog has taken over every aspect of her life. Despite the fluctuation of other long-COVID symptoms, Hannah’s brain fog has persisted for over 900 days.
According to Emma Ladds, a primary-care specialist from the University of Oxford, brain fog is one of the most devastating and debilitating symptoms of long COVID. Despite this, it remains one of the most poorly understood symptoms. When the coronavirus pandemic first began, brain fog was not even considered a potential symptom. However, 20 to 30 percent of patients continue to experience brain fog three months after their initial infection, and up to 65 to 85 percent of long-haulers who remain sick for extended periods also report the symptom. Brain fog can affect anyone, regardless of whether they required hospitalization or not, and even young people in the prime of their mental health can be afflicted.
Long-haulers who experience brain fog describe it as entirely different from other commonly associated cognitive impairments such as hangovers, stress, or fatigue. For Hannah Davis, it has been more severe than her experience with ADHD. Brain fog is not psychosomatic and has actual structural and chemical changes in the brain. It is not a mood disorder, and according to Joanna Hellmuth, a neurologist at UC San Francisco, any suggestion that it is due to depression or anxiety is unfounded, with data suggesting the opposite.
Brain fog is not a catch-all term for every possible mental issue, despite its ambiguous name. According to Joanna Hellmuth, at its core, brain fog is typically a dysfunction of “executive function,” which encompasses mental abilities such as focusing attention, retaining information, and disregarding distractions. These skills are so fundamental that when they deteriorate, much of a person’s cognitive abilities begin to crumble. As a result, tasks that involve concentration, multitasking, and planning, which are essential for daily life, become incredibly challenging. “It brings to the conscious level what are typically unconscious processes for healthy individuals,” stated Fiona Robertson, a writer based in Aberdeen, Scotland.
Although many people with brain fog improve over time and are not severely impacted, those who recover enough to work often struggle with cognitive abilities that are less agile than before. As Vázquez put it, “We’re used to driving a sports car, and now we are left with a jalopy.” For some professions, a jalopy is simply insufficient. “I’ve had surgeons who can’t return to performing surgeries because they require their executive function,” explained Monica Verduzco-Gutierrez, a rehabilitation specialist at UT Health San Antonio.
Although biomedical breakthroughs may take years to develop, long-haulers experiencing brain fog require assistance now. Since cures are unavailable, most treatment approaches focus on helping individuals manage their symptoms. Simple lifestyle changes like getting better sleep, maintaining a healthy diet, and other general practices can make the condition more bearable. Breathing and relaxation techniques can provide assistance during bad flare-ups, and speech therapy may help those experiencing difficulty finding words. Over-the-counter medications such as antihistamines can alleviate inflammatory symptoms, while stimulants may improve lagging concentration.