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I’d like advice about brain fog: how can I force new connections?

My TBI is from 2011, and I’ve never been the same. I’m forcing myself to reconnect by going back to school. I struggle with motivation as well as brain fog. It seems like everything is in the way.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Clinical Specialist

Answer transcribed from the Brightway Answers interview with clinical specialist Marlene Rivera:

I think of brain fog as one of those things that you may experience when you are experiencing cognitive fatigue. This might not always happen - there might be, in some instances, where you experience brain fog and you haven't really been engaged in anything yet so it might feel like you're experiencing it on a more frequent level.

But what I recommend is to assess the pace of your current lifestyle. Doing this will help you to determine what causes your brain fog.

For example, is your sleep inadequate? Are there high levels of physical or cognitive demand that are causing your brain fog?  Are you getting inadequate nutrition or hydration? Assessing those areas of your life and then discussing with your your primary care physician, then they may be able to make some recommendations or identify interventions that you can try to help your brain fog.

Division Director PM&R

Answer transcribed from Brightway's interview with Dr. Thomas Franz:

If you mean brain connections–learning, memorizing, reading, cognitive tasks–we know the memory works by establishing new connections and pruning others. Going back to school and going about those types of interactions are the way that you establish new connections. 

As for the brain fog, that sense that one is out of it and not quite fully present, there are tasks that can be practiced to help with it. Sometimes it does require medications, we talked about those a little bit during the first interview–what's available and particularly things that increase the naturally occurring neuro-stimulants, which are things in the dopamine norepinephrine system. That can be a sign of medications needing to be reviewed. Things that might be sedating and make the person foggy should also be looked at to see if anything can be eliminated. Again, as I mentioned last time, there can be pituitary and hormonal abnormalities from brain injury and those need to be reassessed. If somebody is profoundly low cortisol or low in hormones like thyroid or testosterone because the pituitary is not signaling the body correctly and what to release, those need to be revisited. If the person's not had a good medical evaluation for the cause of their brain fog, that really should be the place to start.

As for behavioral things that this person may be able to do, it depends on the level at which they're already functioning. If they're talking about going back to school, this must be a fairly high-functioning individual. I think things that you would think are very popular right now is what is called mindfulness, but there are also other tasks that one can work on to improve attention and concentration. 

There are techniques that can be taught if a person is very easily distracted: focus on a page when reading or change the computer and other devices to highlight certain areas and bring them more front and center. Also, doing simple things like using earbuds and reviewing information to strengthen those connections could be helpful. Work with a therapist to understand how you can approach written material so that you can organize it in a way that's easier. A speech therapist or again a cognitive therapist psychologist can work with an individual on these types of tasks.