Brain fog, also called cog fog, is a term for the cognitive issues that sometimes come with MS. About half of the people with MS have trouble with memory, focus, problem-solving, and processing or understanding information. Some also have problems with visual or spatial skills, like judging distances or finding their way around.

Brain fog can come and go. It may seem better or worse depending on how tired you are, medications you’re taking, and your stress levels. Sometimes, brain fog is strong enough to make everyday tasks hard to do.

What Are the Cognitive Symptoms of Brain Fog?

Cognitive function includes reasoning, memory, and problem-solving. Because MS can have an impact on any area of the brain, it can affect almost any cognitive function.

These impacts can be mild, affecting only one or two aspects of cognitive function. In some cases, however, they may prevent you from being able to work, go to school, or attend to other responsibilities.

Brain fog affects several aspects of a person’s thinking, such as memory, focus, problem-solving, and understanding information. Here’s how it can show up in daily life.

Memory

People with brain fog may struggle with forgetfulness. They may have trouble remembering people’s names, recent events, or preplanned tasks. If brain fog affects your memory, you may lose objects or miss appointments.

Concentration

Brain fog can make it hard to concentrate. You may get distracted or confused when listening to several people talking at the same time. You may even experience information overload. This feeling is often described as an inability to process what’s going on in front of you. It can be harder to focus on one person or task in a noisy or chaotic setting.

Remembering Words

Everyone struggles to find the right word from time to time. However, if brain fog is among your MS symptoms, you may have particular difficulty recalling words. For example, you might find yourself unable to come up with the word “restaurant,” instead describing it as “a place where you order food.”

Processing Information

MS can make it harder to understand information and follow complicated instructions, especially if there’s a lot to take in at once. Your brain may process what’s happening more slowly, making it tougher to keep up.

Executive Skills

Brain fog from MS can make it harder to plan, solve problems, and think ahead. These changes often reflect problems with executive functioning — the mental skills that help you organize and manage daily tasks. You might not notice these changes at first, but someone close to you might. For example, they may see you’re making quick decisions without thinking them through.

Visuospatial Abilities

Another way brain fog may affect you is through visuospatial skills — the ability to understand what you see and where things are around you. Your brain uses these skills all day to make sense of your surroundings. Brain fog can affect this ability. You might become lost in familiar places, bump into objects by accident, or have trouble judging speed and distances while driving.

What Does MS Brain Fog Feel Like?

MS cog fog often causes people to become forgetful or confused or to feel generally “out of it.” As one MyMSTeam member put it, “I’ve noticed that I can zone out.”

For some people, cognitive fog involves misplacing objects. “I took out a simple bagel this morning, and I thought I set it down somewhere on the counter,” one MyMSTeam member shared. “I went to retrieve it after it was thawed, and it had vanished. I thought one of my dogs took it because they enjoy taking things off the counter, but that was not the case.”

Brain fog may also affect speech or cause difficulty recalling words. “I get my words mixed up, and pronunciation sometimes can be a struggle,” a MyMSTeam member wrote.

It can happen anywhere, and for many people with MS, the symptom is particularly concerning on the job. “At work, sometimes I’m just not ‘all there,’” a MyMSTeam member shared. “I still have to plow through it, both because I want to and because work demands it.” ​

Effect on Self-Esteem

People may feel embarrassed about their MS-related brain fog. In some cases, they may choose to avoid social gatherings. However, one MyMSTeam member noted the importance of spending time with others: “Let your spouse or friends encourage you to go out socially when your other symptoms are in a good place, and your only reason to say no is because you’re embarrassed.”

Brain fog can affect your self-esteem. “Cognitive problems are a big downer for my self-esteem,” wrote one MyMSTeam member.

Many people feel frustrated or ashamed about being unable to function the way they did before their MS diagnosis. Misunderstandings may happen more often, leading to anger or confusion. However, it’s important to remind yourself that cognitive problems are not your fault.

What Causes Brain Fog in Multiple Sclerosis?

MS affects brain health in several ways, resulting in brain fog. In some cases, medications used to treat MS can contribute to cognitive changes.

Cell Damage

Multiple sclerosis damages the brain’s nerve cells and myelin (the coating that protects nerve cells). MRI scans have shown that brain fog can be worse when there’s more damage to the myelin in the brain.

Damage to different connections in your brain can affect what symptoms you experience. For example, if the part of your brain that controls speech is damaged, it can make talking or finding the right words harder.

Brain Lesions

Brain fog has also been associated with lesions in the brain resulting from MS. The overall number of lesions matters most. The number, location, and size of lesions — along with any loss of brain volume — can affect how severe brain fog becomes.

Certain Medications

Some medications commonly prescribed for MS can contribute to brain fog. If you’re having new or worse cognitive problems, you should ask your doctor whether any of your prescriptions could be the cause.

6 Ways To Manage Brain Fog

Fortunately, there are ways to manage brain fog and stay productive. Here are some tips from researchers and MyMSTeam members.

1. Get Some Exercise

Exercise can be very helpful for people with MS. It helps reduce fatigue and rebuild connections in the brain.

Water exercises, pilates, tai chi, stretching, and yoga are great forms of physical activity for people with MS. The best exercise routine for you depends on your overall health and what you enjoy doing.

Your doctor can help you figure out which exercises are best for you. Always talk to your doctor before starting a new exercise routine.

2. Find Ways To Relax and Rest

Brain fog can feel worse if you’re feeling especially tired or stressed. Meditation, getting enough sleep, deep breathing, and positive affirmations may also help.

“My symptoms get a lot worse when I’m exhausted. I need to lie down frequently. It’s the only way I know to relax at all,” advised a MyMSTeam member. “If you can’t lie down, sit down and focus on your breath. Deep, rhythmic breathing relaxes the brain. Pace yourself and use calming self-talk, like ‘This will pass’ or ‘It’s going to be OK.’ It can really help.”​

3. Make Associations To Aid Memory

Memory loss can be a frustrating symptom of MS brain fog. Building connections or associations can help. For example, you might try connecting two activities, such as taking your medication with your first glass of water in the morning. This practice can help reinforce the habit: If you do one activity, you’ll be more likely to think of the other and do it, too.

If you have trouble remembering names when meeting new people, associate them with someone you know who has the same name or with a word that sounds like the name.

Read about more ways to manage memory problems.

4. Use a Calendar and Set Reminders

Brain fog can cause you to forget appointments, special occasions, and everyday responsibilities. Calendars, alarms, and to-do lists can help ensure you stay on top of your tasks.

“I have a calendar on my computer and keep a calendar that tells me birthdays, anniversaries, appointments, and any other things I have to remember. I check it each day. It’s on my phone, too,” one MyMSTeam member wrote. “I also put alarms on my phone to remind me to do things, like call my brother for his birthday, go to a doctor’s appointment at 4, give my dog his flea meds, and remember to buy bread. It may seem stupid to some, but they don’t have MS.”​

5. Try Learning Something New

Sometimes, training one part of your brain can help you strengthen your overall mental health. One MyMSTeam member found that their brain fog improved after they began learning a new language. “I’ve started learning Welsh, as I had heard that learning another language keeps the gray matter of the brain healthy,” they wrote. “Sure enough, after five weeks, I’m actually remembering what I learned — plus remembering a whole sentence both in Welsh and English. Try something new. It’s working for me, and I’m so pleased that I have typed all this!”

6. Talk to Your Doctor

Your neurologist can help you find specialists who know how to treat brain fog and work with you to improve your cognitive function. The first step may be cognitive testing to identify problems. A healthcare professional can refer you to cognitive rehabilitation, a type of therapy that’s been shown to improve cognitive functioning.

Find Your Team

On MyMSTeam, the social network for people with MS and their loved ones, more than 219,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

How does MS brain fog affect your day-to-day life? Do you have any tips for managing any of the common symptoms of brain fog? Share your experiences in the comments below or by posting on your Activities page.