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What MS Cog Fog Feels Like and How to Cope

Managing MS

October 23, 2020

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by Kathy Reagan Young

•••••

Sharon Stoll, DO, MS

Medically Reviewed

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•••••

by Kathy Reagan Young

•••••

Sharon Stoll, DO, MS

Medically Reviewed

•••••

•••••

This common MS symptom can be maddening. Fortunately, there’s a lot you can do to cope.

I’ve never met someone with multiple sclerosis (MS) who didn’t immediately and intimately understand the term “cog fog.”

By definition, it’s a cognitive deficit. It may include problems with thinking clearly, an inability to process information, trouble learning and remembering, problems with organization and planning, slowed processing speed, and lack of executive functioning.

Over 13 years of living with an MS diagnosis, I have so many examples of cog fog. It can be scary, maddening — and even funny, with the right attitude.

For instance, I used to love burning candles. I just love the scent in my house. I had to stop doing that after I walked away from a multitude of burning candles.

I’ve also left burners on after making dinner. Those are perhaps the scariest type of cog fog moments for me.

The saddest was when I couldn’t remember my husband’s name. It probably didn’t last for more than 15 seconds, but it felt like an eternity.

It was just in my head; I wasn’t trying to call him and couldn’t come up with his name (thank goodness). I was looking at him knowing full well that he was my husband but I couldn’t think of his name.

I felt like I was losing my mind.

On the funnier end, I have forgotten to put on makeup and forgotten to get dressed before bringing my kids to school (they stopped me before I got in the car).

I’ve also noticed, while on the beach, that I had only shaved one leg!

Cog fog can come on slowly or suddenly

As with all things MS, cog fog is individual to the person.

It results from damage to the myelin, the covering of the nerves in the brain. Each of us has a different lesion load and area affected, hence, different degrees and types of cog fog.

Cog fog can come on suddenly, or you might notice that you’ve been feeling a bit “off” for some time before the full onset.

I’ve been in meetings and had cog fog hit me out of the blue. It’s embarrassing, scary, and so maddening.

The last time it happened, I apologized, citing a lack of sleep and “2020,” and asked if I could get back to the meeting organizer later on the subject they were asking me about. I was mortified.

Other times, it’s been a slow build of having trouble here and there before a full-on cog fog clog.

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If you don’t have MS, you probably don’t get it

People who don’t have MS can have some degree of cognitive deficits as well. That’s typically caused by stress, being tired, age, or a combination of the three.

It’s transient and often centered around short-term memory, like where they put their reading glasses, or having trouble recalling someone’s name.

MS cog fog is that and so much more.

Unfortunately, many people believe that they understand what we’re going through because they experience other kinds of cog fog from time to time.

It can feel so belittling and minimizing when someone without MS says “I know exactly what you mean. That happens to me all the time too.”

MS cog fog often impacts executive functions, like planning or executing on a plan, motivation, and verbal and nonverbal memory. It often feels like I just can’t think straight.

At times, I’m unable to follow process. By that I mean, I know that I should be doing things in an order, but I literally cannot put that together.

For instance, I can look at my calendar when I’m in the midst of cog fog and see that I’m supposed to have a Zoom call at 3:00 p.m., but I can’t put together what time it is as I’m looking at the calendar relative to when I’m supposed to be on the call.

I also can’t find the icon for Zoom, and the process of clicking on a link and being brought into a virtual room for a meeting is beyond me.

I’ve had to adjust many of my routines

The worst part of cog fog, for me, is that it can threaten your entire routine and how you see yourself.

I’ve always been the sole keeper of the finances in my family. I handled bills, investments, college savings, and more.

Last year, I found I was having trouble with my bills. I would double and triple pay things, and forget to pay other things. When it was discovered that I’d double paid my taxes, I couldn’t deny it anymore. I needed help.

Thankfully, there are systems that can help.

I worked closely with my banker and set up automatic bill pay for most of my bills. I set up QuickBooks to automatically populate and categorize my bills, and I can see all things money-related in my life on one screen.

I think some of the problem had been the “switching” to other accounts. For me, cog fog often has a component of difficulty in sequencing.

I also invested in automatic password keeper software. I only have to remember one master password and the rest are kept in the software. I set it up to automatically fill in the username and passwords to frequently-visited sites.

It was suggested to me, early in my diagnosis, that I should undergo neuropsychological testing. This would provide a baseline of cognitive functioning from which future tests could determine progression and disability level.

I’m grateful to my former neurologist for that bit of insight.

I highly suggest you look into doing the same, even if it’s not early in your diagnosis. Starting from here is still a good measuring stick for future decline.

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How to cope with cog fog

Fortunately, there’s a lot you can do to cope with this frustrating MS symptom — especially when you’re not experiencing it.

Here are some of my favorite tips:

Take advantage of times of clarity

This is the best time to make decisions, like setting up auto-pay or organizing your belongings. The more organized you are, the better.

If everything is in its place, you won’t have to spend time looking for it and getting stressed because you can’t find it.

Have routines and be consistent

I started doing laundry every Sunday. I pay my bills every Monday. I order groceries Sunday night for pickup on Monday.

I front-load my week when I have more energy. And I put everything on my calendar that syncs on my phone, my desktop, and my laptop. I set multiple alarms for things.

Your brain likes consistency, and routines can give you less to think about. And please, do not attempt multitasking — ever.

Pay attention to your mood

Depression, which is very common in MS, can zap your energy and impact cognition.

Be sure to talk to your doctor and get treated if you’re experiencing any symptoms of depression.

Rest and relax

I find getting enough rest — both enough sleep at night and actually taking time to rest throughout the day — can make a big difference.

Stress is our enemy in all things, including cog fog, so building in time for relaxation practices can really help.

Meditation apps, taking a few deep breaths, rolling your shoulders up and back, or petting an animal can all help.

The old standard “eat well and exercise” makes a huge difference as well.

Be gentle with yourself

Find what works for you, mark it on your calendar, and set an alarm to remember to do it!

If all else fails, forgive yourself, lay down, and vow to come back and try again later.

Article originally appeared on October 23, 2020 on Bezzy’s sister site, Healthline. Last medically reviewed on October 19, 2020.

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About the author

Kathy Reagan Young

Kathy Reagan Young is an MS patient advocate, blogger, and podcaster. You can find her at FUMS and on Facebook, and you can get on the waiting list for Patients Getting Paid.

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