Diary of a busy practitioner, juggling work and family somewhere in England

Everyone I speak to at the moment seems to be suffering from brain fog, myself included. It is really horrible. I have always prided myself in being seriously 'on it' - my intelligence, and ability to consume information, is something I have never had to worry about - and it is easy to see how one’s confidence could start to dip. When it comes over me, I feel like the only thing inside my skull is polystyrene. It is a bit like when I was working nights on a temp contract after I returned from travelling and in the mornings I would drive home knowing deep down that I didn’t know what red lights and green lights meant any more. However, these days I definitely don’t have the excuse of being up all night.

Anonymous

Brain fog can be caused, for women, by Reaching a Certain Age, and this can easily go on for 10 years. It is not limited to women and can also be caused by stress, Chronic Fatigue Syndrome, a vitamin deficiency, coeliac disease or gluten intolerance, other intolerances, thyroid problems, MS, pregnancy, medication including chemotherapy, lupus and long Covid.

It is therefore concerning that most of the lawyers and other professionals, who have kindly given me details of their experience of brain fog, cope with it by writing reminders in a notebook. Please, please, please get a blood test.

I appreciate that many blood tests will come back normal though. Perhaps (with long Covid, for example) there isn’t a magic pill yet or you can’t just, like, stop chemo to clear your head. And I don’t want to make light of the lawyers who came back to me about notebooks and reminders. I highly recommend writing everything down and setting reminders on your phone or computer. Set aside time in your work diary to prepare for a meeting so that you don’t forget. Write lists. If you need to take the car seat out of the car before you go to work, put a sign on the inside of the front door while you think of it. It lessens the pressure and panic on you and probably your family too.

Take breaks. If the fog sets in, give up and walk away. I certainly haven’t been able to power through (except in client meetings where I guess adrenalin comes to the rescue). Have a glass of water and a walk.

In terms of diet, luckily whether you are perimenopausal or stressed or have long Covid or Chronic Fatigue Syndrome the advice is the same. Gluten (or at the very least the cheaply produced stuff we make in this country now) is the root of all evil. Monitor how dairy makes you feel too. Your brain is mostly made of water and fat so keep hydrated and don’t follow a low fat diet. Read up on the gut/brain link, stimulating the vagus nerve and increasing BDNF - but to save you some time the gist is to follow a Mediterranean diet, keep your blood sugar constant, exercise, practice mindfulness and make sure food is…er… being processed through your digestive system fairly quickly and not hanging around in your gut.

The sugar thing is really important. I know it is hard, but if I have come to realise one thing recently it is that my brian functioning well is the most important thing in the world to me. If one of my legs stopped working and someone told me to cut out sugar to make it work again, I would cut it out in an instant. So why not the brain? The control centre for your entire life?

I said this in a previous blog but there is a theory that we lost some of our neurological connections in lockdown. Everything literally became two-dimensional. On the subject of neural pathways and brain plasticity I refer you to Robert Winston’s The Human Mind. Or, if you can’t be bothered, just make sure you are seeing friends and interrupting them regularly when they speak, like we used to pre-Zoom, and asking waiters what they would recommend from the menu, and seeing live music, and perhaps engaging in some high octane activities that actually release adrenalin rather than simply allowing it to build up in our bodies. Experience stuff and feel stuff, rather than sitting at home ordering stuff on apps.

If you could be in the potential 10 year lead up to the menopause, I highly recommend The Perimenopause Solution by Dr Shahzadi Harper and Emma Bardwell. Think (or think again) about HRT. I know it can be life changing. Monitor whether things get worse at certain times of the month - as it was news to me that things can get worse on a monthly basis before they get better.

Don’t belittle the effect of stress. More than one person who spoke to me about brain fog (including - wait for it - a man) blamed highly stressful times in their lives for setting off this susceptibility for brain fog. Stress affects your body as well as your mood - in so many different ways. And the reverse is true too - perhaps your mood is fine but your body just isn’t as resilient to stress as it used to be. I know mine isn’t. Don’t feel foolish or pathetic, it is just the way it is. Again, if it was your leg that was affected you wouldn’t feel silly.

Think about how you can reduce the peak times of stress in the week - for me this involves handing everything house - and child-related over to my husband on my working days, as he doesn’t seem to get quite the same rush of cortisol through his body when he suddenly remembers that Wednesday is guitar day and their guitars aren’t even at the front door and have they even practised at all this week and does the guitar teacher think I’m a bad mum for paying for the lessons but showing very little interest in their actual progress because deep down I am interested but Wednesdays are a really bad day for me and have I even defrosted any rolls for their packed lunches? And you thought I was going to talk about Being a Solicitor. That comes hours after all this nonsense in the mornings.

If your body (and I include your brain in that) is feeling the effects of stress, think about what other stress you are putting it through - and we are back to diet. Don’t make it work too hard processing crappy food. In fact, support it. There is so much you can read at the moment about the gut/brain link and I recommend Eat More, Live Well by Dr Megan Rossi.

I want to thank the readers that spoke to me about their experiences of brain fog, and for the sake of completeness here are some of the things that have helped them that I haven’t specifically mentioned above:

  • Praying, both alone and in collective worship
  • A Mirena coil
  • Various supplements (you will have to do your own research) and reminders on your phone to take them.
  • Sleep, of course, is of utmost importance. Prioritise it.
  • Think about whether reading emails and texts on the run is useful if then you are going to forget to reply. Do one thing properly at a time.

I remember my friend’s mum suffering the side effects of the menopause for a long time. She was a stay at home mum and my friend would just roll her eyes and try to stay out of the house as much as possible. Not to belittle my friend’s mum at all, but the worst that she would forget would be to start dinner or wash uniform. The people who spoke to me about brain fog are struggling with large teams of staff, complex cases and multi-million pound budgets. One had recently taken voluntary redundancy to regroup. You don’t have to take the advice above but do prioritise taking someone’s advice, and doing everything you can to treat this debilitating symptom. It is a physical symptom like any other and I do believe it can be managed. Good luck.

 

*Some facts and identities have been altered in the above article

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