Fixing brain fog
Try brain rest
Image: Mindscape.com
A study published this month clears the fog, somewhat, about the cognitive impact of long Covid, and also provides a practical suggestion for recovery.
Rest, particularly brain rest, seems to provide a path to returning to our high-performance selves after Covid.
Lucy Cheke and colleagues, of the COVID cognition study (COVCOG) at Cambridge University, studied 181 Covid-19 patients, compared with 185 demographically matched controls. Strengths of their study include the use of objective cognitive measures and long-term follow-up.
Their study is remarkable for some of the numbers. Two-thirds of the Covid patients experienced ‘Long Covid’ – that is symptoms lasting more than 12 weeks. Of these, between 40% and 78% experienced cognitive impacts. That is – 40% demonstrated ‘semantic disfluency’ (mistakes in saying or typing a word) through to 78% having difficulty concentrating. These issues had real-world consequences – over half were unable to work for extended periods, resulting in one-third of these long Covid sufferers losing their jobs. Another concerning result – half of these people found it difficult to get their doctors to take these persistent symptoms seriously.
Professor Cheke, featuring on this week’s marvellous BBC podcast Science in Action, discusses the hypothesis that a cause of the problem could be lingering systemic inflammation. She also emphasises the importance of rest – the one behavioural factor that results in a better cognitive outcome.
Now I’m going to take a leap – a connection that might be nothing more than a metaphor – the trauma of Covid might be similar to the mild brain injury of concussion. In both of these insults to the brain, inflammation may be part of the picture. Possibly in Covid as a result of the ‘cytokine storm’ where the body’s immune system goes into overdrive in response to the invading virus. In concussion, there is evidence, in a 2019 study of American football players anyway, that markers of inflammation in blood samples distinguished concussed players from matched controls, and in turn, the level of such markers was associated with the duration of concussion symptoms.
Another similarity between long Covid brain impairment and the cognitive effects of concussion is the recommendation for both sorts of patients to have both physical and brain rest. That includes taking time off work or school, limiting mental activities to easy (or ‘over-learned’) hobbies or chores. Further, avoiding activities making mental demands such as rapid reactions, use of memory, or multitasking. In other words, press pause on cognitively demanding tasks such as online gaming, reading complicated books or solving demanding word puzzles or solving complex work issues.
What about our mind’s inclination to find (complicated) stuff to think about? It can be hard to tell the mind to ‘turn off’ and ‘stop thinking’. Leo Tolstoy wrote a short story about a boy tasked to “not think of white bears.” Of course, the paradox is that we immediately spend a huge amount of mental energy keeping those images out of consciousness.
An alternative, mindful approach is to accept the image of the polar bear (or distracting thought), thank our mind for reminding us, but reassure that mind that this is not on our agenda, and then turn our attention to an alternative, such as a sound or image around us, or coming back to the rhythm of our breath.
For all those who've been laid low by Covid – give yourself time to gently come back to your previous high level of functioning. Add both cognitive and physical activities gradually – one at a time, then see how you are doing 24 hours later. If all is going well – add another task. If not, dial it back and take it more gradually.
Stewart Forsyth is an organisational psychologist and executive coach and also the author of a weekly blog on the practical aspects of psychology -