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  [76]Health & wellbeing

Brain fog: how trauma, uncertainty and isolation have affected our minds and
memory

  ‘There isn’t something wrong with us. It’s a completely normal
  reaction’: many people have experienced a dulled state of mind under
  lockdown.
  [ ]
  ‘There isn’t something wrong with us. It’s a completely normal
  reaction.’ Illustration: Franz Lang/Franz Lang at Heart/ The Guardian
  ‘There isn’t something wrong with us. It’s a completely normal
  reaction.’ Illustration: Franz Lang/Franz Lang at Heart/ The Guardian

  After a year of lockdown, many of us are finding it hard to think
  clearly, or remember what happened when. Neuroscientists and
  behavioural experts explain why


  [77]Moya Sarner
  Wed 14 Apr 2021 01.00 EDT
    *
    *
    *

  Before the pandemic, psychoanalyst Josh Cohen’s patients might come
  into his consulting room, lie down on the couch and talk about the
  traffic or the weather, or the rude person on the tube. Now they appear
  on his computer screen and tell him about brain fog. They talk with
  urgency of feeling unable to concentrate in meetings, to read, to
  follow intricately plotted television programmes. “There’s this sense
  of debilitation, of losing ordinary facility with everyday life; a
  forgetfulness and a kind of deskilling,” says Cohen, author of the
  self-help book How to Live. What to Do. Although restrictions are now
  easing across the UK, with greater freedom to circulate and socialise,
  he says lockdown for many of us has been “a contraction of life, and an
  almost parallel contraction of mental capacity”.

  This dulled, useless state of mind – epitomised by the act of going
  into a room and then forgetting why we are there – is so boring, so
  lifeless. But researchers believe it is far more interesting than it
  feels: even that this common experience can be explained by
  cutting-edge neuroscience theories, and that studying it could further
  scientific understanding of the brain and how it changes. I ask Jon
  Simons, professor of cognitive neuroscience at the University of
  Cambridge, could it really be something “sciencey”? “Yes, it’s
  definitely something sciencey – and it’s helpful to understand that
  this feeling isn’t unusual or weird,” he says. “There isn’t something
  wrong with us. It’s a completely normal reaction to this quite
  traumatic experience we’ve collectively had over the last 12 months or
  so.”

  What we call brain fog, Catherine Loveday, professor of cognitive
  neuroscience at the University of Westminster, calls poor “cognitive
  function”. That covers “everything from our memory, our attention and
  our ability to problem-solve to our capacity to be creative.
  Essentially, it’s thinking.” And recently, she’s heard a lot of
  complaints about it: “Because I’m a memory scientist, so many people
  are telling me their memory is really poor, and reporting this
  cognitive fog,” she says. She knows of only two studies exploring the
  phenomenon as it relates to lockdown (as opposed to what some people
  report as a symptom of Covid-19, or long Covid): one from Italy, in
  which participants subjectively reported these sorts of problems with
  attention, time perception and organisation; another in Scotland which
  objectively measured participants’ cognitive function across a range of
  tasks at particular times during the first lockdown and into the
  summer. Results showed that people performed worse when lockdown
  started, but improved as restrictions loosened, with those who
  continued shielding improving more slowly than those who went out more.

    It’s likely that in a year or two, we’ll look back on some event
    this year and say, when on earth did that happen?

  Loveday and Simons are not surprised. Given the isolation and stasis we
  have had to endure until very recently, these complaints are exactly
  what they expected – and they provide the opportunity to test their
  theories as to why such brain fog might come about. There is no one
  explanation, no single source, Simons says: “There are bound to be a
  lot of different factors that are coming together, interacting with
  each other, to cause these memory impairments, attentional deficits and
  other processing difficulties.”

  One powerful factor could be the fact that everything is so samey.
  Loveday explains that the brain is stimulated by the new, the
  different, and this is known as the orienting response: “From the
  minute we’re born – in fact, from before we’re born – when there is a
  new stimulus, a baby will turn its head towards it. And if as adults we
  are watching a boring lecture and someone walks into the room, it will
  stir our brain back into action.”

  Most of us are likely to feel that nobody new has walked into our room
  for quite some time, which might help to explain this sluggish feeling
  neurologically: “We have effectively evolved to stop paying attention
  when nothing changes, but to pay particular attention when things do
  change,” she says. Loveday suggests that if we can attend a work
  meeting by phone while walking in a park, we might find we are more
  awake and better able to concentrate, thanks to the changing scenery
  and the exercise; she is recording some lectures as podcasts, rather
  than videos, so students can walk while listening. She also suggests
  spending time in different rooms at home – or if you only have one
  room, try “changing what the room looks like. I’m not saying redecorate
  – but you could change the pictures on the walls or move things around
  for variety, even in the smallest space.”
  Brain fog has resulted from “degraded social interaction”
  Brain fog has resulted partly from ‘degraded social interaction’.
  Illustration: Franz Lang/The Guardian

  The blending of one day into the next with no commute, no change of
  scene, no change of cast, could also have an important impact on the
  way the brain processes memories, Simons explains. Experiences under
  lockdown lack “distinctiveness” – a crucial factor in “pattern
  separation”. This process, which takes place in the hippocampus, at the
  centre of the brain, allows individual memories to be successfully
  encoded, ensuring there are few overlapping features, so we can
  distinguish one memory from another and retrieve them efficiently. The
  fuggy, confused sensation that many of us will recognise, of not being
  able to remember whether something happened last week or last month,
  may well be with us for a while, Simons says: “Our memories are going
  to be so difficult to differentiate. It’s highly likely that in a year
  or two, we’re still going to look back on some particular event from
  this last year and say, when on earth did that happen?”

  Perhaps one of the most important features of this period for brain fog
  has been what Loveday calls the “degraded social interaction” we have
  endured. “It’s not the same as natural social interaction that we would
  have,” she says. “Our brains wake up in the presence of other people –
  being with others is stimulating.” We each have our own optimum level
  of stimulation – some might feel better able to function in lockdown
  with less socialising; others are left feeling dozy, deadened. Loveday
  is investigating the science of how levels of social interaction, among
  other factors, have affected memory function in lockdown. She also
  wonders if our alternative to face-to-face communication – platforms
  such as Zoom – could have an impact on concentration and attention. She
  theorises – and is conducting a study to explore this – that the lower
  audio-visual quality could “create a bigger cognitive load for the
  brain, which has to fill in the gaps, so you have to concentrate much
  harder.” If this is more cognitively demanding, as she thinks, we could
  be left feeling foggier, with “less brain space available to actually
  listen to what people are saying and process it, or to concentrate on
  anything else.”

    It is the cognitive equivalent of feeling emotionally distressed –
    it’s almost the way the brain expresses sadness

  Carmine Pariante, professor of biological psychiatry at King’s College
  London, is also intrigued by brain fog. “It’s a common experience, but
  it’s very complex,” he says. “I think it is the cognitive equivalent of
  feeling emotionally distressed; it’s almost the way the brain expresses
  sadness, beyond the emotion.” He takes a
  psycho-neuro-immuno-endocrinological approach to the phenomenon – which
  is even more fascinating than it is difficult to say. He believes we
  need to think about the mind, the brain, the immune and the hormonal
  systems to understand the various mental and physical processes that
  might underlie this lockdown haze, which he sees as a consequence of
  stress.

  We might all agree that the uncertainty of the last year has been quite
  stressful – more so for some than for others. When our mind appraises a
  situation as stressful, Pariante explains, our brain immediately
  transmits the message to our immune and endocrine systems. These
  systems respond in exactly the same way they did in [78]early humans
  two million years ago on the African savannah, when stress did not
  relate to home schooling, but to fear of being eaten by a large animal.
  The heart beats faster so we can run away, inflammation is initiated by
  the immune system to protect against bacterial infection in case we are
  bitten, the hormone cortisol is released to focus our attention on the
  predator in front of us and nothing else. Studies have demonstrated
  that a dose of cortisol will lower a person’s attention, concentration
  and memory for their immediate environment. Pariante explains: “This
  fog that people feel is just one manifestation of this mechanism. We’ve
  lost the function of these mechanisms, but they are still there.”
  Useful for fighting a lion – not for remembering where we put our
  glasses.

  When I have experienced brain fog, I have seen it as a distraction, a
  kind of laziness, and tried to push through, to force myself to
  concentrate. But listening to Loveday, Simons and Pariante, I’m
  starting to think about it differently; perhaps brain fog is a signal
  we should listen to. “Absolutely, I think it’s exactly that,” says
  Pariante. “It’s our body and our brain telling us that we’re pushing it
  too much at the moment. It’s definitely a signal – an alarm bell.” When
  we hear this alarm, he says, we should stop and ask ourselves, “Why is
  my brain fog worse today than yesterday?” – and take as much time off
  as we can, rather than pushing ourselves harder and risking further
  emotional suffering, and even burnout.

    People are finding themselves more sluggish – their physical and
    mental weight is somehow heavier, hard to carry around

  For Cohen, the phenomenon of brain fog is an experience of one of the
  most disturbing aspects of the unconscious. He talks of Freud’s theory
  of drives – the idea that we have one force inside us that propels us
  towards life; another that pulls us towards death. The life drive,
  Cohen explains, impels us to create, make connections with others, seek
  “the expansion of life”. The death drive, by contrast, urges “a kind of
  contraction. It’s a move away from life and into a kind of stasis or
  entropy”. Lockdown – which, paradoxically, has done so much to preserve
  life – is like the death drive made lifestyle. With brain fog, he says,
  we are seeing “an atrophy of liveliness. People are finding themselves
  to be more sluggish, that their physical and mental weight is somehow
  heavier, it’s hard to carry around – to drag.” Freud has a word for
  this: trägheit – translated as a “sluggishness”, but which Cohen says
  literally translates as “draggyness”. We could understand brain fog as
  an encounter with our death drive – with the part of us which, in
  Cohen’s words, is “going in the opposite direction of awareness and
  sparkiness, and in the direction of inanimacy and shutting down”.

  This brings to mind another psychoanalyst: [79]Wilfred Bion. He
  theorised that we have – at some moments – a will to know something
  about ourselves and our lives, even when that knowledge is profoundly
  painful. This, he called being in “K”. But there is also a powerful
  will not to know, a wish to defend against this awareness so that we
  can continue to live cosseted by lies; this is to be in “–K” (spoken as
  “minus K”). I wonder if the pandemic has been a reality some of us feel
  is too horrific to bear. The uncertainty, the deaths, the trauma, the
  precarity; perhaps we have unconsciously chosen to live in the misty,
  murky brain fog of –K rather than to face, to suffer, the true pain and
  horror of our situation. Perhaps we are having problems with our
  thinking because the truth of the experience, for many of us, is simply
  unthinkable.

  I ask Simons if, after the pandemic, he thinks the structure of our
  brains will look different on a brain scan: “Probably not,” he says.
  For some of us, brain fog will be a temporary state, and will clear as
  we begin to live more varied lives. But, he says, “It’s possible for
  some people – and we are particularly concerned about older adults –
  that where there is natural neurological decline, it will be
  accelerated.”

  Simons and a team of colleagues are running a study to investigate the
  impact of lockdown on memory in people aged over 65 – participants from
  a memory study that took place shortly before the pandemic, who have
  now agreed to sit the same tests a year on, and answer questions about
  life in the interim. One aim of this study is to test the hypothesis of
  cognitive reserve – the idea that having a rich and varied social life,
  filled with intellectual stimulation, challenging, novel experiences
  and fulfilling relationships, might help to keep the brain stimulated
  and protect against age-related cognitive decline. Simons’ advice to us
  all is to get out into the world, to have as rich and varied
  experiences and interactions as we can, to maximise our cognitive
  reserve within the remaining restrictions. The more we do, the more the
  brain fog should clear, he says: “We all experience grief, times in our
  lives where we feel like we can’t function at all,” he says. “These
  things are mercifully temporary, and we do recover.”
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