Struggling with migraine and brain fog? Laura McKee shares her experience with the two, along with 15 quick-fire tips to beat the brain fuzz.

According to Science of Migraine, “Migraine is a major global health issue that affects over 10% of the population (≈ 1 billion people globally) and is the second leading cause of years lived with disability worldwide.” 01

One of the most pressing symptoms I face is “brain fog.”

Brain fog 02 mostly appears as short-term memory loss and poor thinking skills. For instance, you may struggle to understand what you've just read or mentally stumble when trying to find a word you want to say. Brain fog isn't limited to migraine sufferers but is a common comorbid symptom. 03

As a chronic migraine sufferer 04 , having 15 or more migraines a month, I experience brain fog daily. I have particularly noticed the impact on my time awareness as I was never late before chronic migraine. I have recently discovered why brain fog could lead to poor time perception.

In this article, I'll share my experience with brain fog and how it can affect my sense of time. Lastly, I’ll provide some top tips for managing time with a foggy brain.

What is brain fog?

The American Migraine Foundation says 05: “People who get brain fog often say it makes it hard to focus and find the right words. They may feel distracted, forgetful, less alert, or have trouble completing simple tasks."

It can be caused by various health conditions and human habits, from sleep problems, hormonal changes, or poor nutrition to acute illnesses (such as Covid-19), chronic illnesses, and some medications. 

I asked the chronic illness community to share how they describe brain fog to those who don’t have it. Their responses were: 

"Imagine my brain's running down a hill, but I've no way to stop it."

 “It feels like being very drunk!”

“When you wake from a nap and don’t know where you are.”

“It seems like my brain is mushy.” 

"It's like a really bad hangover without the super-fun night before."

“Everything seems hard to do.”

“Everything is in slow motion.”

"My brain's full of crusty porridge that traps the words I need."

"It's akin to having a nightmare where you're trying to scream, but no sound comes out. But you're awake. That's your reality.'"

Fatigue and brain fog may get confused, as both may make you feel exhausted and groggy. Healthy people tend to think fatigue 06 means being tired due to a long day or participating in heavy exercise. However, it's an intense, unrelenting sense of tiredness that rest doesn't relieve.

Brain fog can be more extreme than fatigue. You may be exhausted along with it, but you'll also have disrupted thoughts and slower mental reflexes. Not to mention the frustration you'll feel! If you experience brain fog, please seek medical advice as soon as you can.

How brain fog feels

Brain fog varies from day to day and fluctuates throughout the day. Every person also experiences it differently. When you have brain fog for a short time, it's frustrating, no doubt about it.

Brain fog may occur as 07 :

• Slowness or inability to think clearly
• Difficulty recalling recent events
• Trouble absorbing information
• Poor concentration
• Inability to focus or being easily distracted
• Becoming easily confused
• Difficulty following conversations
• Long-term memory problems
• Difficulty performing mental tasks
• Mental exhaustion
• Inability to multitask
• Declining mental sharpness and performance
• Difficulty remembering words
• Emotional imbalances and mood swings
• Physical symptoms such as headaches

The mix of my migraine, other conditions, and the medication I take make the fog in my brain dense and constant. When I convey a message or tell a story, the information, and words I need get stuck repeatedly. 

When this is at its worst, I lose all sense of time. My husband's often up until 1 a.m. as I try to tell him something that's happened that day. I lose my place often, miss steps, and take detours. I have to get from A to B, but I misplace the ending so often it hurts.

My husband has named my storytelling after my favorite book: "Laura's Alice in Wonderland Ramblings." I used to be like the White Rabbit, constantly aiming to be punctual. Sadly, my timing is now as unpredictable as the Cheshire Cat's actions!

It's as if my brain's been filled with crumb-filled butter, like the March Hare's watch. Now my husband cries, "Down the rabbit hole!" when I'm rambling, so I (usually) realize I'm talking nonsense and consider what I'm saying more carefully.

As you can see, finding your sense of humor is essential when dealing with chronic problems such as brain fog. I make fun of myself, as do my family and caregiver. There are often fits of laughter when I say the wrong word – like when I told them I was writing about "brain frog"! I've since struggled not to write "frog" here (ha!).

How does the migraine cycle affect the way I process thoughts?

Migraine tends to come in these four phases 08 : 

1. Prodrome: 1 - 2 days before the attack, you have symptoms such as mood changes, cravings, or neck pain.

2. Aura: Only around 25% of people get temporary flashing light-style disturbances. Aura can also occur as tinnitus, numbness, "pins and needles," etc.

3. Attack: This is usually 4 - 72 hours of throbbing pain on one side of the head, light/sound sensitivity, nausea, and vomiting.

4. Postdrome: This is often referred to as a migraine hangover 09. It can feel like an actual hangover without the fun from the previous night.

According to Modern Migraine MD 10 , people who experience brain fog and memory loss during a migraine attack may feel foggy symptoms during any of the four stages. My brain fog lingers in the postdrome stage, leaving me feeling muzzy and out-of-sorts for days after an attack.

As the pain subsides, "migraine brain" can seem as funny as frustrating. People find themselves doing daft things during their daily routines. I've certainly put tea bags in the washing machine or my mobile in the freezer!

“Migraine brain" really affects my sense of time

I've noticed how difficult it is for me to sense time passing. I’ve put my time blindness down to using blackout curtains during the day to help with my photophobia (sensitivity to light) 11 .

I spoke to my husband and caregiver about my general time management. Both admitted to pulling forward my "leaving times" by 30 to 60 minutes. So, if I needed to be somewhere by 4:00, they'd say we had to leave by 3:00 - even if it only takes 30 minutes to get to where we're going.

As I thought about this, I realized that I struggle to plan a day. I have no idea how long I've been brushing my teeth, and I can spend up to 20 minutes in a brushing daze! I need regular reminders when I go out, but I still don't start getting ready until 15 minutes beforehand.

I can no longer tell how long it'll take me to complete a task. I often wildly underestimate the big things and overestimate the small.

My friends know this now. I often find them sat down and settled in when I finally emerge from my bathroom... 20 minutes late.

As my primary caregivers, Joel and Sam have devised different ways of hurrying me along without making me feel babied. Sam often says, "We're not going to chat now, as we've got to…."

I'll acknowledge it, but don't join the dots and still make us late.

Steps to manage brain fog or “migraine brain”

Here is a list of the key things I do to help manage my time perception and my brain fog and awareness of time:

1. If focusing is tricky, don't try to multitask

Multitasking is harder with brain fog; trust me. Save your energy by doing one task at a time.

2. Plan for mental breaks

I plan my day with 15-minute breaks every working hour, where I move, meditate, or do something to allow my brain to rest.

3. Experiment with memory-strengthening activities

I keep my brain working as much as I can by doing activities that make me think deeply, such as doing puzzles.

4. Remember that motivation and reward are directly linked

Choose a reward when you set a goal.

I set myself the task of having a shower by a set time. If I complete this task four times a week, I get a pamper session as a reward.

5. Break things down into small steps

Write the 7-8 steps you need to take to achieve your goal and keep it visible. When you tick it, you'll get a feeling of accomplishment.

6. Talk to your boss about reasonable work accommodations

I can plan my day around what suits me as I work for myself. For instance, mornings are hard for me, so I do most of my work in the afternoon and evening.

If a company employs you, you could be able to get "reasonable accommodations" at work. Talk with your boss and see what's available.

7. Get yourself out in the sun!

My light sensitivity keeps me in a dimly lit room most days, making my brain feel foggier. Safe sun exposure 12 can boost many brain chemicals.

8. Set (many) alarms

The number of alarms I need has always amused my loved ones, but I can't live without them.

9. On your phone a lot? Use that to your advantage

Use your calendar and reminders to help you be more organized and productive. I set reminders for everything from daily activities to unmissable events.

10. Get yourself a diary

I didn't use a diary in 2021 and lost all my motivation to write. So I now plan out my day using time markers and a wall calendar for visual reminders.

11. Manage app notifications

I don't open text messages or emails or click on notifications on social media until I've got the time and energy to reply. There's also less chance of forgetting them (but it still happens most days).

12. Give yourself a head start

Get loved ones to help you get out the door for events. My husband gives us contingency time with 45, 30, and 15-minute warnings.

13. Think carefully about how long something will take

My inability to estimate how long something will take can mean sometimes I'm ready an hour early. On the opposite end of the scale, I can also wildly underestimate how long a task will take.

14. Set "time boundaries" with your family and friends.

We agree on boundaries when it comes to time. For example, late at night, my husband can tell me to hold a thought until morning without causing upset.

15. Ask for help

I need someone, like my caregiver, to take charge of the time plan on big days that are out of routine, such as hospital appointments. This is shared ahead of time to help me feel in control.

The takeaway

The biggest impact of my condition is my inability to keep time. I don't know what time it is unless an alarm goes off or someone tells me. I forget this almost immediately and have no idea how long a conversation or activity has lasted.

I was always on time or early before I had chronic migraine. As a teacher, I knew what I was doing every meticulously-planned 5 minutes of a lesson. Although my new Alice in Wonderland ways can be amusing, they're also a stark reminder of what I've lost.

However much I do to try and regulate my brain fog, I will always have difficulty connecting the dots of time management. Migraine seriously affects my ability to judge how long something will take or how long I've been doing something already.

The individual(s) who have written and created the content in and whose images appear in this article have been paid by Teva Pharmaceuticals for their contributions. This content represents the opinions of the contributor and does not necessarily reflect those of Teva Pharmaceuticals. Similarly, Teva Pharmaceuticals does not review, control, influence or endorse any content related to the contributor's websites or social media networks. This content is intended for informational and educational purposes and should not be considered medical advice or recommendations. Consult a qualified medical professional for diagnosis and before beginning or changing any treatment regimen.