Brain Fog: What It Is and How to Treat It (With TCM)

Brain fog has been more in the public eye since 2019, when it was a defining characteristic of COVID infections. It isn’t actually a condition, so much as a constellation of symptoms that make it seem like we’re living in a fog – hence the name.

People who experience brain fog describe it in different ways. Often it’s a sort of mental malaise; focusing can be difficult, remembering information is a struggle, or they may ‘space out’ for extended periods of time. The varying presentation is a reflection of the varying causes.

If you were to look up the causes of brain fog on the internet, you’d get results that run the gamut from ordinary stress to multiple sclerosis. This can, of course, contribute to the anxiety that brain fog may already cause. When experiencing these symptoms, taking a wide view is important. Being clear and analytical makes potential causes clearer – but of course it’s hard to be clear and analytical when you have brain fog! That’s why seeking help is important.

‘Brain fog’ is also a concept in Chinese Medicine. The Ling Shu, written around the 2nd century BCE, states:

‘If the Sea of Marrow (brain) is abundant, one feels light and vigorous. They have vitality and can exert themselves. If the Sea of Marrow is deficient there will be dizziness, ringing in the ears, blurred vision, fatigue, and a desire to lay down.’

Here we see many of the complaints associated with brain fog; fatigue, lassitude and lack of motivation, and trouble with the sense organs. Why does this happen? The internet is correct in that the reasons are multifarious. The most common culprits are stress, diet, and sleep.

Stress is an activity. We may not feel like it, but when under high loads of stress our mind is working overtime. We’re measuring risk, evaluating threats, pondering the right move – all of that is taxing on the mind. Without a way to disengage from this stress response, we quickly become exhausted. When combined with pensiveness and overthinking, it becomes the plague of modern times – anxiety.

There is not an equivalent for ‘anxiety’ in the old literature for traditional Chinese medicine, but they do spend a great deal of time discussing fear, worry and pensiveness. These emotions, when in excess, are very draining. Overthinking in particular impacts the gut, which we are learning plays a big role in many areas of health.

This report explains that brain fog could be a result of the gut’s failure to absorb tryptophan, a precursor to serotonin. A deficiency in serotonin was identified as one of the major drivers for the constellation of malaise, low mood and sluggishness we define as brain fog. If stress and anxiety impairs our digestive function, then the resulting reduction in serotonin can cause brain fog.

In a similar vein, improper diet may also be a culprit. Failure to eat a balanced diet can lead to deficiencies, especially in b-complex vitamins, that impair thinking. However, it’s more likely that we are eating inappropriate things that are causing gut inflammation, and the subsequent lack of tryptophan absorption described above.

The Chinese describe a proper diet as a balance of the five elements. In essence this means whole foods, from natural sources, with variety and in measured portions. For instance, a Chinese meal may consist of rice (Metal element), cabbage (Earth), mushrooms (Water), Zucchini (Wood), and a few small pieces of lamb (Fire). By contrast, the American diet often involves large amounts of very rich and dense foods – steak, cheese, and oil. Or, alternatively, we go to the other extreme and have only cold raw foods like salads and smoothies which are difficult to digest.

In my experience, the vast majority of patients who come to me for help with brain fog are experiencing an imbalance in their gut. Once this is corrected, they quickly being to experience improvement. The following basic guidelines should be followed:

1.       Stick to an exercise regimen: Routine, moderate exercise increases dopamine and serotonin, improves gut motility, and raises metabolism. This will improve cases of both stress and poor diet. But be wary! Too much exercise may have the opposite effect. Make sure you balance activity and rest, and you aren’t covering your anxiety by living at the gym.

2.       Clean, consistent diet: With the new year comes the motivation to make change, but that usually takes the form of crash diets and extreme changes. Keep things simple, clean, and moderate. Use whole foods, try to balance the various types. The key is consistency. Remember that most lifestyle changes take at least two weeks to start showing changes.

3.       Goldilocks Principle: Not too much, and not too little. Eat until you’re about 70% full. To do this, you need to be present and mindful while you’re eating. This has the added benefit of downregulating your autonomic nervous system, switching you into ‘rest and digest’ mode. Better digestion = less brain fog.

If stress and anxiety are high, findings ways to manage those should be a priority in order to resolve brain fog. For some, they may say that they don’t feel stressed but will then state that they have trouble sitting still, or like to keep their brain busy. Stress doesn’t always manifest as anxiousness or worry, it can just as much be that sensation of always having to be on the move. For someone with chronic stress, sitting still can be a difficult and uncomfortable endeavor.

Here are some tools and strategies we can use to manage the mental culprits of brain fog. It usually requires a combination of strategies to get the best effect, and everyone is different so test several.

1.       More exercise!: As mentioned above, exercise is a good way to get those happy hormones going. It also breaks up stagnation. For some sufferers of anxiety and brain fog, there is a sensation of being ‘stuck.’ For this person inertia works against them to get moving, but usually movement helps dispel the symptoms.

2.       Mindfulness: People conflate mindfulness and meditation. But while meditation is mindfulness, not all mindfulness is meditation. For someone who struggles to sit still, they will balk at the idea of meditation (although learning to accept stillness may be precisely what they need). Other forms of mindfulness are cooking, exercise, dancing, bike riding, gardening – anything that gets you out of your head and transfixed on the present moment. Practicing mindfulness is important, but even more important is learning to call on the skills we learn through mindfulness whenever we need them, not just when meditating (or whatever mindfulness practice you prefer).

3.       Break up patterns: This is most effective for over-thinkers, but can be very helpful for busy-bodies. Brain fog that’s derived from mental taxation or diet is a consequence of bad habits. If we can identify and limit or eliminate these bad habits, the brain fog will resolve on its own. Recognize where you may be caught in a bad pattern and interrupt it consistently. It’s helpful to replace a bad habit with a better one in a similar vein: If you tend to make lists of things you have to do, replace it with lists of things you’re grateful for.

Finally, sleep (or the lack thereof) is a major cause of brain fog. From trouble falling asleep, to waking often, to ‘revenge bedtime procrastination’, the lack of restorative sleep takes a toll. If sleep is an issue, take a look at this article about sleep hygiene from a TCM perspective.

What you may notice is that these three factors – sleep, diet and mental health – are very closely intwined. For best results with brain fog and other related symptoms, it’s best to use a combination of strategies that address each of these. Having someone to help recognize the issues, plan strategies, and help the process along can make a big difference. If brain fog is something you’re struggling with, acupuncture and traditional Chinese medicine like herbs can get you out of that rut.