Brain Changes in Illness and Injury
We all have times when we are thinking less clearly or forgetting something we should remember, and these usually are times of stress or fatigue. We get foggy-headed when we have a cold, for example, and even if we drag ourselves to work or school, not much gets accomplished. We try to read something late at night, and our eyes get to the bottom of the page, but we have no idea what we’ve read. This is the brain on “power-saver.” Just as the higher level processes of thinking and attention only work when we are safe and our basic needs are met (see Mood and Motivation), they don’t work well when we are sick or fatigued, or when we are worried or upset about something. Because we have all had these brief experiences of brain malfunction, we tend to become concerned only when they persist over time.
Brain Fog – the experience of not being able to think or concentrate – is very common, but little information is available about it. It can interfere with your ability to do your job or manage your household, maintain your relationships, pay your bills and take care of your kids. It is caused by both illness and injury, whether mild or more severe. Brain fog in illness (immune-mediated cognitive dysfunction) occurs in infectious diseases such as Lyme disease as well as inflammatory or autoimmune disorders, such as multiple sclerosis, lupus and rheumatoid arthritis, and in poorly understood conditions like fibromyalgia and chronic fatigue syndrome. People undergoing chemotherapy frequently suffer from brain fog, or “chemo-brain,” although it is rarely discussed beforehand as a possible side effect.
The symptoms of Lyme disease area usually flu-like aches and pains, joint and muscle aches, and fatigue. However just about any symptom can be caused by Lyme, including headache, stomach or digestive problems, heart palpitations, vision changes, and so on. Sleep disturbance – problems falling asleep or staying asleep, are very common, as is mood disturbance – irritability, depression or anxiety. In Lyme disease, a frequent complaint is “brain fog”, or cognitive dysfunction, that interferes with school or job performance. (See my article on Educational Accommodations for Children with Lyme Disease)
Concussion & Traumatic Brain Injury
The brain is well protected inside the bony encasement of the skull, cushioned by a surrounding layer of spinal fluid. But sufficient force can cause damage to delicate brain tissue, and even minor injury can result in impairment of cognitive function and disturbance or mood and behavior. The most common causes of traumatic brain injury (TBI) are falls, car accidents, collisions and assault. This does not include military personnel who suffer TBI in blasts. Depending on the force of the impact, there may or may not be a loss of consciousness. In a mild injury, this may last seconds or minutes, whereas in a more serious injury a prolonged loss of consciousness, known as a coma, lasting weeks or months, usually indicates significant damage to brain tissue. A person may be conscious (awake) and still have disturbed consciousness – meaning that their brain is injured and not working properly. They may seem confused or extremely angry, which is also evidence of brain injury, and may not remember what happens during this time.
How do you know if you should be worried about your memory? If you are under 50, you probably don’t panic when you forget something, worried that you are developing dementia. But many of us are very concerned, either about ourselves or someone we love. Here is an article I wrote a few years back that may be helpful. Memory Loss: What You Need to Know