Podcast Summary: “There's a lot of fog around brain fog”

Podcast: What's That Rash? (ABC News)
Date: January 28, 2025

Episode Overview

This episode explores the complex and often misunderstood phenomenon known as “brain fog.” Hosts Tegan (C) and Norman (B) respond to listener questions, discussing the validity, symptoms, causes, history, and potential treatment options for brain fog, including its recent surge in public discussion following the COVID-19 pandemic. They share personal experiences and medical insights, aiming to clarify misconceptions and provide practical perspectives for those suffering from brain fog or curious about it.

Key Discussion Points & Insights

1. Defining Brain Fog

• Is Brain Fog Real?

  • The hosts strongly assert that brain fog is a real experience, not a figment of imagination, even though it is not a specific medical diagnosis.
  • Quote [01:55] — Norman (B):
    “It is real. And brain symptoms are a feature of long Covid. But they're not just a feature of long Covid. [...] There's a whole list of conditions which can cause what some people call brain fog, baby brain, chemotherapy produces it [...] It is a real thing. What it's not is a medical diagnosis.”

• Symptoms

  • Forgetfulness, difficulty concentrating, feeling disconnected, slow thinking, trouble expressing oneself, head pressure or fuzziness, and fatigue.
  • Quote [03:44] — Norman (B):
    “Forgetfulness is kind of the number one symptom in most studies. Difficulty concentrating is not far behind. Dissociative phenomenon really means that you're kind of out of body, you're not feeling yourself, you're feeling a bit weird in the world…”

2. Personal and Listener Experiences

• Tegan recounts a colleague’s assumption about “baby brain” during her pregnancy and reflects on the frustration such comments can cause.
• Norman shares his own experience post-hepatitis A infection, describing lasting cognitive fogginess [02:44].

3. Brain Fog vs. Medical Diagnosis

• Brain fog is a descriptive label, not a distinct diagnosis. Causes and experiences vary widely.

  • Quote [02:37] — Norman (B):
    “...people don't agree on what brain fog actually is. And there's lots of different causes. So to say it's a medical condition is not really right...”

• Commonality: Despite differing causes (e.g., infection, autoimmunity, chemotherapy, psychological distress), symptoms of brain fog often overlap.

4. Objective Assessment & Challenges

• Standardized psychometric tests and experimental “brain fog scales” are being developed, but are not widely adopted or definitive [04:40].

5. What Causes Brain Fog?

• Physical (Neurobiological) Causes: Viruses, autoimmune conditions, chemotherapy, chronic pain syndromes, HIV, and others can affect brain function.

• Psychological Causes: Depression, anxiety, or stressful life events can contribute to cognitive symptoms, though this cause is sometimes dismissed or misunderstood.

  • Quote [06:40] — Norman (B):
    “…people really resent the idea that psychological issues can cause brain fog. And that's misplaced anger in a sense, because our brain and body are one.”

• COVID-19:

  • Noted for bringing brain fog into greater public awareness; some post-COVID brain fog correlates with observed MRI changes in the brain [08:40].

6. History of the Term "Brain Fog" [09:17–10:47]

• The term dates back to at least 1850—James Tunstall described it among sedentary professionals.
• Historical figures like Florence Nightingale and William Osler described similar conditions under different names, suggesting brain fog is not a new phenomenon.

7. Treatment Approaches

• Time: Many people recover, especially from post-COVID brain fog, but this is not universally reassuring [11:01].

• Treat the Cause: Doctors should search for treatable underlying causes.

• Psychotherapy/CBT: Particularly effective if brain fog is related to psychological factors or causes secondary depression.

• Physical Treatments: For some, cautious physical exercise might help, but this is controversial in certain conditions (e.g., myalgic encephalomyelitis).

• Experimental Approaches: Emerging research into pharmacological treatments, including repurposed drugs, is ongoing but inconclusive due to limited data [12:15].

• Quote [12:38] — Norman (B):
  “Doctors need to take it seriously and look for a cause for it. Cause the cause may be treatable in its own right. [...] With long Covid and post-viral brain fog, it does get better in most people. So there's cause for optimism…”

Notable Quotes & Memorable Moments

• On the Subjectivity of Brain Fog

  • Tegan (C) [03:42]: “So I was actually kind of curious. […] Have you ever experienced it yourself?”

• On Cognitive Load and Stress

  • Norman (B) [07:46]: “When I'm under a lot of stress… you feel your cognitive processing slowing down. [...] I think you can call that fog, you might well call it fog, but it's one that goes away and you know what the cause is.”

• On Historic Attitudes

  • Tegan (C) [09:52]:
    "James Tunstall wrote [...] about functional disorders which afflict those who make great use of the pen and at the same time take but little exercise. Authors, journalists, solicitors and clerks. Norman. We just need more time outside hiking up and down mountains and less time in front of computer screens."

Important Timestamps

• [00:36] – Introduction to topic and listener questions (“brain fog” as symptom in various conditions)
• [01:55] – Is brain fog real? List of possible associated conditions
• [03:44] – Common symptoms of brain fog outlined
• [04:40] – Objective assessment of brain fog and challenges
• [05:25] – Discussion on physical versus psychological causes
• [08:40] – COVID-19’s role in bringing “brain fog” into the mainstream
• [09:17–10:47] – Historical mentions and longevity of the term
• [11:01] – What is currently known about treatment options
• [12:38] – Conclusion on seriousness and treatability of brain fog

Summary Takeaways

• Brain fog is a legitimate and common experience, though not a singular medical diagnosis. It can occur as a symptom in a wide range of physical and mental health conditions.
• The causes of brain fog are diverse. Identifying and treating the underlying issue is crucial for relief.
• Recovery is possible, particularly for post-viral and stress-related brain fog, but persistent cases may require a nuanced, multi-factorial approach.
• New research is ongoing into both the biological mechanisms and experimental treatments for brain fog.

For listeners: If you have questions about confusing health symptoms or want your query discussed, you can contact the show at thatrashbc.com.