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What to Do about the Brain Fog of Psoriatic Arthritis

By Claire Gillespie
June 07, 2021

Fatigue, swollen fingers, and painful joints are some of the well-known symptoms of psoriatic arthritis. But this chronic, inflammatory disease can affect the mind, as well. Many people with psoriatic arthritis report experiencing brain fog, which can manifest in different ways, including mental confusion, memory issues, or difficulty concentrating.

It’s difficult to pin down a brain-fog definition, because it’s not actually a recognized medical condition. “Brain fog is not a term a neurologist would ever use—it’s an ethereal condition that’s hard to diagnose and treat,” says Clifford Segil, D.O., a neurologist at Providence Saint John’s Health Center in Santa Monica, California.

“Usually, what people refer to when they say ‘brain fog’ is difficulty thinking and the inability to remember simple things and perform tasks that are seemingly easy,” says Mithila Fadia, M.D., a neurologist at Northwestern Medicine Lake Forest Hospital, Illinois.

What Causes Brain Fog?

Scientists are still trying to work out why some inflammatory conditions like psoriatic arthritis, plus autoimmune illnesses, such as lupus and fibromyalgia, may be linked to brain fog. “This may be due to changes in the brain from inflammation,” Fadia explains. But there are a few potential causes.

Depression

If a particular condition causes fatigue or pain, this can also affect mental clarity, concentration, and focus. Plus, some conditions, such as psoriatic arthritis, are linked to a greater risk of depression, which can impact cognitive function. According to an article published in Rheumatology and Therapy, about 20 percent of people with psoriatic arthritis also have clinical depression––a significantly higher rate than in the general population.

“When a person is depressed, they often experience a decline in their cognitive functioning. This means they have trouble with their concentration, memory, and attention,” says psychologist Sheila Forman, Ph.D. “Depressed people report that they ‘cannot think straight’ or they ‘don’t feel like themselves.’ The worse the depression, the worse the brain fog can seem.”

Chronic Stress

Psychiatrist Leela R. Magavi, M.D., believes that stress, anxiety, and burnout are the biggest culprits of brain fog. “Research indicates that burnout and chronic stress could potentially stimulate and enlarge the amygdala, the fear center of the brain, thin the prefrontal cortex, which is implicated in cognitive functioning, and weaken connectivity and parts of the brain responsible for memory and creativity,” she explains.

Medications

Sometimes, brain fog may be caused by medication, Segil adds. “Unfortunately, many new infusions or injectable medications used to treat inflammatory conditions may cause cognitive complaints,” he says.

Other Factors

Brain fog may also be caused by hormonal abnormalities, vitamin deficiencies, and sleep disorders, Fadia says. So if you’re experiencing brain fog and feel that it’s impacting your ability to function in everyday life, seek medical advice.

Lifestyle Strategies for Reducing Brain Fog

There’s no miracle cure for brain fog—and any medication promising to fix it completely is unlikely to deliver, Segil warns—but there are things you can do to improve mental clarity and focus.

Exercise Regularly

First of all, get moving. By boosting certain neurotransmitters and hormones that affect mood, exercise has undeniable mental benefits. “Exercise can release natural endorphins, which improve energy levels and baseline motivation,” says Magavi. “Taking part in physical activity can also distract people from worrying about their brain fog.”

Adopt Healthy Sleep Habits

Sleep is also a vital tool in your brain-fog battle, particularly if you believe it’s a symptom of stress. “Sleep lets you decompress and regain energy to embrace the next day,” Magavi explains. “It also allows consolidation of memories, so you can experience new events with more clarity.”

To get a good night’s sleep, Forman recommends establishing a healthy sleep pattern by going to bed and waking up at the same time every day. She also advises sleeping in total darkness, as light (from any source) can interfere with the body’s production of melatonin, a hormone that helps regulate sleep.

“Don’t use your bed for anything other than sex and sleep,” she says. “When you eat, watch TV, answer texts, or work in bed, your mind creates an association between your bed and active activities which can make it much harder to relax so you can fall asleep.” And know that too much sleep can make you feel foggy, too. The National Sleep Foundation recommends most people set a goal of seven to nine hours.

Practice Mindfulness

You might not realize it but practicing mindfulness meditation can also help you deal with brain fog.

“Developing a mindfulness-based meditation practice actually teaches you—and your mind—to focus,” Forman explains. “It also teaches you to be present with your symptoms without judging them, which can, in and of itself, lead to a reduction of those very symptoms.”

To meditate mindfully, Forman suggests finding a comfortable place to sit or lie, closing your eyes, and focusing on the in-and-out movement of your breath. “When your mind wanders away from your breath, simply return your attention back to it,” she says.

Remember, meditation isn’t about shutting the mind off from thoughts—that’s impossible. Instead, it’s about noticing the thoughts but not getting caught up in them by shifting attention back to the breath. “Start with one minute a day and gradually work up to 10 minutes––the brain-fogged mind will be grateful,” Forman says.

If your attempts to make your brain less foggy just don’t work, or the fogginess is getting in the way of your life, check in with your healthcare provider. They can help you identify a possible cause and recommend treatments and therapies that might help.

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