Depression can cause a range of symptoms, including cognitive changes that people commonly refer to as brain fog. These symptoms often occur during depressive episodes, but they can develop before these episodes begin and continue during remission.
Medications that doctors currently use to treat depression do not improve brain fog symptoms and can actually make them worse. Research into new ways to treat these symptoms is still ongoing, but some at-home tricks may help reduce them or make them more manageable.
Keep reading to learn more about brain fog, including its links with depression and some other conditions that may cause it.
People generally use the term brain fog to describe a range of cognitive symptoms associated with depression. Other names for it include pseudodementia and false dementia.
Experts have linked many cognitive symptoms to depression, most of which interfere with memory, processing speed, attention, and executive functioning. In a study in CNS Spectrums, people with major depressive disorder (MDD) reported experiencing cognitive symptoms that typically involved difficulty with:
- remembering information and recalling words
- making decisions and prioritizing tasks
- handling periods of divided attention
- maintaining clear thought and focus
- thinking or responding quickly
- learning new skills or information
Depression may also make people more likely to interpret information negatively and focus on unfavorable facts or events, which can result in low-self esteem, frustration, and a negative perspective.
Not everyone with depression will experience cognitive symptoms, though many people do. Of the people who do experience brain fog, not all of them will have the same set, severity, or range of symptoms.
According to some estimates, the prevalence of cognitive symptoms in people with MDD is 85–94% during depressive episodes and 39–44% during periods of remission. Cognitive problems, especially difficulty thinking, making decisions, and concentrating, feature as hallmarks of depression in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).
Depending on their severity, the symptoms of brain fog can greatly reduce a person’s quality of life and impair their ability to function. Furthermore, because brain fog symptoms often overlap with those of depression, they often go overlooked and untreated.
However, over the past decade, researchers and doctors have started to focus more on the role of cognitive dysfunction in depression and how to treat it properly.
Researchers are still learning how depression causes cognitive symptoms and to what extent.
Ultimately, depression seems to involve a dysregulation of the neural networks in critical brain regions, including the:
- prefrontal cortex
- anterior cingulate cortex
- basal ganglia
Neural disruptions that relate to depression appear to cause or worsen cognitive symptoms by reducing the brain’s gray matter volume and white matter connectivity. Gray matter is an important part of the nervous system that plays a role in both sensory perception and muscle control. White matter serves to link and connect the gray matter.
Reductions in the levels or effectiveness of specific neurotransmitters may also influence the symptoms of brain fog. These neurotransmitters include:
- serotonin (5-hydroxytryptamine [5-HT])
- gamma-aminobutyric acid (GABA)
Some research indicates that depression may also cause cognitive symptoms by:
- reducing brain and nerve cell growth
- dysregulating brain-derived neurotropic factor (BDNF)
- causing chronic immune and CNS inflammation
Anyone can experience depression and related brain fog at any age, though it usually begins in adulthood. Researchers think that depression develops due to a combination of genetic, environmental, physiological, and biological factors.
Common risk factors for depression currently include:
- personal or family history of depression
- substantial or chronic stress
- major life changes
- chronic or disabling physical or mental illness
- certain medications
Much more research is necessary to understand the complex relationship between brain fog and depression. However, the severity of cognitive symptoms seems to be an important indicator of several factors, including a person’s:
- response to treatment with medications
- likelihood of experiencing cognitive side effects from drugs called selective serotonin reuptake inhibitors (SSRIs)
- ability to engage in psychotherapy
- current and future quality of life
- long-term functioning
- risk of relapsing
Some research also indicates that improving cognitive symptoms seems to increase the likelihood of full remission from depression. Cognitive symptoms that persist during or after remission may also make recovery from depression more challenging by reducing the person’s:
- ability to work, maintain relationships, keep a routine, and take care of themselves
- coping skills and social support network
- likelihood of complying with treatment
Several medical conditions other than depression, including multiple sclerosis, anxiety, and stress, can cause brain fog or increase the likelihood of developing it. Other common causes include:
- certain medications, including SSRI medications
- some lifestyle factors
- lack of sleep and fatigue
Current treatments for depression do not seem to improve brain fog symptoms, although serotonin-norepinephrine reuptake inhibitors (SNRIs) generally appear to be more effective than SSRIs.
One type of SSRI, vortioxetine, seems to have some effect on cognitive symptoms and overall functioning, though.
The wake-promoting medication modafinil may also help treat cognitive symptoms by acting on noradrenaline and dopamine. A 2017 study found that taking 200 milligrams per day of modafinil improved working and episodic memory in people whose cognitive symptoms persisted after remission from depression.
Researchers are still trying to figure out which medications or other treatments can help people cope with and recover from brain fog. In some studies, people with depression who received treatment for cognitive symptoms seemed to show short-term and long-term improvements in overall functioning.
Treating brain fog symptoms may also reduce the risk of relapse in people with depression. Some psychotherapy approaches, such as cognitive behavioral therapy (CBT), may teach people skills that help them cope with cognitive symptoms and gain a more neutral perspective.
Therapies that focus on cognitive functioning, such as cognitive remediation and neurorehabilitation programs, may also help reduce brain fog symptoms.
Some people may also find home remedies and lifestyle choices that improve cognitive skills beneficial. These may include:
- meditation and other stress-reducing practices
- word or matching games, such as puzzles, crosswords, and crypto quotes
- identifying common distractions and avoiding them
- using pacing and energy-saving tricks
- breaking larger tasks into smaller ones
- learning when cognitive skills are sharpest and doing important tasks then
- establishing quiet time for work or mentally stimulating tasks
- learning personal limits and respecting them to avoid becoming frustrated or overwhelmed
- speaking slower to increase mental processing time and asking others to speak slower
- establishing a strong social support system
- staying organized and keeping items such as keys, glasses, and wallets in the same place
- using reminders, including diaries, calendars, Post-it notes, cell phone alerts, and lists
The impact and extent of cognitive symptoms associated with depression are still not well-understood. However, the severity and persistence of cognitive symptoms may reduce quality of life, impede recovery from depression, and increase the risk of relapse.
No medications are currently approved in the United States to treat brain fog, although a few medications, types of psychotherapy, and at-home techniques may reduce the symptoms or make them easier to manage.
People who think that they are experiencing brain fog should speak with a doctor to discuss ways to address it.