MAINTAINING YOUR MENTAL HEALTH: FIVE TIPS TO HELP BEAT BRAIN FOG
Dr Sabina Brennan
Sabina Brennan starts her new book, Beating Brain Fog, by pointing out that if you search online for ‘brain fog’ you will find “tens of millions of results” in a second, but if you go to more formally recognised sites, such as the NHS, an identical search will produce… nothing. This is because brain fog — like many of the non-life-threatening conditions that ail us — is hard to define, hard to diagnose and hard to resolve.
But however hard it may be to define, it is something that strikes an instant chord with anyone who has experienced it — a collection of symptoms that give rise to a loss of mental clarity or foggy thinking, making it difficult to concentrate, to remember, to learn new things. It is debilitating and can be long-lasting, and lead to a loss of self and self-confidence.
It affects more women than men and those with it have often found it hard to be taken seriously or given useful solutions. As it can be the result of different things — including hormonal imbalance (often from menopause), medication side-effects, depression, poor sleep, cancer treatment, serious illness, including sepsis, and now Covid-19 — that means many of us can be affected.
Sabina really knows her stuff, not just as a professional — she is a neuroscientist, psychologist, and, yes, a former TV actor — but she has also experienced exactly the kind of mental exhaustion and confusion that she writes about — from a variety of different sources, including hormones, illness and medication reactions.
She is therefore uniquely qualified to write about this.
“Brain fog is something that it is extremely debilitating,” she says. “I speak from the experience of having had periods of what I would describe as brain fog in my life, and fatigue that has led to brain fog. And there is a certain amount of stigma associated with it. We don’t really talk openly about it.
“Women especially don’t. Certainly I wasn’t going to say in work, ‘you know
I’m struggling here…’ We’re terrified to say it because it’s another nail that they could hammer into the ‘females-are-lesser’ coffin.”
The book is a clear, authoritative look at the brain itself, the causes of brain fog, and possible solutions, including a 30-day plan for “beating” it that includes guidelines around sleep, exercise, daily routines and rituals. Throughout she is cheery and encouraging about reversing the fog.
“For anyone living through brain fog, life is bloody challenging enough as it is,” she says. “So I wanted to make that 30-day plan also about recharging, resetting, revitalising and being kind to yourself.”
One of the things that brain fog gets confused with is dementia.
“One of the key drivers for this book was a group of women who are catastrophising and thinking that they may be getting signs of dementia. That was a real concern,” says Sabina.
“I wanted to get through to those people, because even I, with all my knowledge, became concerned about that when I was in the throes of menopause. My mother had dementia, and I directed a dementia research programme for years. I’ve written another book around reducing your risk of developing dementia.
“But even so, my fog got so bad that I asked my rheumatologist to refer me to a neurologist.”
Her “fog” was caused by “a combination of stress, menopause, side effects of medications that I was taking for my autoimmune disease.
“That’s the thing to try and get through to people — it’s generally multiple things. So even if one of the things is something that you can’t change, like an ongoing chronic health condition, by changing the other factors, such as sleep and managing your stress, you can minimise the symptoms. That’s an important take-home message.”
For all that she is encouraging about solu
tions, it’s equally encouraging to know that Sabina — who has had at least three different careers — has battled it herself, and still managed to pack a remarkable amount into her 58 years.
Career One was “the safe, steady job”, which she started straight out of school.
did my Leaving Cert at 16. I was the youngest of five children, and my father worked in Irish Life. His greatest ambition was that one of his kids would work there. So I said, OK, I’ll do that. I didn’t go to university, I went in to Irish Life in 1979 aged 17, and worked there for 15 years in the pensions division, in a job that I really hated…” she half-laughs, half-grimaces at this.
“I had great fun, it was a really young company, really buzzy. We worked to socialise. And I won’t knock it, because I got a mortgage at 24, bought a house, got married, and had two kids in my 20s.”
Having her children was “a pivotal moment,” she says.
“I started to think about my life and their lives. I didn’t want them ending up in a job that they did just to pay the mortgage. I wanted to encourage them, to find something they loved. Then I thought, ‘well, I’m not doing that’. Kids learn by example. So I thought, ‘what do I want to do?’”
What she really wanted to do was act. “I had studied drama from the age of eight, and I just loved it. I didn’t know ordinary people could be actors. But then I thought, ‘why don’t I give it a shot?’
“I was pragmatic. I finished my teacher’s diploma while I was still in Irish Life so that I could teach drama and then I thought, ‘OK, now I’ll give it a shot.’ As far as my parents — everybody — were concerned, I was being rather self-indulgent. I can remember my father saying if I became an actor, I’d ruin my marriage. He was of the generation that still thought an actor was disreputable, ‘the bishop and the actress...’, that kind of thing. There was no ‘oh, follow your dream’, it was very much, ‘that’s your hobby, you can’t work at that’.”
But she did. That was Career Two.
“I got a job in Fair City and loved it. Then my part finished, and my agent said, ‘you’ll be a bit unemployable for a while’, because the storyline I had was intense – my char“I acter was a victim of domestic violence, and ultimately murdered. It was one of the first times that issue was covered on TV in Ireland. So I decided to do a night course in the meantime.”
She chose psychology. Enter Career Three.
“The reason I became an actor is because I was interested in the human condition,” she explains.
“I did psychology in Maynooth, and I thought I could do my acting as well, but I loved the course so much that I stayed with it. I had intended to become a clinical psychologist, but I did some phone counselling with a crisis helpline, and I realised that the reason I was an actor was the reason I couldn’t be a counsellor — my empathy was too high. I could help people in the moment, but I couldn’t shut it off.
“I could still tell you all those stories now
The reason that I became an actor is because I was interested in the human condition
— obviously I wouldn’t — but they went round and round my head.”
Instead, one of her supervisors suggested a PhD.
“I wasn’t all that certain what a PhD was,” Sabina says. “But I got a scholarship to Trinity, the Institute of Neuroscience, and that set me on the trajectory I’m on now.”
What really fired her up was finding “so much useful info in academic papers, that hadn’t reached the general public”.
“It bothered me. I thought, ‘this isn’t right, how come I don’t know that there are these things that you can do to reduce your risk of developing dementia, for example?’”
When she finished the PhD, she applied for a co-ordinator role to highlight the research the EU was doing around brain health awareness.
“I didn’t know I wasn’t qualified,” she laughs. “I just figured, I could do that.”
She got the job.
“The EU gave me €1m to create this programme with accessible information on how the brain works, how to keep it healthy. That still exists at hellobrain.eu.”
From there, she won funding to create animations around dementia and brain health in MS. She started doing “radio, talks, then a book was the next step”. That book was 100 Days to a Younger Brain, published in 2019.
Along the way, Sabina had health challenges that would feed into her new book.
“I was very unwell in my early 30s, with mad stuff. I would cut my finger and wake the next day to find it was hugely infected. I woke one morning and my whole ear had swollen to the point it nearly damaged the cartilage. I had abscesses in my teeth and mouth.
“I went to my doctor and blood tests suggested it was borderline lupus [where the body’s immune system attacks its own tissues and organs], but I didn’t want to know.
“And I started to get better — with auto-immune diseases, they seem to come in cycles. And you get used to stuff, the brain is adaptive and it compensates. I was pretty OK for about 10 years. In my mid-late 30s I became very sanctimonious. I gave up alcohol, ate very well, I actively managed my stress, I gave up smoking. Without any diagnosis, I was doing things that were good.”
However, doing the PhD put her under great stress again.
“I was working round the clock and through the night. I started to develop fatigue and pain, and felt I wasn’t as sharp as I used to be. The pain got horrific, I felt like I’d overdone it in the gym all the time — constant aches and pains. I started to pull back all my activities. I stopped walking the dogs, stopped going out, the only thing I did was my PhD. I was too tired to stir a Bolognese, washing my hair became an ordeal. It was just total exhaustion.”
She went to her GP, who “kept doing regular blood tests – for cancer, infection and so on”.
“I remember her saying, ‘they’re all normal, you’re perfectly healthy. I wish all my patients were as healthy as you.’ And I remember going home and crying. I thought I was going insane. I eventually went to the doctor in college and told her I had had borderline lupus bloods in my 30s, and I figured something similar was going on. She did a huge spectrum of auto-immune bloods and came back with some alarm bells, so she sent me to a rheumatologist.”
Following an invasive biopsy that required the removal of a two-inch section of her front lip, and has left her with no feeling in that spot, Sabina was diagnosed with Sjogren’s syndrome, an autoimmune disease where your immune system attacks the glands that make tears and saliva. Getting that under control took time. “I remember my rheumatologist saying, ‘I know you can’t walk but you’ve got to…’ I started walking 100 yards, and I used to feel someone was stabbing hot pokers into my thighs. But I did it, and then I went a little further, and a bit further.”
And now?
“I’m really pretty good,” she says.
“I went through some years of fairly heavy medication, I was on an anti-epileptic to manage the pain, and that impacts on your cognitive function. But I came off that. Now the only thing I’m on is a prophylactic for migraine.”
Auto-immune disorders, she points out, “are not life-threatening, but these things impact on your ability to function, like brain fog”.
“What matters is that there are things you can do about it. I go through cycles: every four to six weeks, I have a few bad days where all I want to do is sleep, and I have quite a bit of pain. Now, I know not to work on those days. You have to know when to rest and when to plough through. Brain fog makes you depressed. I’ve been there, it makes you feel useless.”
And if you are heading towards menopause, as many women who experience brain fog are, then, “you feel very vulnerable anyway”.
However, she points out: “I feel much more comfortable in my own skin now, than I did in my 20s. I know who I am, what’s important, what I want. Rather than this image of us becoming these crusty, barren old women with nothing to look forward to, you get a new lease of life. I have my wrinkles, I’m grey, but it’s about embracing life, enjoying life. This is all I have and I’m going to make the most of it.”
For those of us who are afflicted with what might be called “pandemic brain fog” — the result of too many days at home, without stimulation, along with the constant stress caused by Covid — there are useful suggestions here too.
“There’s the brain fog post-Covid,”
Sabina agrees, and there’s “the brain fog of lockdown — feeling sluggish, not feeling as sharp or as creative or as innovative as we’re used to. There are people really struggling with this now, and I hope that the book shines light on brain fog itself.
“This book, over a period of time, hopefully will help that to improve.”
I started to develop fatigue and pain, and felt I wasn’t as sharp as I used to be. I stopped walking the dogs, stopped going out, and washing my hair was an ordeal. It was just total exhaustion
‘Beating Brain Fog: Your 30-Day Plan to Think Faster, Sharper, Better’ by Dr Sabina Brennan published by Orion Spring, €16.99, is available now online from bookshops