5 Strategies for Coping With Lupus-Associated Brain Fog

By: Howard Smith, MD

Monday morning finds many of us feeling foggy, but 20 percent to 50 percent of people with lupus have a unique feeling of mental fogginess, including:

• Depression
• Memory problems
• Headaches
• Fatigue
• Confusion
• Other neurologic symptoms

This set of symptoms, often called brain fog or lupus fog, is important to identify if you or a loved one has lupus. Knowing what to expect and having coping mechanisms in place can help with these issues.

What causes confusion? Patients with lupus can be confused because of cognitive defects, short- or long-term memory problems, psychosis, severe depression or anxiety, dementia, an infection or fever or sometimes even because of medications.

If brain fog occurs, it usually happens within the first year or two after diagnosis.

Treatments may target lupus or symptoms

Treatments for brain fog are available, but it might take some time for you and your doctor to find one that will work for you. Not all treatments work the same way on each patient with lupus.

A physician will try to identify what could be causing the confusion. Depending upon the patient, we’ll try various medications, including those aimed at treating the underlying lupus itself and those that target an associated problem, such as depression, anxiety or psychosis.

Steroids are commonly used to treat lupus, but they can sometimes worsen confusion or cause mood changes, so patients need to be monitored closely while taking them.

5 coping strategies

Medications are just one part of the puzzle when it comes to treating lupus and brain fog. It’s important to look at your overall health by working to:

1. Foster a good emotional environment. A warm, supportive environment and being surrounded by positive people at home and at work are important to help lupus patients manage symptoms.
2. Partner up with your doctor. The No. 1 goal is to get the disease under control. Having a good rapport with all your physicians and a supportive environment at home, taking your medications, and following your doctors’ instructions will help with that.
3. Take care of your body. People with lupus should eat a healthy diet and exercise regularly. Avoid alcohol, tobacco and illegal substances.
4. Challenge your mind. Give yourself cognitive challenges. Do whatever you can to keep your physical and mental health at its peak.
5. Consider therapy. Cognitive-behavioral therapy (CBT) can be helpful in teaching people to cope with their illness and its symptoms.

Regaining control

Counselors can play a big role in helping manage brain fog. The goal of counseling is to help patients identify any anxiety or depression that could contribute to feelings of confusion and to strategize about how patients can regain control.

One strategy to consider is list-making, which is helpful in easing anxiety for many patients.

CBT won’t cure memory problems, but might make them easier to deal with.

In general, make sure your doctor knows about any mental or emotional issues you’re having, so the two of you can work out a treatment plan that clears the fog.