Feeling Foggy During Psoriatic Arthritis Flares

Brain fog is common for people with autoimmune conditions. Here’s how it’s affected my life and the ways I manage it.

I’ll always remember how badly one of my college projects turned out. I was in the midst of a horrible psoriatic arthritis (PsA) flare and felt out of it. My poster was fraught with spelling errors.

While presenting, I couldn’t remember the words I needed and couldn’t quite get to the point I was making. Thank goodness it didn’t count for much toward my grade!

My flare brought along a host of symptoms: pain, stiffness, and horrible fatigue. It was hard to concentrate on anything except the pain and how tired I felt. Even when I gave my best effort, my work wasn’t great, and I had trouble learning new concepts. Thanks to brain fog, this would be the first of many projects I would struggle through.

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What is brain fog?

Brain fog isn’t a disease or condition. It’s a term used to describe symptoms such as forgetfulness, difficulty concentrating, and impaired problem-solving. Many people with autoimmune diseases face these symptoms, which can feel much worse during flare-ups.

Also known as cognitive impairment, brain fog is common for people with arthritis and other autoimmune diseases. It comes from a mixture of inflammation and pain, which demands a lot of your brain’s attention. Fatigue and poor sleep also contribute to feeling less than attentive.

Brain fog isn’t exclusive to PsA; other conditions such as depression, pregnancy, menopause, and seasonal allergies can also trigger it.

The impact on my life

I started getting horrible brain fog in college when my PsA was out of control. It was incredibly frustrating to suddenly lose my words, mix up numbers and letters, and forget deadlines and events. The worst was feeling like I could read the same paragraph repeatedly, yet I couldn’t tell you what I just read.

It was challenging to cope with, not only on a practical level but also on an emotional level. Previously, I had an excellent memory, and my attention to detail was flawless. But dealing with brain fog made me feel useless and unreliable. I knew PsA was always going to have an impact on my body, but now I felt hopeless now that it seemed to impact my brain.

I got frustrated when loved ones would suggest I needed to slow down and be more careful. In hindsight, it wasn’t bad advice, but it felt like it dismissed my current struggle as carelessness.

Brain fog took away my confidence, and I took this advice too personally.

Will it ever go away?

My first solution was to fight it tooth and nail. I worked harder for longer hours, totally exhausting myself. I ended up making it much worse this way.

Brain fog is usually triggered by inflammation, exhaustion, poor sleep, and pain — all of which are attributed to PsA. So naturally, the best way to get rid of brain fog is to get your PsA under control. It’s always a relief when a flare starts to break, and I feel less foggy.

PsA is stubborn and can be hard to treat. So the best way to treat brain fog is to be kind to your body — it’s crying out for help!

Be consistent with treatments and let your rheumatologist know how bad your flares are. If you can, reduce your responsibilities and stress. Take naps if possible. But above all, try to be kind to yourself and your body, and do not stay up until 4 a.m. studying for your history quizzes (lesson learned).

How to work with symptoms

In the meantime, you may need to work on ways to deal with brain fog. It may take some time to figure out what will work for you. These are the things that help me the most:

Jot it down

The most important piece of advice I have is to write everything down. It was a hard adjustment for me, but remembering (ha) to write things down was a total game-changer. Keep a calendar, ongoing to-do list, or agenda — whatever works for you.

Set a timer

Beyond setting an agenda, using your phone timer or reminders can help with short-term things. I have set multiple timers with labels for doing chores or to help keep me on track throughout the day. I prefer timers to reminders because they’re more noticeable. Reminders easily go unnoticed unless you’re actively using your phone.

Double-check your work

Despite hating this advice, it doesn’t hurt to carefully review your work. I take it a step further and have someone or something else check when possible.

I use spelling and grammar checkers all the time. Sometimes I ask people to check my work. I especially like having another set of eyes on addresses, phone numbers, and bank checks because numbers and ordering are my weaknesses.

When mistakes occur as a type-A person, I try to show myself some mercy: I thank the person who pointed them out, fix them, and move on. Dwelling wastes my limited energy.

Break it up

Try to take a break when you find it too difficult to concentrate. For me, this happens later in the workday.

Taking a short break for a walk and a drink of water helps. Sometimes it helps to focus on more straightforward tasks for a while. I frontload my days, so mornings are for more complex things when I’m at my sharpest, and afternoons are for grunt work once I’m tired and find it difficult to concentrate.

Learning to coexist with PsA and brain fog

Despite being hit hard in college, I graduated with honors and a near-perfect GPA. I felt so proud of myself on the day of my graduation. I’ve since joined the workforce, and I still struggle with brain fog. Only now, I have the tools and experience to help me through it.

But even with every coping mechanism in my pocket, there are still times I feel like I’m treading water. It’s challenging to manage the symptoms of a chronic illness while having a life.

I’ve been slowly learning to resist the urge to push through and ignore my body’s cues and accept brain fog as a sign that my body needs me to slow down. When brain fog hits, it’s almost like it is saying, “Pay attention to me!”

Over the years, prioritizing my health and acknowledging my body needs extra care has helped a lot. That’s not to say I can drop everything to meet my needs; life doesn’t stop for flares.

At the very least, recognizing when I am struggling and being kind to myself has helped give me the resilience to keep trying and moving forward. Brain fog is frustrating, but I am still capable (even if I can’t find my phone).