The Mental Fog of MS

Man thinking on a train journey.

Perhaps the most frustrating issues of MS are I have too often “fallen into” profound fatigue and an unshakable mental fog: A fog that is especially heightened by stress and  mercifully not always present.

Even when I attempt something as simple as shopping, if I cannot effortlessly find the item, I completely and irretrievably lose the ability to focus on what I was doing and the MS fatigue accompanied by a mental fog begins to take me over.  Suddenly, I am not thinking well enough to make any decisions and certainly not able to deal with more than one issue at a time.  i.e.minor multi-tasking.  Yes, that DOES include “simply” having to contend with a shopper blocking my path while I simultaneously try to get out of the way of a different shopper, then going right past the item I needed because I forgot what that item was!

Leslie E. Silverman’s article “Lost in Thought: When Cognition Changes” in the Fall 2013 NMSS publication “Momentum” is particularly poignant.

In it Leslie relates an experience by MS sufferer and Milwaukee attorney, Jeff Gingold, who said “’One day in court I turned to look at my client, and suddenly I didn’t know who she was or why I was there,’ Gingold, now 53, recalls. ‘I didn’t want to make mistakes that damaged my partners or clients. When I left my practice in 2001, I walked out the door physically, but cognitively I still had a real problem.’” [Read more at:]

As life with MS evolves, I am consistently confronted these days with strong undeniable evidence that my problem “solving” produces embarrassing moments. It is disheartening and often makes me hesitant or causes me to second guess. My inability to quickly, consistently and appropriately solve problems is all the more frustrating because I eventually – as in a day or days later in a “duh” moment of realization – come to recognize that my initial decision was flawed and the correct/better solution finally comes to mind: the solution that pre-MS I would have my immediately identified and chosen.

My once highly valued and reliable Executive Functioning (the ability to make sound instantaneous decisions) is easily thwarted.  Dysfunctional cognition causes what was almost an automatic decision making process to become excruciatingly challenging.

Silverman continued to write, “. . . these processes become especially challenging, particularly when considering multiple sources of data. Driving, for example, requires you to be aware of traffic signals, other cars, pedestrians, weather conditions, etc., and to use the information to make ongoing, rapid-fire decisions.”

For many with MS, thoughts about again being able to be employed are unceremoniously driven right into a granite wall at 100 miles an hour.  The myriad of MS impacts often includes experiences of feckless failure punctuated by a perplexing inability to remember where we were going or what we were doing or what we were intending to do.  Employers generally cannot tolerate an employee who continuously makes fundamental mistakes and in some cases, these cognitive mistakes could result in a dangerous situation.

Even “reminder” tools such as an MS Outlook calendar entry or pill-minders are useless if you do not remember you have these.  It would not be not uncommon to be reminded of a meeting an hour prior to its start only to suddenly remember it hours later.  You missed it and were completely unaware at the time.

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