Overcoming ADHD Brain Fog

Dear Dr. Saline:

I’m a 30 year-old AuDHDer who would love your input. I pride myself on my ability to focus and concentrate on what needs to be done. I’m achievement-oriented and used to be able to blaze through a to-do list. Lately though, brain fog has been hitting me hard. It’s been a period of very high stress. I find myself struggling to make sense of things people say which I would previously decode with ease. I’m hoping this is temporary but it’s embarrassing. What can I do? 

Thanks!

Crystal

Dear Crystal-

Brain fog can certainly be disorienting, confusing and even a bit scary for folks with and without ADHD or autism. Brain fog refers to a group of symptoms that impact how you function cognitively–your thinking, your recall and your concentration. It can also reflect difficulty with making decisions, mental fatigue, slower response time and uncertainty. While we don’t know what causes brain fog exactly, research shows that it’s associated with chronic fatigue syndrome, long COVID, chemotherapy, autoimmune conditions or depression. But, brain fog is not a medical condition so you can’t be diagnosed with it. It’s more like a set of symptoms that arise when something else is going on and you are not thinking as clearly as you could.

As you have shared, the symptoms of brain fog can make it difficult for people to engage in conversations, perform routine daily tasks and follow instructions. Plus, brain fog differs from person to person, particularly women. In fact, it disproportionately affects women because of hormonal changes related to menstruation and menopause. For folks with ADHD who already struggle with focus, memory and organization, stress can bring on brain fog by overwhelming weaker executive functioning skills. 

Develop coping strategies for daily stress

Of course, living with ADHD and AuDHD means living with a baseline of stress that neurotypical adults don’t have to deal with. The consistent inconsistency of being neurodivergent leads to being unclear– if you will follow through on things, if you will arrive on time, and if people will like you. You may freeze in the moment, unsure of what to say or do. Perhaps you lose your train of thought more often and get distracted more easily. Or, maybe you interrupt others or say something awkward without knowing it. This is especially tough in the middle of social situations, peer interactions or important work meetings.

Rely on coping strategies

Crystal, it seems like you’ve developed some useful coping tools to help you make sense of what others are saying to you and respond effectively. I can’t even imagine how frustrating it is for you to deal with this disorienting brain fog. And, let’s be honest, everybody spaces out sometimes. Yes, this may happen more intensely and more often for folks living with ADHD due to how their brains are wired. You are not alone in your embarrassment when this occurs. But, being upset with yourself for something that you cannot control only increases your stress and worsens the very brain fog that is troubling you in the first place.

It seems that  the question you are asking is, “How do I navigate these moments with more ease and less self-criticism?” I think your first step to lower your stress. I am a big fan of being authentic. Authenticity means being transparent and non-defensive when you miss a comment in a conversation or do something that you later regret. Self-care, exercise and self-compassion are all ways to reduce the tension in your life and hopefully the brain fog too. Try these  strategies to lower your stress.

4 techniques to manage brain fog in your life:  

1. Reduce stress by focusing on one task at a time: In today’s busy, constantly connected world, we live with too much to do and not enough time to reset. When we take a walk while talking on our phone or scroll while eating lunch, we don’t actually give ourselves the true break that we really need. We shred our time into distracted chunks instead of having space to exhale and regroup. When we multitask, we stress our brains and exhaust ourselves. Opt for single tasking as often as possible. You may not be able to eliminate all media multitasking habits but, with single tasking, you’ll feel more productive and less stressed.

2. Get enough sleep:Nothing weakens our coping abilities like a lack of sleep. Many people with ADHD struggle with sleep issues. Typically, folks wrestle with three aspects of sleep: falling asleep, staying asleep and waking up. It can be tough to turn off your mind. Perhaps you experience racing thoughts, intrusive worries or a fitful night of sleep marked by “tossing and turning” throughout the night.

Some people sleep so deeply that they struggle to get up in the morning, requiring numerous alarm clocks or physical reminders. Think about your sleep needs: how much, when and what helps you relax. Practice consistent sleep habits by going to bed and waking up at the same times and staying off screens for at least thirty minutes before you nod off.

3. Exercise regularly: I cannot emphasize enough how much exercise helps with clear thinking. The endorphins that are released during exercise enhance focus and increase your overall sense of well-being. Moving your body has been found to improve motivation, build energy and reduce confusion. The Centers for Disease Control (CDC) recommends that adults engage in at 150 minutes per week of moderate-intensity activity such as brisk walking, running, biking, etc. Of course, eating well helps your overall health too. So the next time that you are feeling brain fog descend, try to move your body and see what happens.

4. Chunk your activities and write things down: Instead of relying on hyperfocus, try breaking tasks down into 30-45 minute work blocks. You want to give your brain time to reset and rest a bit throughout the day rather than go intooverdrive and burnout. It can be tough for a lot of people who like to hunker down and plow through a set of projects. But overworking like this uses up the natural glucose fuel in the brain and then relies on cortisol. You wind up creating stress that doesn’t need to be there. Trying to remember everything also adds pressure. Give yourself a break and write things down. This also reduces stress and gives you the visual cues you need to be productive and stay focused.

Aim for reducing brain fog not eliminating it

Learning how to schedule adequate down time to integrate and process information, asking for someone to repeat what they said without self-criticism and taking care of yourself with good sleep, nutrition and exercise habits will reduce your overwhelm and your shame. Remember, brain fog is not your fault; you didn’t choose this. Instead, just explain what’s going on to someone when it is happening and move on. You’ve got this!

Boost Mental Well-Being for Women with ADHD: Reduce Self-Criticism and Build Self-Confidence

May is Women’s Health Month: a time to recognize and advocate for women’s physical and mental health care. Women with ADHD, and those who care for neurodivergent children, frequently deal with additional stressors, anxiety and depression, often without adequate support. At the same time, they can berate themselves for the things they are not in the face of impossible social standards laid out for females of all ages. Self-doubt frequently creeps in and plagues your ability to make decisions and feel good about your choices. Sadly, too many women with ADHD are often their harshest and loudest critics, making it tougher to feel good enough, worthy and empowered. Psychological and emotional wellness for women begins with learning to quiet that negative inner-voice, practice self-compassion and develop resilience.

The harsh feedback loop in women with ADHD

Women are socialized to please others and take care of them–emotionally, physically and psychologically. Their self-worth can be tied to what people think about them and how many friends (real or virtual) they have instead of the uniqueness of their innate talents and personal traits. In today’s busy and over-connected world, it’s easy to compare yourself to others and come up short. Suddenly you may find yourself in a cycle of negativity in the midst of scrolling your Instagram while waiting in line for a latte or for school pick-up. This self-critical feedback, generated from years of messages about missing the mark, tuning out during a conversation, or being chronically late, can be hard to shake off. Women with ADHD, already sensitive to feedback or rejection, repeatedly interpret things more negatively and personally than the situation may actually call for. They are especially vulnerable to feelings of low self-worth.

Change your relationship with the negative voice

While it’s unrealistic to eliminate negative thinking, reducing its power and influence is crucial for fostering self esteem and resilience–two key issues for women. You have to change your relationship to the negative voice: to separate actions you regret and the layer of shame you add onto them. Identify the lies that voice tells you such as: “You are stupid, you make bad choices or nobody likes you.” We all have moments when we doubt or blame ourselves. But there is a difference between what happens in real life and the stories that you tell yourself about those events. These harsh interpretations directly influence the way someone takes meaning from whatever occurred. 

Although the inner critic seems to increase insecurity and self-loathing, deep down it’s goal is to protect you and ensure you are safe. It puts you down in a misguided effort to keep you from experiencing pain from others. If you already think you aren’t good enough, then whatever anybody else says on this subject can’t hurt you. Nobody can be more critical of you than you are of yourself so you avoid the vulnerability of receiving negative feedback. This may sound confusing and even crazy but it happens for all of us.

Stumbling and regrouping is part of being human

It’s natural for all of us to stumble and make mistakes. Being accountable for an error and making amends to set things on a better course differs significantly from repeated apologies, not learning from your experience and engaging in the blame game. Your goal is to turn down the volume and intensity of that negative voice by acknowledging and accepting who you are in a given moment with whatever resources you have available. You don’t have to believe what the inner critic is saying. Instead, acknowledge the feedback loops in your mind without being ruled by them. See the inner critic as the irrational, unbalanced and demented protector it is–holding you back from taking risks and sharing your true self with the world.

Make space for confidence and resilience with a growth mindset

The most powerful tool women have to counter negative thinking is self-esteem and its cousin, resilience. Confidence empowers you to make decisions, get through life’s ups and downs and recover after setbacks. It’s your inner ally. Confidence also helps quiet the inner critic by reassuring it that your wise, inner self has the resources to meet whatever challenges you are facing. So while you’re quieting your inner critic, turn up the volume on the voice that nurtures you with compassion, kindness and support.

  1. Identify limiting core beliefs and negative self-talk. Name your limitations and the ways that you put yourself down. Then, find evidence that contradicts those beliefs. Write these down. If you believe that people don’t really like you, think about the ones who do. Recall a time when you had fun together. Write this down as a reminder. Remember that no one is judging you as harshly as you judge yourself. Talk to people in your life who love and know you best and get their perspective on all your best qualities.
  2. Separate feelings from being: Feeling bad doesn’t mean you are less than or unworthy. It may be tough, but your work is to stop letting negative feelings from defining who you are. Imagine that your mind is the sky and your thoughts and feelings are clouds that pass by. They aren’t the essence of the beautiful blue expanse of who you are. Use self-affirming phrases such as “I can feel anger without overreacting,” “I’m disappointed in myself but I’m not a bad person” or “I can try something new and handle whatever happens because I’ve done that before.” 
  3. Nurture a growth mindset approach: Shift away from trying to prove your worth to others, using false comparisons or judging yourself as less than. Transition from seeing yourself in a negative light to practicing compassion and kindness toward yourself. If you are saying something to yourself that you wouldn’t say to a third grader with a skinned knee, stop. Remember that we are all works in progress, learning and developing at our own speeds. Believe in the power of “YET.” Tell yourself, “I may not be able to do this YET, but I am learning.” Practice kindness and patience towards yourself.
  4. Create phrases of encouragement to strengthen your inner ally: Having a few helpful phrases to say to yourself can really help you get through those low moments. Positive self-talk counter-acts that negative voice so you don’t have to believe it. Build your confidence, reinforce your strengths and tame your inner critic with reminders of your gifts and traits. Sample statements might be: “Everyone makes mistakes, including me. What can I do differently next time?” OR, “There’s no such thing as perfection. It’s okay to stumble, just keep trying.” Write these down on your phone so they’re handy when you need them.
  5. Practice mindfulness and self-compassion with meditation: Picture yourself in your “happy place”–somewhere you love where you feel calm and content. Visualize the face of someone whom you love and trust. What supportive words would this person say to you? How would these words comfort and encourage you? Put your hand over your heart and send their love to you. Write these phrases down and return to these images and words whenever you need a boost. Learning how to fill up your own bucket fosters the essential resilience women need now more than ever. 

If you’ve been stuck in a pattern of knocking yourself down, learning to pull yourself back up takes A LOT of practice and grit. Learning to control the volume on that negative voice is a life skill based on persistent resilience and genuine self-esteem. It’s one step at a time so stay patient because two steps forward and one step backwards is still forward motion. 

 


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