Is Brain Fog a Form of Dissociation?

Short-term memory loss, confusion, difficulty with focus and concentration, and an overall feeling that routine tasks seem harder to do—are all symptoms of “brain fog.”  Brain fog has gotten a lot of attention recently as it is one of the major symptoms of long COVID. But is it a form of dissociation?

In fact, a 2023 study published in the Journal of Neurology, Neurosurgery, and Psychiatry revealed that the terms “brain fog” and “dissociation” are often used synonymously. But they are not the same.

Here’s what you need to know about brain fog and dissociative disorders in order to discern the differences and ensure proper treatment.

ABOUT BRAIN FOG

Surprisingly, brain fog is not a medical diagnosis. Rather, it’s a term given to a number of cognitive health symptoms.

There are many brain fog causes, including:

• Long COVID
• Autoimmune issues such as celiac disease, chronic fatigue syndrome, fibromyalgia, or multiple sclerosis
• Stress
• Food allergies
• Alcohol and drug use
• Obesity
• Some medications
• Sleeplessness
• Hormonal changes such as those that occur during pregnancy and menopause

Brain fog can also result from a number of mental health conditions, such as dissociative disorders, PTSD, ADD/ADHD, depression, anxiety, and more.

What’s difficult to pinpoint about brain fog is that each individual experiences it in a unique way. Still, there are common brain fog symptoms such as:

• Feeling spacy or having fuzzy thinking
• Feeling confused
• Feeling exhausted (not related to exertion, and not remedied with rest)
• Having slower cognition than usual, requiring more time to complete simple things
• Finding it nearly impossible to do normal tasks
• Being easily distracted
• Trouble with organization – with thoughts and/or activities
• Memory problems, such as forgetting daily tasks or losing a train of thought mid-sentence; not being able to recall the right word
• Difficulty with speech
• Trouble with concentration

When someone has brain fog, they simply cannot perceive, understand, or think clearly. They feel “dissociated” or disconnected from reality, which makes it challenging to respond to external events.

Brain fog’s effect can be profound and severely impact normal day-to-day functioning. An individual with brain fog may not hear when someone speaks to them, or they may not notice traffic when crossing a street. When momentary clarity comes, an individual may not remember what happened during a period of “cloudy” thinking.

We are all forgetful at times, but memory lapses with brain fog are frequent and sometimes disconcerting. Forgetting to blow out a candle, leaving the oven on, or forgetting where you’re driving can be scary.

The confusion that comes with brain fog makes focusing and decision-making difficult. Concentration can be nearly impossible. You may feel disoriented, lost, or unable to track time. You might also have trouble finding words for your thoughts, causing long pauses in mid-speech.

DISSOCIATION AND DISSOCIATIVE DISORDERS

Taking a close look at dissociation and dissociative disorders, you’ll see just how many similarities there are with brain fog, as well as some clear distinctions.

Let’s start with dissociation. The word “dissociation” means to be disconnected from others, from the world around you, or from yourself.

There are everyday experiences of dissociation that almost everyone has from time to time. Examples of common dissociation not related to trauma are when you might get so absorbed in a book or movie, you lose awareness of your surroundings. Or when you take a familiar route when driving, say on your morning commute, you may have no recollection of how you got there when you arrive.

During a traumatic experience—such as a natural disaster, accident, physical or sexual abuse, or assault—dissociation serves to allow a person to tolerate what might otherwise be too difficult to bear. Dissociation acts as a mind-coping mechanism that is triggered in overwhelming situations where there’s too much stress.

Dissociative symptoms include:

• Brain fog
• Memory loss of specific times, events, or people
• Out-of-body experience
• Watching self from a distance
• Emotional numbness
• Delayed reactions
• Difficulty making decisions

Symptoms may clear up following a trauma, but sometimes they persist. These types of brain fog symptoms can potentially mask dissociative disorder and delay proper diagnosis.

While many of us may experience some dissociative symptoms at some point in our lives, about 2% meet the criteria for dissociative disorder. Dissociative disorders are serious and need to be properly diagnosed and treated with the help of a mental health professional.

TYPES OF DISSOCIATIVE DISORDERS

There are 3 types of dissociative disorders.

1. Dissociative Amnesia

People with dissociative amnesia are unable to remember essential information about their lives. Again, this is often related to a traumatic or stressful event. The amnesia may be:

• Localized – unable to recall an event or period of time (most common type)
• Selective – unable to recall details of an event or some events within a period of time
• Generalized – total loss of identity and life history (rare)

Dissociative amnesia is most frequently associated with childhood trauma, especially with experiences of emotional abuse and emotional neglect. Often, individuals may not even be aware of their memory loss or may have only limited awareness. They may also minimize the importance of memory gaps.

It’s easy to see how this type of dissociative disorder might be mistaken for brain fog. This is especially true when an individual does not have knowledge about the dissociative response to trauma.

2. Depersonalization/Derealization Disorder

With depersonalization/derealization disorder, a person may experience detachment from one’s mind, self, or body. It can feel as if you’re outside of yourself watching events happen (depersonalization). Or you might experience detachment from your surroundings, feeling like things and people around you are not real (derealization).

Childhood emotional abuse is highly associated with depersonalization, some research indicates. Derealization, however, is more highly associated with childhood sexual abuse.

During these “altered” periods of time, an individual is aware of reality and that their experience is unusual. It is highly distressing, even though the individual may appear to be unreactive or lacking emotion.

Although more specific to dissociative disorders, these symptoms could also be written off as brain fog related to some other issue. One distinction though is that the symptoms can begin in early childhood and are most commonly seen by age 16. Only 20% of cases begin experiencing this form of dissociation in adulthood.

3. Dissociative Identity Disorder

Dissociative identity disorder (DID) usually occurs as a result of overwhelming experiences, traumatic events, and/or repetitive abuse that occurred in childhood. It used to be referred to as multiple personality disorder and has been highly misunderstood, in part, due to inaccurate portrayals in media.

People with DID have 2 or more distinct identities or personality states. Each identity has its own behavior, memory, and thinking, which may be observed by the individual or others.

Individuals with DID may have ongoing memory lapses about everyday events, personal information, or past traumas. The symptoms are highly distressing and may cause problems socially, at work, or in other areas of life.

The memory lapse can be written off as a symptom of brain fog. However, the personality changes are a clear indication of dissociative disorder.

TREATING BRAIN FOG AND DISSOCIATION

If you or someone you love is showing signs of brain fog and has a history of trauma, there’s a greater chance that the symptoms could be a result of some form of dissociation. However, if brain fog symptoms are present without any past trauma, it’s possible they are linked to another health issue or condition.

In either case, cognitive issues should be taken seriously. There are many treatments available.

Effective treatments that address trauma and related cognitive issues include eye movement desensitization and reprocessing (EMDR) therapy and cognitive behavioral therapy (CBT).

To resolve brain fog symptoms that aren’t due to trauma, it’s important to address any underlying biological causes or mental health conditions. Seek help from an integrative mental health professional who evaluates both medical and psychological issues.

Brain fog, dissociative disorders, and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.