Maybe this sounds familiar. You used to run a full diary without thinking about it. Now you stop mid-sentence in a meeting, hunting for an ordinary word like "invoice". One hour of spreadsheets leaves you needing to lie down, and you have started writing notes for things you would never have forgotten before. The infection was months ago. Your brain, it seems, did not get the message.
What long-COVID brain fog feels like
Long COVID is the name given to symptoms that continue or appear in the months after a COVID-19 infection and cannot be explained by something else. Brain fog is one of the most commonly reported complaints.
The fog tends to affect what are called executive functions. These are the brain's management skills: planning, holding information in mind, switching between tasks and staying on track. People typically describe:
- Losing words or names in the middle of a sentence
- Forgetting why they walked into a room or what they just read
- Struggling to follow a conversation when more than one person is talking
- Mental tiredness after tasks that used to be easy
- Feeling worse a day or two after doing too much
What may be happening in the brain
The honest answer is that scientists are still working this out. Several explanations are being studied, including lingering immune activity, changes in small blood vessels, and disruption of the autonomic nervous system, which is the automatic system that controls heart rate, blood pressure and the balance between alertness and rest. It is likely that different people have different mixes of causes.
What can be described is how fog feels. Tasks that used to run on autopilot now seem to need deliberate effort, and effort uses up energy quickly. Sleep is often unrefreshing, which makes everything heavier the next day.
See your doctor first
Long COVID should be diagnosed by a doctor. Part of that process is checking for other conditions that cause tiredness and poor concentration, such as anaemia, thyroid problems, diabetes, sleep apnoea or depression. These are treatable, and you would not want to miss them.
Seek urgent medical attention if you experience:
- Chest pain, a racing or irregular heartbeat, or shortness of breath
- Fainting or near-fainting
- Sudden confusion, a severe headache, or trouble speaking
- New weakness or numbness on one side of the body
- Thoughts of harming yourself. Please tell someone today.
Your doctor may refer you to other professionals, such as an occupational therapist or physiotherapist with experience in post-viral fatigue. Neurofeedback is complementary to that care. It does not replace it.
Pacing, the most important skill
Many people with long COVID have a pattern called post-exertional malaise. This means that physical or mental effort beyond a certain point brings a crash, sometimes a day or two later. Pushing through, which works for ordinary tiredness, tends to backfire here.
Pacing means staying inside your energy limits. Break tasks into smaller pieces. Rest before you are exhausted, not after. Alternate thinking tasks with quiet ones. Put the most demanding work in your best hours.
Recovery from fog is rarely a straight line. It is more often a slow widening of what a good day can hold.
Where neurofeedback may fit
Neurofeedback is a non-invasive form of brain training. Small sensors on the scalp read the brain's electrical activity. Nothing is sent into the brain. When your brain shifts towards a steadier pattern, you receive feedback through a sound or a picture on a screen, and the aim is that, with repetition, the brain learns the rewarded pattern. Our article on what neurofeedback is covers the basics.
Every client at our Krugersdorp practice starts with a 19-channel brain map, which takes about an hour and a half. The map is not a diagnosis, and it cannot show that a virus caused your fog. It is a recording of how your brain is working at the time.
It is important to be clear about limits. Neurofeedback does not treat a viral infection, clear inflammation or repair the brain. Research on neurofeedback for long COVID specifically is still at an early stage. What training aims to do is help the nervous system regulate itself more steadily, which may support sleep, mental stamina and a feeling of clarity. Results vary.
Training sessions last 45 to 60 minutes and begin with a short check-in on how you are feeling. The what to expect page explains each step.
If your working day runs out of steam by early afternoon, our article on decision fatigue and the afternoon crash has practical ideas. And because fog overlaps with other long-term conditions, you may also want to read about brain fog in autoimmune illness.
Common questions
Can neurofeedback cure long COVID?
No. Neurofeedback does not treat the virus or the underlying causes of long COVID, and nobody can promise a cure. It is a complementary form of brain training that may help the nervous system regulate better. It aims to ease how fog, poor sleep and low mental stamina are experienced, but research is at an early stage, results vary and medical care comes first.
Will the sessions tire me out?
Some tiredness afterwards is possible, much as you might feel after a period of concentration. Because crashes after overexertion are common in long COVID, treat any new activity, brain training included, as something to pace with care. Mention how you feel in the day or two after a session to the practitioner, and tell your doctor if you crash.
Can I carry on with my medication and other therapies?
Yes, please do. Neurofeedback works alongside your medical treatment, occupational therapy or physiotherapy. Keep taking any medication as prescribed, and only change it in discussion with the doctor who prescribed it. Tell everyone involved in your care what other treatment you are receiving.
Fog can shake your confidence in a way that few other symptoms do. Be patient with yourself. If you have seen your doctor and would like to explore whether brain training could support you, you are welcome to get in touch with Irine and ask whatever is on your mind.
- long covid
- post viral
- brain fog
- chronic fatigue
- recovery
