'Living with brain fog made me think I had early onset dementia'

Sinéad McNamara, 55, started experiencing frightening symptoms that led her to believe she was suffering from early onset dementia. Here, she shares her journey to discovering it was severe menopausal brain fog and how she found herself and passion again. Plus, a doctor living with MS explains brain fog symptoms, causes and treatments.

"After a year or so in perimenopause, a particularly discombobulating and distressing menopausal symptom hit me like a steam train around April 2020," says Sinéad, who works in events and now menopause advocacy. "And one that I had very little knowledge or awareness of."

While Sinéad had experienced some of the more known menopause symptoms like hot flushes (though not to the extent of others) and irregular periods, she admits, "I had not bargained for (nor was aware of) the paralysing effects of severe menopausal brain fog."

With many of her friends around 10 years older, she'd occasionally heard of this symptom "in hushed tones" before, but as nothing had seemed as extreme as this, she didn't connect the two.

All-encompassing brain fog

"I had no idea about how many people are affected by menopausal brain fog but also the detrimental effect it can have on your quality of life, including how you see yourself as an individual and the severe toll on your mental health," Sinéad explains.

Prior to menopause, she had never suffered from brain fog – which can also be linked to many other health conditions including long COVID – or any kind of anxiety or depression.

"I reached a point where I struggled to manage my own diary and self," Sinéad recalls. "I was making school kid errors; inputting meeting times and dates in the wrong month or missing them.

"I was completely forgetting things people told me. I was utterly overwhelmed and severely anxious about work stuff I would have taken in my stride previously…. my self-confidence and belief in myself crumbled."

For Sinéad, it became something chronically bad in a very short time.

Suspecting early onset dementia

"Things got so unmanageable that I had myself convinced I was suffering from early onset dementia. I felt I was losing myself, totally losing my edge and was becoming increasingly of no value to our business [in festivals and events], or to anything much else for that matter," Sinéad explains.

"At the time, it was monumentally frightening and stressful. I was absolutely terrified about my future and what was going to become of me.

"When you see yourself in the most part as organised, diligent, strong, confident and someone who thrives in fast-paced environments there are no words for how bad severe brain fog can make you feel.

"I felt that the old me was evaporating. The me I knew was fading away into the ether and I believed my busy work life would be over."

Meanwhile, she was still pretending nothing was wrong.

Uncovering menopausal brain fog

In the summer of 2020, Sinéad eventually organised a Zoom appointment with her doctor, who assured her it was not dementia, but menopause, that was behind her brain fog.

Personally a big advocate of HRT, deciding with her sister years before they would try it when the time came, she says, "And so I did. And that was a game changer (albeit not an instant one)."

While she found herself using things like "notes to remind herself of notes", Sinéad says it was hard enough to get through the day, without having to incorporate a range of other coping strategies.

When telling her colleague what was going on and that she wouldn't be able to work for a while, she recalls the reply being: "Jesus Christ, I thought there was something seriously wrong with you Sinéad."

Then, after adjusting to her HRT journey, her brain fog began to settle down towards the end of 2020.

Finding purpose again

"Ironically, I’m now thankful for my experience as it afforded me the passion, interest and motivation to put a menopause event of huge calibre together which I’m very proud of," says Sinéad.

The National Menopause Summit, a 'Masterclass in Menopause', returns to Dublin, Ireland in April 2024, but Sinéad and fellow co-director Shell plan to bring it to the UK by the end of the year.

Whether through events or any means possible, Sinéad believes more awareness and fact-based information on things like menopause and brain fog is hugely important, for men and women.

"Brain fog in menopause is not just a woman’s problem, it’s a relationships problem, it's a work problem. It's ultimately a problem for the economy," she says.

"I'm not saying brain fog happens to everybody or to the severity it did for me, but people need to know more about it."

Brain fog and symptoms

Dr Clara Doran, founder of Noggin The Brain People and former GP, says brain fog is a cluster of symptoms that includes:

• unclear thinking

• reduced ability to concentrate

• difficulty focusing

• memory changes

• tiredness

• irritability and frustration

"There is no structural brain damage when you have brain fog that can be seen on MRI scans or in blood tests like in some brain affecting conditions like MS or Alzheimer's, a type of dementia," says Dr Doran, who has been affected by brain fog herself.

"Your cognition is impacted, which can be harder to measure or quantify without formal psychological testing.

"Whilst the cause and severity may be different, the symptoms are often similar." People's ability to 'just keep going" can vary depending on their situation and other health conditions they're dealing with.

"Brain fog can impact many aspects of day to day performance at work and ability to complete tasks at pace. This can add to feelings of stress and anxiety and create a difficult cycle of symptoms which can impact on personal relationships," D Doran adds.

Brain fog causes

"Chronic stress, autoimmune conditions and long COVID are some of the common reasons people experience brain fog. We think these conditions can trigger chronic inflammation which impacts brain cells and their efficiency of functioning," says Dr Doran.

"Hormonal changes, specifically reduced oestrogen, associated with perimenopause and menopause are also triggering factors."

Can we experience brain fog in isolation? "Brain fog is the result of other things going on within our brain. The difficulty is that it isn’t always obvious what the underlying trigger/s are, therefore symptoms may feel like they're occurring alone."

Managing brain fog

While we might all experience brain fog-like symptoms at some point, it becomes a problem when they're ongoing or affecting your life.

"Identifying possible causes for you is the most important place to start," says Dr Doran, who advises:

• De-busy yourself – ask for help to share the load at work and home

• Rest – screen-free down time will help ease symptoms regardless of cause

• Reduce distractions – between our phones, kids and colleagues, hone down on the essentials

• Prioritise brain healthy habits – sleep, exercise, hydration and nutrition

• Talk to your GP – you may benefit from tests to exclude medical conditions like thyroid dysfunction and Vitamin B12 deficiency, referral for talk therapies, management tips, and/or discussion about HRT if menopause

• Get professional advice on nutritional supplements

Dr Doran says people can fully recover when there is a specific cause and this is treated, while for some, symptoms may fluctuate. "Acceptance isn't giving in – being kind to yourself will help you get the support you need. "

Read more: Living with undiagnosed ADHD felt like I was always chasing my tail (Yahoo Life UK, 8-min read)

• Read more: Living with chronic migraines: 'It felt like I was being hit with a hammer for weeks' (Yahoo Life UK, 9-min read)

• Read more: Living with body dysmorphia: 'I convinced myself I needed a hair transplant' (Yahoo Life UK, 8-min read)

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