Brain fog in the U.S.: documenting symptoms and arranging work accommodations

It didn’t arrive as a dramatic plot twist. It was quieter than that—like opening my mouth and finding a word-shaped hole where a word used to be. On a Tuesday, in the middle of an ordinary email, I stared at the blinking cursor and forgot what I meant to say. That’s when I started keeping notes on what I half-jokingly called “the fog.” I don’t want to sensationalize it, and I don’t want to minimize it either. I just want an honest map—something that helps me track symptoms, talk with a clinician, and negotiate fair changes at work so I can do my job without feeling like my brain is running through sand.

The day my words got stuck in traffic

My first clue wasn’t dramatic: I began rereading simple paragraphs and losing the thread. I couldn’t hold multiple steps in my head. Short meetings left me drained in ways they never had. At first I chalked it up to sleep, stress, or caffeine timing. But patterns kept showing up—especially after poor sleep or back-to-back calls. I learned that many people use “brain fog” as a lay term for problems with attention, memory, processing speed, and word-finding. In some folks, it can follow viral illness (including COVID), autoimmune flares, migraines, perimenopause, certain medications, or mental health conditions. The label “brain fog” isn’t a diagnosis; it’s a description. That was my first high-value takeaway: description is a start, but documentation is what turns feelings into facts.

When I looked for clear, non-hyped information, a practical approach emerged: track, test, and translate. Track what I notice; test my assumptions with a clinician’s input; translate what I need into plain, workable requests at the office. For a concise overview of brain fog as one of the commonly reported symptoms after COVID, the CDC has an accessible page you can skim here. And to understand why a clinician might suggest a brief cognitive screen (which by itself can’t diagnose a specific disorder), MedlinePlus has a straightforward explainer here.

What I mean when I say brain fog

I try to be precise. Instead of “I’m foggy,” I write what happens:

  • Attention: losing track during a 30-minute meeting unless I have an agenda
  • Working memory: forgetting the second step in a two-step instruction unless it’s written down
  • Processing speed: needing extra seconds to read dense text or pivot between tabs
  • Word-finding: pausing mid-sentence for an everyday term
  • Post-exertional effects: worse concentration after long stretches of mental effort

In other words, I log functions, not just feelings. This makes the conversation with my clinician—and later with my manager—more concrete.

A simple framework that keeps me honest

I use a three-part framework that doesn’t promise miracles; it just helps me notice the right things:

  • Step 1 — Notice: What specific task becomes harder? What time of day is worst? What else was happening (sleep, stress, illness)?
  • Step 2 — Compare: What makes it better or worse (breaks, noise, lighting, multitasking)? Can I compare days with good sleep vs. poor sleep?
  • Step 3 — Confirm: What does a clinician observe or suggest? Are labs, a brief cognitive screen, or referrals indicated? See the MedlinePlus cognitive testing overview here for what screening can and can’t tell you.

I keep reminding myself: uncertainty is not failure. It’s just part of the picture.

A way to document symptoms without losing your day

I wanted a log I’d actually use. Here’s the one that stuck:

  • Daily snapshot (2 minutes) — Sleep hours; meds/supplements; stress level (0–10); physical activity; any illness.
  • Task check — Choose one cognitive task I often do (reading reports, data entry, writing). Note: duration planned vs. actual; interruptions; where it got hard (start, middle, switching).
  • Triggers and helps — Noise, multitasking, screens, long calls, bright lights; what helped (timer, checklist, written agenda, noise control).
  • Impact — Did it affect deadlines, accuracy, or meetings? One or two sentences, max.

By week’s end, I can sketch a pattern without spiraling into over-analysis. If you suspect post-viral issues, the CDC’s Long COVID pages are plain-language and updated periodically; the symptom overview is here.

What my doctor visit looks like now

Instead of showing up empty-handed, I bring patterns. I ask simple questions: Are there reversible causes (thyroid issues, B12 deficiency, sleep apnea, medication side effects, depression or anxiety)? Do my symptoms fit something like migraine or a post-viral syndrome? Would a basic cognitive screen help guide next steps? The goal isn’t to “pass” or “fail,” it’s to find the next reasonable test or habit to try. A short, non-urgent visit still matters. If anything sounds urgent—confusion, new one-sided weakness, severe headache with fever—I know that’s different and needs immediate medical attention.

Turning a messy log into a clear pattern

At the end of each week, I translate my notes into two brief summaries:

  • Function summary — “Reading dense policy pages is slow after 2 p.m.; 15-minute breaks help; READY rate is up when I multitask.”
  • Work impact — “I needed two extra hours to review a report; I missed a minor formatting detail; I did well when I had an agenda and written instructions.”

These summaries become the bridge between healthcare and the workplace. They help my clinician write a generic note that focuses on functional limits and suggests categories of support without oversharing.

What counts as reasonable at work

Under the Americans with Disabilities Act (ADA), U.S. employers generally must provide “reasonable accommodations” to qualified employees with disabilities unless doing so would create an undue hardship. The Equal Employment Opportunity Commission (EEOC) explains the legal standard and the give-and-take process in its guidance here. If your brain fog is related to Long COVID and it substantially limits major life activities (concentrating, thinking, working), the U.S. Department of Health and Human Services and the Department of Justice note that it can meet the definition of a disability; their joint guidance is summarized here.

“Reasonable” doesn’t mean special treatment. It means practical adjustments that let you perform essential job functions. The keys are specificity, proportionality, and trial periods. I’ve found it useful to propose time-limited pilots and measure results.

Accommodations that actually helped me think

These are examples I tested and tracked. They won’t fit every job, but they’re a starting point. For more ideas across attention, memory, and executive function, the Job Accommodation Network maintains pragmatic lists (see ideas for memory here).

  • Information capture — Written agendas before meetings; action items summarized by email; permission to record meetings where policy allows.
  • Attention support — Noise-reducing options; uninterrupted focus blocks; delayed-response expectations for complex messages.
  • Memory aids — Checklists, templates, and step-by-step SOPs; pinned notes in apps; shared trackers so tasks don’t live only in my head.
  • Time and pacing — Slightly extended deadlines for dense review; split long tasks into two sessions; brief pauses between back-to-back calls.
  • Task design — Fewer parallel tabs; batch similar tasks; clarify “essential functions” vs. nice-to-have duties.
  • Lighting and visual load — Adjusted brightness, dark mode, or larger fonts for reading-intensive roles.

How I start the ADA interactive process without drama

I send a short note to HR (or the person designated for accommodations) that says: (1) I’m requesting accommodations under the ADA; (2) the functional areas where I need support (concentration during long reading, memory for multi-step tasks, processing speed for dense materials); (3) examples of adjustments to try; and (4) that I can provide a clinician’s note if needed. I don’t include medical history in that email. Then I measure results during a 4–6 week pilot and report back.

My clinician’s note is succinct: “This patient has a health condition that affects sustained concentration and processing speed. Recommended accommodations include written agendas, brief rest breaks during extended cognitive tasks, and additional time for dense document review when feasible.” Notice: it focuses on function, not private details. If the employer asks for documentation, I provide only what’s necessary. The EEOC has a public-facing primer for employers here; I’ve found it helpful to know what they read, too.

Little habits I’m testing in real life

  • Two-column note-taking — Left column: facts; right column: to-dos. I can scan the right column quickly at day’s end.
  • Focus timers — 25 minutes on, 5 off, repeated twice; after two cycles, a 15-minute walk or stretch. This keeps effort sustainable.
  • Agenda-first meetings — I ask for agendas and propose them when none exist. It reduces cognitive overhead for everyone.
  • Externalize memory — I never rely on “I’ll remember.” If it matters, it’s written, calendared, or tracked.
  • Recovery windows — I leave 10 minutes after cognitively heavy tasks for a reset; the next task goes better.

Signals that tell me to slow down and double-check

I draw a bright line between everyday fog and urgent warning signs. If I (or someone near me) notices any of the following, I treat it as a reason to seek prompt medical care:

  • Sudden confusion, new slurred speech, or facial droop
  • New one-sided weakness or numbness
  • Severe headache, fever, neck stiffness, or seizure
  • Head injury with worsening symptoms

For non-emergency cognitive concerns—memory slips, attention issues, word-finding—patient education pages (like MedlinePlus on cognitive testing here) help me prepare better questions for my clinician. If symptoms began or worsened after COVID, it’s worth reviewing the CDC’s Long COVID symptom guide here and the federal civil-rights guidance on when Long COVID can qualify as a disability here.

What I’m keeping and what I’m letting go

I’m keeping the principle that specific beats vague. “I need a 10-minute break after 60 minutes of dense reading” is more actionable than “I’m drained.” I’m also keeping the idea that pilots beat permanence; we can test an accommodation and revise. And I’m keeping a short list of reputable sources. The CDC tells me what’s common. MedlinePlus explains tests in plain language. EEOC sets expectations for the workplace. The HHS/DOJ guidance clarifies disability rights for Long COVID. The Job Accommodation Network helps me translate symptoms into practical adjustments. That, for me, is a workable map.

FAQ

1) Is “brain fog” a real medical condition?
Answer: “Brain fog” is a common phrase for difficulties with attention, memory, or processing speed. It’s a description, not a diagnosis. A clinician can help look for causes and next steps; the CDC lists brain fog among commonly reported Long COVID symptoms here.

2) Do I need a formal diagnosis to ask for work accommodations?
Answer: Not necessarily. Under the ADA, employers engage in an interactive process when a health condition substantially limits major life activities. Documentation usually focuses on functional limits and accommodations, not your entire medical file. See EEOC guidance here.

3) What if my brain fog started after COVID?
Answer: Long COVID can qualify as a disability when it substantially limits major life activities. HHS and DOJ explain how that works under federal civil-rights laws here.

4) Which accommodations are reasonable for cognitive symptoms?
Answer: It depends on your job’s essential functions. Common examples include written agendas, quiet spaces, memory aids, and extra time for dense reading. The Job Accommodation Network lists options and how to implement them here.

5) Can cognitive testing at the clinic “prove” brain fog?
Answer: Screening can document areas of difficulty, but it doesn’t diagnose a specific disease on its own. It helps guide further evaluation and practical planning. MedlinePlus has a clear overview here.

Sources & References

This blog is a personal journal and for general information only. It is not a substitute for professional medical advice, diagnosis, or treatment, and it does not create a doctor–patient relationship. Always seek the advice of a licensed clinician for questions about your health. If you may be experiencing an emergency, call your local emergency number immediately (e.g., 911 [US], 119).