Women’s Mental Health: Cognitive Overload or Brain Fog?

Wondering why you walked into a room? Feeling less effective at work? Overwhelmed with household tasks? Forgetting appointments? Do you have cloudy thinking or a sluggish thought process? Struggling with basic decision-making? Being unable to deal with an issue because it seems too complex? Becoming passive or apathetic when it comes to forming opinions or making decisions?

These are common complaints I hear as a women’s health psychiatrist. The first step, when a patient complains of these symptoms, is to conduct a thorough psychiatric evaluation that rules out underlying mental health conditions that could explain the symptoms—chronic stress, depression, anxiety, PTSD, addiction, and dementia.

When a formal mental health condition is ruled out, it is not uncommon for me to have conversations with my patients about cognitive overload and brain fog. These are two conditions (similar but different and often confused with each other!) that, in my experience, don’t get addressed as they should.

Here are five key lessons about cognitive overload and brain fog that are important to understand in women’s mental health.

1. One is an official psychological term, the other is not

Cognitive overload

In cognitive psychology, cognitive load describes the effort being used in the working memory, the mental effort required to process information. Cognitive overload occurs when one is given too much information all at once, or too many simultaneous tasks, resulting in the inability to perform or process the information.

Brain fog

The term brain fog is used colloquially to describe difficulties in the cognitive domain but is not an official medical or psychological term.

2. They each have different symptoms

Cognitive overload

Cognitive overload is associated with an increased rate of errors, inability to carry out activities to a similar competence as achieved previously, or more subtle signs such as a deterioration in intrapersonal and communication skills.

Brain Fog

Brain fog consists of a wide variety of complaints from dissociation, temporary experiences of forgetfulness, cloudiness, and difficulty with thinking or processing information, as well as trouble with learning, speaking, or understanding.

3. Women are more vulnerable to both, but probably for different reasons

Cognitive overload

Women may be more vulnerable to higher cognitive loads due to gendered expectations about their accessibility (it’s more acceptable to interrupt a woman while she is at work, or make last-minute requests) and accountability (it is assumed that women are available to take on psychosocial tasks such as providing reassurance, encouragement, or empathy to others). As long as cultural norms expect women to be more accountable and accessible (whereas for men, this might be viewed as merely being helpful or as an additional bonus) women are at risk for ongoing cognitive overload.

One study specifically investigating cognitive dimensions of household labor—planning, anticipating, and delegating household tasks—found the division of cognitive labor was particularly gendered; women’s share of cognitive labor was more disproportionate than physical household labor. The researchers reported that cognitive labor was also associated with women’s depression, stress, burnout, overall mental health, and relationship functioning.

Brain fog

Longitudinal studies find small but reliable declines in objective memory performance as women transition into perimenopause, and these are not explained by advancing age alone. While the research exploring brain fog is limited, existing studies indicate that brain fog is probably a biological phenomenon, found predominantly within females, which is influenced by hormone changes, and illness, and modified by diet and lifestyle.

Brain Fog Essential Reads

Why NIH Must Not Abandon Brain Fog Research

The Top Causes of Brain Fog

4. It’s vital to consider social context: have we been blaming the victim?

Cognitive load

We live in an information society and while it has become easy to access diverse information, we also have to process large amounts of information and messages. How large? Researchers have reported that the amount of information created every two days is roughly equivalent to the amount of information that was created between the beginning of human civilization and the year 2003. The amount of information available has thus become overwhelming, but it is difficult to assess its quality.

Is it any wonder then that women complain of cognitive overload?

Some authors argue that action is needed on a systemic level to improve cognitive ergonomics in the workplace where constantly switching tasks or being interrupted or interacting with user-hostile technology are the factors to blame as opposed to one individual's ability to manage their cognitive load.

5. Treatment approaches for both are different

Cognitive overload

Common recommendations for managing cognitive overload include:

• Prioritizing tasks
• Breaking down tasks into manageable chunks
• Managing time to allocate specific time slots for different tasks
• Organizing information using lists, calendars, and reminders
• Limiting multitasking and following the rule of one task at a time
• Learning to say no to unusual demands or extra tasks
• Seeking support from colleagues, supervisors, and your spouse to distribute the cognitive load evenly.

Brain fog

Common recommendations for managing brain fog include:

• Improving sleep habits and prioritizing high-quality sleep consistently
• Eating healthy and nutritious meals
• Getting at least 30 minutes of physical activity in each day
• Writing down important information
• Mindfulness and relaxation techniques and deep breathing exercises to improve cognitive resilience