Can't Think, Can't Remember: More Americans Say They're in a Cognitive Fog | Hacker News Reader

Can't Think, Can't Remember: More Americans Say They're in a Cognitive Fog

nytimes.com

53 pointswalterbell63 comments

Throughout much of 2022 something like this happened to me. Calling it a "fog" would have been a complete misnomer, it was more like a complete blackout - I was unable at one point to keep as little as 3 digits in my head for more than a few seconds, it became a real problem while trying to enter MFA prompts, to the point where I'd give up and start sobbing. I forgot my own address at one point, which prompted me to go to a neurologist who tested for everything under the sun including dementia.

Nothing came up.

Turned out it was the pandemic - sorta. I had been completely isolated for a while due to the pandemic and remote work, had severe physical pain due to some pending surgery I couldn't get treated (also indirectly due to covid), and some deep personal loss (also covid).

As soon as that stuff cleared up and got better, my memory returned promptly. Maybe it was a little covid going on, but I think these studies discount the secondary and tertiary effects of the pandemic a little too quickly. Lots of these symptoms are self-reported too, which is really really prone to error.

They need to start putting these people in double-blind studies that test cognition over long periods of time to really get to the root of this.

Are you vaccinated with mRNA?

Yes, why?

Have you consider it as cause of your symptoms?

No - because there is no data to support this, and I got my first vaccine over a year before this started in the first place, and have had subsequent vaccinations since it cleared up.

I am on day 10 of recovery from pretty severe COVID and I would have been a long covid skeptic except I just woke up one day and felt like a completely different person. Its like I have all the memories and abilities of the person I was but all emotional motivation is just gone and I struggle to remember why I liked to do anything I used to do. Everything also feels kind of soft and hazy in a way that is difficult to describe. This is not at all subtle or anything stress or attention related as some have suggested. It is utterly unlike anything I’ve ever experienced.

That’s a good description for how I’ve felt since I got Covid a few months ago. I have to force myself to do anything, even sleeping is hard. I can’t focus on anything and life feels unreal somehow.

Yes, me as well. It's been 3 months since I started testing negative. My overall state is certainly better than three months ago, but this stuff persists. Based on what I've heard from people IRL as well as here, I'm not going to actually start worrying for another 3 months.

Sorry to had to experience it first hand to become a believer. it's unbelievably horrible. What would you say to your former skeptic self who might have bought the mass histeria or other "long covid isn't real" explanations in order to convince them long covid is actually real.

I don’t know I wasn’t exactly going around shouting down long covid sufferers saying it was fake or anything. I just would have questioned the health of the sufferers beforehand. But I was totally healthy so its kind of eye opening to go from normal to feeling so strange overnight.

Thats actually a very scary side effect of the virus, did you get vaccinated or not? Naive curiosity, not implying anything

I had gotten the original 2 part vaccine, though not any of the many boosters so its possible that having one of those would have given me a lot more resistance and a smoother recovery.

Or maybe it helps to give you those symptoms.

https://news.ycombinator.com/item?id=37999349#38006436

If they have the means and the opportunity, people should try an isolation retreat e.g. go camping in nature with a friend (or solo is personally preferable) for 2-3 days and only power on your cell phone for emergencies. As always, research and take preparations like telling people where you are going and went to expect you back if you're going into the wilderness. It only takes about 30 steps off the marked path to potentially get lost (forever).

People so vastly underestimate the role of their attention-seeking, cognition-theiving phones in their ability to think clearly. I would hazard a guess that most people increased their phone addiction (and psychological importance placed on their phones) during COVID.

However, it's well-known and confirmed that long-covid does cause brain fog. Plus all the other viruses that people got when they started mingling again after the entire population was inside allowing their immune systems to be mostly dormant... Long-covid really kick-started the research into long-virus issues.

Anecdotally most of my friends are now quick to attribute their (mostly benign) behaviors to various mental health shortcomings. This is new, the same people ten years ago were not doing this.

My narrative (based entirely on hunches) is that it has become very trendy in social media to assign any “strange” behavior to mental disorders like autism, adhd, bipolar… Conveniently, the same social media that thrives on cultivating these behaviors. Short attention spans, niche interests, and mood swings are all part of the SM addiction machine.

So social media says “you might have ADHD if (insert normal thing)”. People self identify, and now watching videos for 4 hours can be chalked up to the mental deficiency instead of the addictive substance.

Over-all this trend to me is a way of relinquishing responsibility, since it’s “just my brain” it is outside of one’s locus of control.

There is also more pressure now than ever to be a rational economic agent, and compared to that most of us have forgetfulness, procrastination, social shortcomings, moods that are not conducive to being an employee, etc.

I have a hard time believing that modern people are any more mentally challenged than those in the past, we are just much more quick to pathologies normal human experiences. It is convenient that this pathologizing is a boon for TikTok.

30 years ago, my mom explained to me that my cousin was "retarded" and made all sorts of excuses for how she was mistreated and infantilized by her family. Today, she's on the high functioning end of autism. Which my mom doesn't "believe in." My cousin has a greater degree of self-confidence than she did in the past, enabled in some part by a more specific diagnosis and a more accepting culture surrounding mental health variation.

It's more nuanced than that - yes there are people who are self-diagnosing themselves and finding a way to cop out.

And there are charlatans - taking advantage of the situation.

Cerebral comes to mind - https://slate.com/technology/2022/03/cerebral-order-adhd-anx...

But on the flip side - these disorders are getting attention and people who were simply told that they were "dumb" and "retarded" are seeking diagnosis and treatment and becoming productive members of society.

> Over-all this trend to me is a way of relinquishing responsibility, since it’s “just my brain” it is outside of one’s locus of control.

That would only be the case if one didn't seek treatment, perhaps because of stigma due to attitudes like this; if someone pursues a course of treatment they are in fact accepting responsibility.

Doesn't that treatment mean medication they want? Mind altering drugs. Some ADHD medication seems to be a weaker version of Speed

They literally are amphetamines. But they aren't "mind altering" for people with ADHD, like me. They reduce anxiety. I can fall asleep on Adderall.

They don't change me at all, they're kind of like glasses. Suddenly I don't have to work nearly so hard to do things.

That's facile. Those conditions were always underdiagnosed. In the past, people just struggled.

For example, I was diagnosed with ADHD in my late 30s and it explained a lot of things I had always struggled with, and meds were incredibly helpful.

There's no value in making life any more difficult than it already is, and there's no award for who can endure the most.

I did manage without meds or a diagnosis, but with them, it's like dropping a 50lb pack you didn't know was there.

People (especially parents and teachers) espousing opinions like yours make life dramatically harder for people with real challenges. :(

"It's not real, you're fine, probably just lazy" is crazymaking. You simply have no idea what you're talking about.

There's also a pathologizing of human behaviour, or things we could call Personalities. Boys at a certain age can have difficulty sitting in a classroom and focusing on classes for 6 hours like their female counterparts, and can be diagnosed with ADD/ADHD. Things that they "grow out of". This isn't to say ADHD doesn't exist, just that there is misdiagnosis

Thirty years ago it was also believed that you could just cure gayness.

And 70 years ago woman were not allowed to vote.

It's so common that even today you hear people defending rapists because either it wasn't rape or a family member or it would be shameful to the family to have a dirty person.

While your one sided analysis might also have some merits the past was not known at all to be full of facets.

This is an achievement of modern times thanks to more global and faster communication through the internet and also denser population.

And yes it is a real problem when everyone has a smartphone and uses it constantly. The answer? Time budgeting build into our phones.

> My narrative (based entirely on hunches)

Thankfully, we base our society around science, which looks to hard data, as much as possible, over the gut feelings of the local shaman. It's imperfect, but it's better than the past, when the Sun revolved around the Earth, and explanations (epicycles) and people were tortured.

>Because the census relies entirely on self-reporting, experts say the data could also be capturing a shift in how people perceive their cognition, even absent changes to their health.

>People with disabilities might have taken note of rising disability acceptance and become more likely to answer the census questions honestly, researchers say.

>But those changes in perception are likely to have a relatively small influence on the numbers, said Monika Mitra, who directs the Lurie Institute for Disability Policy at Brandeis University. Most of the increase is probably capturing real changes in people’s health, she said. [emphasis added]

In conclusion, experts and researchers say one thing, Monika Mitra says the opposite, so we really don't know.

I can’t help but notice the word “honestly” there.

I am sceptical that people are being more honest now than they were before. I think that people feel more sick than they did before. I also feel there is a huge societal trend of medicalizing how people act and feel and expressing it in terms of it being a mental illness or disorder.

I’ve noticed that mental health outcomes keep getting worse and worse and doctors consistently go “wow that’s great there must be so much more awareness and acceptance of mental health problems!” That’s a very self-serving interpretation and I don’t understand why people don’t question it more.

> That’s a very self-serving interpretation and I don’t understand why people don’t question it more.

People say "don't talk to police" because they can fuck you over, legally speaking. Regardless of whether you're innocent or guilty, you stfu when police are around

Psychologists can also fuck people over legally speaking (and likely will be able to even more so in the future), but the same standard doesn't exist for some reason, instead it's a bunch of people willingly talking. And there's also no due process either, the entire system goes around it

This is a whole different tangent, but I could go on about

1: That psychiatrists can give you a lifetime diagnosis, without your consent to doing so, or agreement as to the diagnosis, with demonstrably negative social and legal consequences, without your consent or ability to remove the diagnosis from your medical history (barring exceptional circumstances). Being gay/trans already had to be removed as mental health conditions due to psychiatrists admitting they were only hurting them by labelling them mentally ill, but they fixed this by deeming these things as NOT mental health problems, but still not actually giving people the ability to refuse to consent to a diagnosis which would have prevented much of the harm to begin with.

This is then reinforced by scheduling and denying access to useful medicines like amphetamines and insurance coverage UNLESS you accept a legally and socially consequential label of being mentally disordered first, so even if people had the choice not to be labelled as disordered, they may not take it anyways because they will live a lower quality of life if they do not accept that label. I have NO idea how to solve this issue.

2: the whole involuntary hold thing. This I won’t get into that much, because it’s one thing to come up with a morally self-righteous take on this issue, and it’s another to deal with the reality that some people if left to their own devices WILL hurt themselves. Also there really is a lot of due process around this matter, the problems are really around the details and implementation. I have NO idea how to solve this issue.

> This is then reinforced by scheduling and denying access to useful medicines like amphetamines and insurance coverage UNLESS you accept a legally and socially consequential label of being mentally disordered first, so even if people had the choice not to be labelled as disordered, they may not take it anyways because they will live a lower quality of life if they do not accept that label. I have NO idea how to solve this issue.

Is an ADHD diagnosis really that "legally and socially consequential?" What are these consequences you describe, and how would one become subject to them?

I'm struggling to think of any real consequences, unless you are an airline pilot or have a security clearance, and even then I don't think ADHD is a deal breaker.

It really is, and I only used ADHD as an example. Still:

> The diagnosis may result in exclusion or special scrutiny in various militaries.

How: The military can require access to your medical records.

> Mental health is legally required to be considered in a custody dispute to evaluate the "best interest" of a child. A diagnosis can make it a legal fact that you have a mental health problem.

How: The courts can request your medical records.

> Immigration to other countries, notably America, especially under Trump, denies people with disabilities entry under certain circumstances and always gives them special scrutiny. This can impact both the disabled person and anybody with disabled family members. This specific issue is actually potentially impactful to somebody on HN.

How: Immigration will find out by simply asking you and threatening you if you lie.

> When trying to get medical services, healthcare providers who have access to your medical records themselves stigmatise the condition[1], and know that you have it. Also diagnosis of virtually all disabilities correlate to having other issues, obesity/asthma/sleep disorders in the case of ADHD. However, the very fact you have the diagnostic overshadowing[2] where physical health problems just get treated as mental health symptoms by doctors, and are less likely to be treated.

How: Medical records can be directly looked at.

> It's also that once the data about somebodies disability is on a database, it could be there for a century, and it can leak. Unexpected social changes are a bit of a threat. Germany went from conservative christians to socially left to far right in about a generation and went from totally being against killing the disabled, to totally being in favour of killing disabled. This, incidentally was facilitated by German doctors, who were early and fervent Nazi Party supporters[3].

How: Medical records will be directly looked at.

> There are sperm bank bans on donating with ADHD and other disabilities[4], and even more commonly than that policies of disclosing any diagnosed disability, so generally being diagnosed as disabled makes you subject to contemporary eugenics as well.

How: Such places will request medical records.

>K-12 schools, I can go on and on about the practice of removing disabled kids from PE classes to try and get them to study more and ignoring their physical health problems, or about the systemic unwillingness to consider what the disabled child wants to any degree when it comes to something like accommodations in an IEP (not accommodating them in socially stigmatising ways for instance). Private schools notably can just straight up discriminate against students for having ADHD and this DOES happen although I think the ADA in the US does outlaw this[5][6].

How: The school needs to either be told or have formal confirmation of a disability here

>Casual employment discrimination happens all the time

How: Generally word of mouth has to get around.

>Some people really do have negative attitudes towards anything considered a disability

How: Generally word of mouth has to get around

[1] https://journals.plos.org/plosone/article?id=10.1371/journal... [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4219761/ - hard to find a good source this is more illustrative [3] https://pubmed.ncbi.nlm.nih.gov/23040706/ [4] https://www.standard.co.uk/news/health/harley-street-sperm-b... [5]https://www.theage.com.au/national/victoria/disabled-childre... [6]https://www.westernwheel.ca/beyond-local/airdrie-parent-clai...

P.S. Out of everything here, "diagnostic overshadowing" is the issue that seems most relevant to this topic. If some physical issue started causing a bunch of health problems that looked like mental health problems, what are the changes we would attribute it to a physical health condition instead of "mental health awareness" and the patient population simply being more woke than in the prior year?

First, Monika Mitra is a professor of disability policy, so she is also an expert.

Second, it's a little ambiguous how much they disagree. To use slightly contrived numbers, it's possible the first group of experts and researchers think perception changes and increased honesty explain 2/3 of the increase, but Mitra things it explains 1/3. The wording also leaves open the possibility they basically agree with Mitra and just feel less confident ruling out changes in perception.

Yeah. I don’t believe I’m dumber now than when I was younger. I believe I’m more aware of the cognitive fog I’ve always had in my head, how unintelligent I’ve always been.

/sarcasm… right?

This “one person disagrees therefore it’s not settled”… this needs to die. We collectively need to raise the bar of human discourse above this tiny hurdle and put an end to anyone who isn’t drunk accepting the argument of one single person against the global consensus…

And before anyone chimes in with arguments about examples of righteous crusades against genuine problems in the world sparked by a single person… the obvious counterpoint is that these people stop being “one single person” when they convince someone else in a one to one conversation… good arguments persuade people and gather people around them… one lone voice arguing against the consensus is a crank who should be ignored without guilt… not platformed under the guise of balancing some illusionary other side of an argument… Looking squarely at you BBC… the ABC in Australia aren’t particularly good at this either but the BBC are the absolute fucking worst at this.

The “global consensus” is decided by doctors who have a vested interest in claiming that any negative rise in mental health outcomes is a victory because it shows better mental health awareness, rather than a failure and showing that contemporary medicine is either ineffective or actively harmful.

Relying on the “global consensus” here is a fox guarding henhouse situation. In any case, nobody has any real evidence as to what could be causing this effect, only conjecture.

Wouldn't their interest be in the opposite? Wouldn't they want people to think that doctors have the answers rather than doctors failing at helping with mental health issues?

That would be in their interest, but being concerned about things like declining mental health metrics only happens if there is public pressure for the mental health field to be accountable by some sort of empirical measure.

What I sort of wish people did more was hold the mental health field, from pharmaceutical conglomerates to individual practitioners, to some sort of standard. What we have now is either the field is succeeding because self-reported mental health is improving, or it’s succeeding because self-reported mental health is going down which means mental health AWARENESS is improving. I feel how the mental health field has spun things like gradually increasing suicide and drug addiction rates (proof of mental health underfunding!) has been broadly successful for the field.

What I would like to see mental health practioners just start treating a patient population and for them to improve so dramatically that they discontinue treatment and live “normally”. Or maybe their lifespans measurably improve. Or suicide rates plummet. What I see instead is this sprawl of mental health services which are big on promises, big on “pro-awareness” rhetoric, and short on results at the societal scale.

Every mental health drug on the market was approved based on improvement in some sort of metric. Measuring improvements in lifespan or lack thereof is impractical because it takes too long for any differences to become apparent in study populations. Suicide rates are also difficult to study because the baseline annual rate is very low even in mentally ill populations so that also requires large, long-term studies to see statistically significant effects.

We generally have no way to cure the root causes of mental health conditions severe enough to qualify for an official DSM5 type diagnosis. Discontinuing treatment is often not a realistic goal, although in some cases patients can learn coping strategies which reduce the need for medication or frequent talk therapy sessions.

This stuff is just fundamentally different from treating a medical condition like type-2 diabetes where there are clear biomarkers and results are often clear within months.

> And before anyone chimes in with arguments about examples of righteous crusades against genuine problems in the world sparked by a single person… the obvious counterpoint is that these people [stop being “one single person” when they convince someone else in a one to one conversation]

> good arguments persuade people and gather people around them… [one lone voice arguing against the consensus is a crank who should be ignored without guilt].

Self-refuting "logic" like this is what we need much less of if you ask me.

I've definitely experienced this. Lately, I often forget that I'm making coffee and just leave the grinder on the counter. This is utterly bizarre behavior for me. I'm usually very focused on what I'm doing. I'm in my early forties so dementia feels unlikely.

http://archive.today/lcqEK

If you "improved" the insulation on your domicile in the past few years and/or people in your household began working at home more, consider the average CO2 may have increased notably (which will vary by season) leaving you foggier. Try cracking windows for a cross-breeze (or more than cracking them if the temp is not too different outside from inside).

Aranet4's are an investment but can be worthwhile once you recognize it as an issue for you.

I felt this way after a COVID infection, takes 6 months at least to get cognitively back.

Maybe there's hope for me. It hasn't yet been 6 months since I stopped being actively sick with Covid, but my head is still foggy and I still get tired absurdly easily.

There certainly is hope - my wife had long covid back before we even heard the term or knew what it was. But she's largely recovered now, despite long covid hitting her really hard with measurable impacts (myocarditis, POTS etc.)

At times it felt liked she'd never improve, but she has - she just needs to build her strength again. If you want more hope look for people who had similar symptoms from SARS - they largely recovered in a similar time frame.

This helped me.

https://www.yalemedicine.org/news/long-covid-brain-fog-treat...

The legal weed? Not judging, just observing this at friends that are now consuming daily.

The chronic lack of sleep? Doom scrolling at 2am is so common in the post-pandemic world.

The continuous notifications and distractions coming from our devices having an effect on our mental sharpness? I barely use Facebook but its icon on my iPhone always has a number on red on it.

And I could go on.

I've definitely found that my attention span has shortened, but I wonder if I shouldn't attribute at least some of that to my age (50 now). I could concentrate a lot longer when I was younger, maybe it's normal to lose some ability to concentrate like losing eyesight and hearing?

In his autobiography, the linguist R.M.W. Dixon (who could concentrate at least well enough to produce great scholarship into old age) suggested that the break was puberty. He wished he could go back to that halcyon time of boyhood before a redblooded man would constantly find his thoughts turning to sex. No later advance in years was as clearly harmful as that.

Not American, but can confirm. And I think the statement can be generalized to most, if not all, urban population, sadly. I've been observing this problem for at least 10 years, and EVERY age group is affected. And also, among people I know, the farther from large cities they live, the better they feel. (EDIT: I was implying that COVID may have boosted something that was already a trend before it)

It is easy to spread oneself too thin on Youtube. Following clickbait titles and doom scrolling disconnects me from sequential thinking.

It is really unhealthy.

I don't deny the possibility that there are long-term post viral health effects and covid is obviously a big possibility there, but I've said many times that I think a lot of the health issues that people are experiencing are from stress and anxiety. I say that as someone who has had near lifelong issues with them. When I was going through the experience of working for a company acquired by private equity, it was incredibly stressful to see rounds of layoffs and wondering when my number would come up (I really need my health insurance). When it actually did it was actually relieving and I found I was able to think a lot more clearly and able to learn things much more easily, though this process easily took a year and I'm probably still continuing to improve (through some real work) a few years later.

So while the virus is a real biological factor, I can't help but think that the mass stress event of the pandemic and all that came with it had enormous effects on its own.

Yeah, I suppose it's mostly information overload—scrolling through many apps, constantly ingesting information at a high bandwidth without utilizing memory recall. There could also be some biological origins, perhaps related to food or disruptions in the nervous system.

I wonder if it is in many ways loss of attention span and capability to concentrate due to too many distractions and opportunities to be distracted.

Smartphones, social media, internet in general.

Probably unrelated to the fact that a ton of Americans now smoke weed from the moment they wake up until the moment they fall asleep.

All these mm-waves must have an impact too.

(well the science claims that they do already).

Pretty sure the impact is in what the waves (mm or otherwise) transport onto people’s screens.

I'm still more curious,if not wary, about electro-magnetic fields disrupting neural activity as far as I'm concerned.

There's a very high possibility that EM radiation emitted by smartphones can indeed disrupt neural activity. My money is on the 380 - 700nm kind.

Yeah I understand but don't remove your eyeballs from their sockets just yet. If that's one (quasi-permanent) solution to your worries, that is still not very advised. Try to shut down your phone first to mitigate that. The concern is about what one cannot control...

This is definitely a problem for me.

I think this is mostly due to the increasing complexity of modern informational society – and the failure of information processors like the New York Times to live up to their supposed roles. Reading the news today, nothing adds up to a coherent whole. It’s just chaos, opinion pieces, emotional reporting, and outright propaganda.

I don’t blame the average person for becoming cognitively overloaded by all of this and then feeling lost, unable to think, and unable to order their memories into a logical narrative that explains the world.

Lately it's been feeling to me like we live in a theocratic hellscape.

Like, so much of our "life" occurs on a plane of existence that doesn't actually exist. It's all virtual. Fake worlds! Fake relationships! Fake money! (Fake news!). Then we have to reconcile that with the reality we live in. We might as well be living according to the arbitrary whims of God all over again. The rules change arbitrarily; systems that work predictably one day get silently updated overnight to overhaul everything from the business logic to the interface itself. God willed it!

Making it worse, it's bureaucratic beyond comprehension. I have weeks at work where I don't even know what my job even is. I could write some code, I guess. Deploying it is going to require interacting with a number of teams to beg for provisioning, credentials, firewall exceptions, etc. I have to ask this from people I haven't seen in so long they might as well be NPCs in a scripted loop. I don't even know if they still manage whatever it is I need. This isn't even my job, it's just what I need to do in support of my actual job, since nobody can just have one role anymore.

We're supposed to have faith that God/tech will provide. Robots were supposed to do difficult or dangerous work so we could live a life of leisure! But instead tech is eliminating the unskilled jobs. There's no time for mental breakdowns. The cracks are starting to show.

Life feels too much like I'm trying to multiclass in four different MMOs while fending off real-life pickpockets and patching holes in the roof-- all at the same time.

Reply on news.ycombinator.com