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Keeping Up in a Fog: Should I Feel Bad?

What is cog-fog (cognitive fog)? If you are living with Multiple Sclerosis (MS) then you probably already know, but you may call it something different. Cog-fog, or brain fog, refers to MS symptoms that cause some sort of deficit in your ability to think clearly, quickly, remember things, concentrate, or solve problems (among other thinking-related things).

Walking through a thick fog

People describe this like it’s walking through a thick fog where you are not able to see very far ahead of where you are going, and where everything you just passed quickly fades away in the fog behind you. This fog is so close to you that you can’t even see what you are doing; whatever you are working on, even if it’s at arm’s length from you, is hidden by fog, causing a sometimes intense feeling of confusion and, at least for me, frustration. In most cases, medication like Adderall is prescribed to help with this, as well as the terrible fatigue that is so often experienced by people with MS. But because these medications are commonly abused by people who are trying to enhance the performance of their brains in order to get ahead of everyone else (much like athletes who take performance enhancing drugs so they can work harder, be faster, and feel stronger), I can’t help but wonder, “should I feel bad for using this kind of medication to help me keep up?”

People with MS are at a disadvantage

Logically speaking, it’s simple. It’s like everyone in life is a runner who is competing in a race, and while everyone should have to start at the same place, people with MS have to start twice as far back with a heavy ball and chain tied around their waist. This medication simply brings them closer to where everyone else is starting in this race, and it lessens the weight of the ball and chain they are dragging so that they can better keep up with the pace of the other runners. It is just an attempt to level the playing field. People who abuse this medication are trying to get an early start in this race, as well as increase their running speed so that they can stay well ahead of everyone else. They don’t want to level the playing field, they want to enhance their abilities to gain an advantage over everyone else.

I would choose my old brain in a heartbeat

Now, I’m going to go out on a limb here and say that there probably aren’t many people with MS who are on this kind of medication and feel like they are cognitively performing better than they did before MS became a factor in their life. I am pretty sure no one said, “Awesome! This is my ticket to get me some Adderall” after being diagnosed with MS. I mean, for me? If I had to choose between my cog-fog brain on something like Provigil/Nuvigil (Modafinil/Armodafinil), and my brain from before I was diagnosed with MS, I would choose my old brain in a heartbeat because these medications, even on a good day, don’t help me perform half as fast as my brain used to on a bad day. These drugs/medications can help clear some of the fog but never all of it; honestly, I can’t really remember what it actually feels like to operate with a fog-free brain.

Feeling hesitant to ask my doctor

So yeah, by taking a medication like Nuvigil or Ritalin (methylphenidate), I know that I am just trying to level the playing field. I am just trying to keep up with all the other runners in this race we call life who don’t have to run through a heavy fog like I do. But because there can be a bit of a taboo associated with using medication often labeled by people as “smart drugs,” “cognitive enhancers,” or “study drugs,” I sometimes wonder if I should feel weird about it. For example, I am hesitant to ask my doctor to try something like Adderall, which may offer me the clarity I am seeking without the side effects of what I am currently on.

Just trying to keep up

I know it’s just another medication and that I am just trying to explore all my options regarding treating something that severely hinders my ability to function in life but I can’t help but feel like a doctor would just see me as someone seeking drugs. But what do I care what people think if it means me not feeling terrible and instead being productive? When I think back to my “logical assessment of the situation” my conclusion is that no, I shouldn’t feel weird about it because I am not using them to try to get ahead, I am using them to just try to keep up. But even still, I can’t help but feel a tiny bit weird about it. I don’t know why I just can’t shake that feeling, it really makes no sense to me.

What are your views on this topic? Do you ever feel weird about having to use drugs like stimulants to try to combat symptoms of cog-fog brought about by MS? Or do you not even see it as a taboo subject? Let me know in the comments below!

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • DawnW
    2 years ago

    Honestly, I didn’t even know if I would take one of those drugs, it could help me. Nobody, including my doctors, have ever mentioned this to me and I must not have read the right articles. I will ask about this at my next Dr. appt. Thanks!

  • Matt Allen G author
    2 years ago

    Yeah! Most the people I know who have MS are on one of these medications, I OFTEN have no idea how I could make it through the day on my own. I wish I didn’t need them but I sure don’t wish I couldn’t be put on them.

  • LuvMyDog
    2 years ago

    As a child, I had a very high IQ. As an only child, I lived with a house full of very intelligent adults who treated me most times like a small “big-person”. My uncle was becoming a doctor, many of his medical text books were within reach, that’s how I learned to read, not from some silly “Dick & Jane Walk Spot Up The Hill” kid’s book.
    I learned so many things that I advanced in school very quickly, skipping two grades in grammar school, one grade in junior high and two grades in high school.
    Skipping ahead….one of the things that I loved and amazed people for many years was my memory. I could recall anything you asked going back to when I was a baby.
    My lightening quick thinking and great memory served me well in my job.
    Skipping ahead….Then I was diagnosed with MS.
    For many years I was okay, sort of okay. I did well.
    I am at a point now, after 36 years with this disease, that I can’t remember something from the day before.
    I have a hard time recalling what I ate.
    Did I go out? Or was that a few days before or maybe even….last week?
    I have always loved movies and have seen hundreds over the years.
    As a kid, I loved the old movies, the old actors from the 30’s, 40’s and 50’s. I knew all of their names, all the names of the movies.
    Can I remember them now? Maybe one or two.
    My thinking is no longer lightening fast and my former great memory is like an old 25 watt bulb, flickering in a lamp that needs repair.
    I am no longer the great conversationalist I used to be because I can’t think of the words fast enough. I know what the words are, but they seem to stick at the bottom of my throat for what seems to be an eternity, sometimes they come out, many times not.
    It makes me feel stupid, it makes me look stupid…..I am not stupid, far from it.
    But people who don’t know me or not that well, judge by how I speak now.
    When I was a little kid, my mother always said, “you can’t judge a book by it’s cover.”
    That is very true.
    Appearance belies what is on the inside.
    I am not someone who likes or trusts medications. So many have terrible side effects.
    If there was a medication that could wake me up, get my brain to come out of this terrible fog and give me back my ability to remember something I choose to call up at a moment’s notice and converse in an intelligent manner again and not have side effects, I would love that.
    But, I’m thinking that would be way too much to ask for.

  • Alina Ahsan moderator
    2 years ago

    LuvMyDog, thanks so much for sharing your experiences. It sounds like you had a really great, stimulating childhood. Your comments on the site are always so thoughtful and relatable, and I know many in the community enjoy them- so please know that we really enjoy conversations with you online! Chatting online can be easier sometimes when you have time to compose your reply. I’m so sorry you’ve had to deal with these issues related to MS; I can’t imagine how frustrating they must be. Thanks for your comment,
    -Alina, Team Member

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