Rheumatoid arthritis (RA) is a chronic inflammatory condition that occurs when your body's immune system—designed to fight off infections and foreign substances—targets your own cells instead. RA frequently attacks joints throughout the body, but it can also affect your brain. This "brain fog" can show up as difficulty concentrating, memory issues, trouble learning, and a depressed mood.

This article discusses brain fog that can occur with rheumatoid arthritis, including symptoms, risk factors, causes, and tips for handling it.

How RA Affects the Brain

Rheumatoid arthritis is caused by an overactive immune system. Proteins called cytokines play a large role in the excess inflammation and structural damage that occurs in the joints with RA. Cytokines also play a role in raising levels of inflammation in the brain, which causes brain fog with RA.

When inflammation increases in the brain, it interferes with the function of neurotransmitters—chemical messengers that send messages between nerves in your brain.

Depression associated with rheumatoid arthritis can also contribute to brain fog. Around one-third of people with RA will experience depression.

Symptoms of Brain Fog

In technical terms, brain fog is called "cognitive dysfunction." Symptoms of brain fog with RA include:

• Difficulty concentrating
• Loss of memory
• Confusion
• Trouble with problem-solving
• Lack of energy
• Sleepiness
• Mood swings
• Difficulty communicating
• Feelings of hopelessness

Risk Factors for Brain Fog With RA

Certain risk factors can make you more likely to have brain fog when you have rheumatoid arthritis. These include:

• Chronic pain: This is a nearly-universal symptom of RA. Areas of your brain that process pain signals are also involved with cognitive function—specifically your ability to pay attention and remember things. As a result, pain interferes with your brain's ability to focus.
• Medications: RA is often treated with disease-modifying antirheumatic drugs (DMARDs). In addition, steroid medications are often used short-term to help control symptoms during a flare-up. Unfortunately, cognitive problems and mood swings can be side effects of both of these types of medications.
• Narrowed arteries: RA can cause inflammation in your blood vessels, reducing blood flow to your brain, and leading to cognitive problems.
• Sedentary lifestyle: People with RA who exercise regularly have been shown to have improved cognitive function.
  

How to Handle Brain Fog With RA

While you might not be able to prevent brain fog if you have rheumatoid arthritis, there are things you can do to help cope with your symptoms.

• Get enough sleep: Lack of sleep can make brain fog worse. Establish a bedtime routine and stick to a regular schedule to make sure you are well-rested.
• Stay active: Exercise several times per week to help improve your mental sharpness. RA causes significant joint issues, and certain kinds of exercise can make this worse. Choose activities that take the pressure off your joints, such as riding a stationary bike or swimming. Exercise also produces endorphins in your brain, which can boost your mood.
• Explore medication options: If you suspect your brain fog is a side effect of medication, talk to your healthcare provider about other options.
• Write it down: Take notes and use a calendar to record important information to help with memory loss.
• Schedule your day: Brain fog can be worse at certain times of the day. Avoid tasks that require your full attention during these times.
  
• Talk it out: If you're dealing with depression, or are overwhelmed by the symptoms caused by your RA, consider talking with a mental health professional such as a therapist.
• Reduce stress: RA symptoms, including brain fog, are often worse when you're stressed. Incorporate stress-reducing activities into your day, such as deep breathing or meditation, and make time for leisure.

Summary

Rheumatoid arthritis (RA) is an autoimmune disorder that not only attacks your joints, but can lead to brain fog. Cognitive issues can develop when proteins called cytokines increase inflammation in your brain. Symptoms include memory loss, difficulty paying attention, mood swings, confusion, fatigue, and even depression. Treatment includes healthy lifestyle behaviors and sometimes medication changes.

A Word From Verywell

Rheumatoid arthritis can take a toll on you—not just physically, but also mentally. Brain fog can be particularly frustrating, but you don't have to settle for poor quality of life. Take steps to clear you head by following a consistent schedule, staying active, and getting good sleep. Discuss your symptoms with your healthcare provider to see if medication changes could help.

Most of all, remember that you are not alone—consider joining a support group for additional tips for managing RA and brain fog.