Cognitive Symptoms with MS | MS Blog

One of the many difficulties of having multiple sclerosis, is that many of the symptoms are “invisible.”  I’ll get on my soap box about the phrase “but you look so good!” another time.  For now, I just want to focus on the cognitive component of MS.

Before my diagnosis I was a straight “A” student…

I will never forget (ironically) the feeling I experienced when I received my grade for the first test I took after my diagnosis.  I failed the test.  I studied just as much as I had for previous tests and felt confident in my ability to succeed at the same level of every other test.  I didn’t even realize that my cognitive abilities had declined.

MS failI was very blessed that the teacher, Mrs. Mari Siegel, was familiar with MS because of people in her life with the diagnosis.  She took the time to discuss the possibility of cognitive symptoms with me.  From that point on, I had to study several hours longer than I was used to doing before my diagnosis.  I had to start studying for an exam much earlier too so that I could have more time to rehearse facts which increased the chances that I would commit them to memory. 

I started to notice other things too which still affect me today.  Speaking articulately is a challenge in and of itself.  I struggle to find the right words to express my thoughts adequately, and my vocabulary is nowhere close to the above average level of vocabulary I had as a 6th grader.  That alone is hard to admit, but it’s the truth – I had a better vocabulary in 6th grade than I do today, and it isn’t for lack of trying!  Which brings me to the point of cognitive fatigue.

Thinking, just attempting to concentrate on something, can be exhausting sometimes.  As a result, I pick and choose where to allot my cognitive energy.  I’ve stopped trying to increase my vocabulary because I need that energy for other cognitive tasks, like finding the words I already know, or remembering what I promised someone I would do.  (Not to mention who I made the promise to, and when I said I would do it!)

Memory honestly deserves an entire post dedicated to it because it is such a pervasive symptom affecting virtually

every part of my life

To address the cognitive challenges in a general way I would say that on a regular basis, I feel like part of my brain is blocked off and inaccessible.  This is a such a hard concept to describe and professionals and advocates in the community use all kinds of terms like “cognitive fog.”  Being the person inside that foggy brain, it seems impossible that someone else could grasp what this feels like I am going to do my best, and I hope that others facing this illness will either confirm that this description is accurate or provide a better illustration.

Imagine that your Brain is a Big Swimming Pool


MS glass wall pool

(which isn’t that odd of a comparison since the brain is actually somewhere between 75% and 80% water).   I want you to imagine a glass wall in the pool right at the point where the bottom drops off to become the deep end.  Now get into the pool at the shallow end and start swimming laps.  You’re going to bump into that glass wall without realizing it.  You can see that there is still further to go in the pool, you want to keep going, but you can’t pass the wall.  I feel like that sometimes.  It’s like there’s a wall somewhere in my brain.  I know there is more, so much more, that belongs to me behind the wall, but I can’t access it.

I’ll try to explain this another way.  Let’s say that every person’s brain has 10 cylinders that the brain uses to function.  Perhaps for different tasks, a person uses less than the 10 cylinders but overall, to operate at full capacity (which most brains don’t), it requires all 10 cylinders. 

I fee like my brain has ONLY two working cylinders 

and the others are permanently “out of order” 


funny MS quote

I can’t even fire up the other ones if I wanted or needed to think critically about an accounting problem or even an interpersonal issue.

I need to be clear that I’m not putting myself down or complaining that I’m not smart.  To be honest, I think I am able to do a lot more with my TWO cylinders than some people are able to do with all TEN.  I’m not bragging, I’m just clarifying that I am not using this explanation to make myself seem dumb or ask for pity.  I am a very competent adult and I don’t believe that this reduced cognitive functioning should be an excuse for someone with MS to just give up trying to succeed in life. 


What I’m trying to express is the phenomenon of knowing that those other eight cylinders exist.  It is so frustrating sometimes to see how capable I am with two cylinders and to think how much more I could do or know if I could activate even just a couple more cylinders.

MS speaking

Alright, I gave it my best shot.  I’m not sure if these examples help people to understand what it is like having cognitive symptoms with MS but I certainly hope so.  It is just one category of the many invisible symptoms that a person with MS might have.

It’s enough of a challenge to live with what feels like a wall in my brain, but so much more challenging when others don’t realize it’s even there

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