- Concentrate on one thing at a time.
- Break down each task into more manageable components.
- Spend a few short periods of time on each task, rather than one long period of time
- Plan regular breaks in between each task or activity.
- Improve your quality of sleep as this will make you fatigue less quickly and last longer.
- Start exercising. For example going for regular walks can improve your energy levels in the long run.
- Remove any distractions like the TV or radio, when you know you need to concentrate.
- Keep record of each activity that you are planning to do in a daily or weekly planner or calendar.
- In social situations, the smaller the group the more focussed you will be because there are fewer distractions.
- Repeat information that was told to you.
- Break down your tasks and activities into smaller, more manageable components and complete them one at a time.
- Plan and organise yourself so you can make goals and complete them in order.
- Repeat information back to yourself and others to confirm that you have heard and understood the information and to consolidate it in your mind.
- Have designated places in your house where you put important items, such as your keys, wallet and phone.
- Leave visual reminders as prompts in places you will be able to see them immediately, e.g. the fridge, or front door.
- Try to reduce your exposure to stressful situations as stress, anxiety and tiredness can affect your memory.
- Try to avoid environments that are over stimulating and distracting.
- Carry a notebook or electronic device like a mobile phone or dictaphone to record information when you are out and about.
- Try to stick to a routine, as this will help you reduce demands on your memory.
- Don’t be afraid to ask for help or for others to repeat information if you can’t remember what was said.
- Ask people to speak in brief, clear sentences.
- Try to avoid long sentences or questions with multiple parts.
- If the information is complex, try to write it down and take some time to think about it.
- If you struggle to find words, try talking about the word or describing it.
- If speech is difficult but writing is ok then carry a notepad and pen with you so that you can write down what you want to say.
- Explain to others that you need time to express yourself and more time to understand them.
- Don’t rush or put too much pressure on yourself as this may make it harder to communicate.
- If you feel stressed or frustrated, take a deep breath, pause and then try again.
- If you are struggling to communicate terms such as ‘yes’ or ‘no’, a communication board can be made with a yes and no written on it. Then you only need to point to the word to avoid misunderstanding.
- Keep a card with key information about yourself and your difficulties written down on it so that you can show it to someone if required.
Visuospatial processing tips
- Reduce clutter.
- Keep home and work places organised where possible.
- When looking for an item you should pace your search and repeat, either in your head or out loud, instructions to follow. Such as “It’s the brown glove I need…the brown glove.”
- Keep items in the same place when not being used so that you can find them more easily.
- It can be helpful to make objects more noticeable so they don’t blend in to the background. Place dark items against light coloured backgrounds and vice versa to help them stand out.
- Be aware of your surroundings, crossing the street may be dangerous if you have trouble with judging distances. Make sure you use zebra crossings when possible.
- If you are in a new environment, it may be useful to have someone with you to help you become accustomed to your surroundings.
- If you find reading a page of text difficult, try covering the text that you are not reading.
- If possible, you can also try to increase the font size and spaces between the words.
- Remember, if you are struggling, you can always stop to take a deep breath and relax.
Executive function tips
- Use a step-by-step approach when planning an activity. Break it up into small, manageable steps and write these down. Then you can work through these steps, ticking them off as you go.
- Use alarms to remind yourself of tasks that you need to do.
- Link together behaviours that often occur at the same time. For example take medication at mealtimes.
- In unfamiliar situations, establish a routine that will help reduce your anxiety.
- Allow yourself plenty of time to plan tasks or journeys.
- Write down instructions.
- When making decisions, write the options down and talk through them with someone if needed.
- It can be helpful to use cards saying ‘STOP-THINK-ACT’ to help you with any impulsive decisions.
- If you have multiple things to get done in a day, write these down and prioritise them so that you can work through the most important tasks first.
- If things get overwhelming, take a deep breath and pause, then have another go.
Sleep hygiene tips
- Create a sleep friendly bedroom.
- Have a wind down routine where you prepare yourself for sleep (ideally start 90 minutes before bedtime).
- Try to keep your bed for sleep and intimacy only.
- The quarter-of-an-hour rule. This is for the times that you may find yourself not being able to get to sleep straight away. If you find that 15 minutes has passed, try getting out of bed, go to another room and wind down until you are feeling sleepy. Then try to go back to bed to sleep again.
- Set a regular time for you to get up each morning and see whether you can stick to it 7 nights a week. To help with getting up you can play some lively music or have a shower.
- Keep active! This will help tire your body and mind so that you are ready to sleep at bedtime. However, try not to exercise within 2 hours of bedtime.
- Avoid caffeine, alcohol and nicotine in the hours before bed. Also try not to eat a heavy meal right before bed.
- Natural light suppresses the production of melatonin (a hormone associated with sleep). Avoid bright light before bedtime and try to expose yourself to natural light in the mornings to help you wake up.
- Avoid using electrical devices before bed as they produce blue light that is the strongest type of light to suppress melatonin production.
- Be smart with naps. Try to avoid them if you can but if you desperately need one, take a short nap of around 20 minutes, preferably in the morning.
Stress reducing tips
- Learn calming techniques such as relaxation, taking time out or reading a book.
- Try to control your breathing and muscle relaxation. Yoga and mindfulness practice may help with this.
- Identify your triggers and where possible try to change how you respond to these triggers.
- Challenge your negative thoughts. Try not to dwell on them.
- Find distracting activities that you enjoy to try and break the cycle of rumination. Doing the housework, listening to music or reading are some examples people find helpful.
- Get organised! This will help create a clear plan for your day and can alleviate stress. Make sure you choose achievable demands for yourself.
- Exercise is a great healthy way to help reduce stress. Taking regular exercise helps improve mood, sleep and increase the amount of energy.
- Ensure that you are getting enough sleep.
- Be assertive and challenge situations effectively to feel more in control.
- Reduce stimulants such as caffeine, alcohol and cigarettes as these can affect mood and general wellbeing.
- Be realistic about planning activities and pace yourself.
- Don’t brood on things you haven’t achieved because of your fatigue.
- Have regular breaks and prioritise where to use your energy.
- Remove distractions when you need to concentrate.
- Schedule your time.
- Improve your sleep hygiene by:
- Having a routine in the evenings around bedtime.
- Using your bed for sleeping only – no TV.
- Avoid eating heavy meals, reduce caffeine, nicotine and alcohol before going to bed.
- Get regular exercise because it will energise you and have a positive effect on your mood.
- Practice mindfulness and relaxation techniques.
- Have a balanced nutritious diet and drink lots of water.
- Have 30 minute “power-naps” if you feel you need one, your body knows best.
Sometimes it is possible to tackle common psychological distress and mild cognitive problems without having to see a psychologist.
Here are some useful resources for various cognitive and psychological symptoms that may help you understand more about what you are going through.
- Headspace is a meditation app for your phone and computer that contains a range of meditation and relaxation exercises. There is a free trial period so you can try it before you consider paying for it.
- Moodjuice for Anxiety contains information based on a Cognitive Behavioural Therapy (CBT) approach to understanding and treating anxiety.
- Living Life To The Full is a free online course that covers low mood and stress and some of the common problems they cause.
- Moodjuice for Depression contains information based on a Cognitive Behavioural Therapy (CBT) approach to understanding and treating depression.
There is no robust evidence to suggest that brain training helps improve cognition; however, some people find that it helps them when it comes to maximising everyday functioning, and it is always a good idea to keep the brain active.
Brainwell and Lumosity Brain Training: Challenge & Improve Your Mind are two brain-training apps that you may wish to try.
There is evidence to suggest that leading a healthy lifestyle, such as taking regular exercise and eating a balanced diet, may also help promote better cognition. This is particularly important for healthy ageing and can also help reduce stress, depression and anxiety.
Here are some links to charities and organisations that specialise in various neurological illness and injury:
Motor Neurone Disease
- MS Trust
- MS Trust: Staying Smart (information about cognitive problems associated with MS)
- MS Society