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Do you lose your car keys regularly? Have trouble recalling your best friends’ names? Often can’t remember what you were going to do next? If so, you’re not alone. Cognitive problems such as forgetfulness and confusion are common among people with multiple sclerosis. Lesions in the brain are mostly to blame. But other less obvious causes can also affect your ability to think – and they’re usually much easier to control than MS. Here are seven of them:

1) Medication - Some medications can cause problems with thinking. If you’re on any of the following types of medications talk with your doctor about whether or not they might be affecting your cognition and what your options might be. Never discontinue a medication without speaking with your doctor first.

2) Hearing Loss - Recent studies suggest a link between hearing loss and cognitive problems ranging from mild impairment to dementia. Stressed by the constant strain to understand what others are saying, your brain becomes overloaded and memory functions can be impaired. If you think you have hearing loss, ask your doctor for a recommendation to an ear, nose, and throat specialist. Your hearing loss may not be due to MS (hearing symptoms are rare), and hearing aids can bring your hearing to back to normal.

3) Dehydration. Evidence suggests the cognitive tasks that require attention, immediate memory, and psychomotor skills are the most negatively affected by dehydration. The “8-by-8 rule” (eight ounces of water eight times a day) is a popular hydration guideline, but your fluid intake is probably adequate if you’re rarely thirsty and your urine is colorless or light yellow. You don’t always have to get your fluids by the glass. Many fruits and vegetables, such as watermelon and spinach, are almost 100 percent water by weight.

4) Depression - A common symptom of MS, depression can contribute to the following cognitive problems:

Fortunately, depression responds to treatment. The most successful approach includes a combination of cognitive behavioral therapy and medication. If you think you might be suffering from depression, ask your doctor for help.

5) Sleep Deprivation - MS symptoms can keep you from getting the deep, restorative sleep you need for optimal brain functioning. Thought processes can slow down, you’re less alert than normal, and your ability to concentrate suffers. You can become so confused you can’t perform tasks requiring complex thought. It’s also difficult to remember and learn new things when you’re sleepy. Focusing becomes more difficult, as working memory is affected. It makes you less vigilant and reduces both your accuracy and speed on mental tasks. Natural supplements such as melatonin as well as sleep medicine can help. Learn about healthy sleep habits to improve your chances of getting the  “zzzs” you need. 

6) Environmental Distractions - Phones ring, appliances hum, people talk, lights glare, air blows too hot or cold — there’s no limit to the distractions that can hijack your attention when you’re trying to concentrate. If you’re fighting too much noise and can’t retreat to a more quiet space, try using noise-cancelling headphones. Another option is to use headphones to listen to some soothing classical music — whatever works for you. 

7) Stress - If you’re living with an unpredictable disease such as MS, stress is inevitable. Job problems, relationship issues, and health concerns can be major distractions. When it becomes chronic, stress can have dire consequences on focus and concentration. Important cognitive functions can be short-circuited, and if you have to reread things a lot because you can’t focus, your work may not get done. That alone causes even more stress. Many complementary and alternative medicine options can help reduce stress, including deep breathing, mindful meditation, yoga, and relaxation exercises.