“The hardest thing is that Ellen often can’t remember what she’s doing,” Richard Friedman, 42, told his wife’s multiple sclerosis (MS) support group in San Francisco. “She’ll leave a pot cooking and never think about it until the smoke alarm goes off. She’ll be talking with you and completely forget what she was saying. It’s hard for both of us.”

Ellen, 45, is a school teacher who is currently out on disability.

Ellen’s attention loss is called a “cognitive deficit.” Other cognitive (thinking) deficits include difficulty learning new information and remembering it, slowed thinking, and problems with planning and organization.

According to an expert opinion paper by the National Medical Advisory Board of the National Multiple Sclerosis Society (NMSS), cognitive deficits affect up to 50 percent of people with MS, but in most cases, they do not significantly impair daily functioning.

Just like physical symptoms of MS, cognitive symptoms result from damage to the myelin covering of nerve fibers in the brain. Since different nerve fibers are affected in different people, the effects on cognition vary for each person.

Depending on the cognitive symptoms you’re experiencing and their severity, the following suggestions may help you manage your symptoms, minimize their impact on your life, and prevent new symptoms.

To Stay Focused, Avoid Multitasking

Psychologist Nicholas LaRocca, PhD, associate vice president of health care delivery and policy research for the NMSS, says, “In MS, divided attention tasks, or paying attention to more than one thing at a time, seem most affected.”

To improve your ability to focus on any one task, don’t multitask!

Ellen has learned to apply this rule to avoid burning things. “I stay in the kitchen until everything is finished and turned off,” she says. “Or if I can’t do that, I set a timer to remind me to check in, even if I’m just boiling water.”

When Ellen drives, she says, “I leave the radio off and don’t talk to people. If there are passengers, I ask them to keep quiet. I set my GPS for every trip to remind me where I’m going. I have to keep things simple, but it works.”

Conversations usually go better if the participants are focused on what’s being said. Psychologist Rosalind Kalb, PhD, vice president of the professional resource center at the NMSS, recommends “taking conversations into a quiet place, keeping eye contact with people you are talking to, turning off the television, and removing other stimulation.”

Even when you’re not trying to do two or more things at once, noises or activities around you can distract you from your task, and distraction is an attention-killer.

When you need to concentrate on something, consider wearing earplugs to cut out background noise. If possible, take “mind breaks” in a dark, quiet environment when you need to.

Write It Down to Remember It

Librarian Louise Fletcher, 61, of Vallejo, California, has had chronic progressive MS for 20 years. She says her memory is “not good, but I’m very organized.” She keeps little notebooks for different parts of her life. She has books for each child and grandchild, and for shopping, home repair, cleaning, and her art projects. She consults her notebooks regularly and writes everything she needs to remember in the appropriate book.

Fletcher applies her “write it down” practice to cooking, too. She forgets recipes and forgets what she has already done to a dish, so she’s made many copies of her favorite recipes. As she cooks, she crosses off each step in the instructions until she gets everything done.

Other Tips for Managing Cognitive Symptoms

A number of other self-help measures, as well as a couple to discuss with your healthcare provider, can help with other mental tasks if you’re having trouble:

Organize your environment. We’re not all natural organizers like Fletcher. But having a place for everything and being consistent in where you put things will make it easier to find what you want.

Relax. The less stressed you are, the better your focus will be. Try meditating, praying, practicing yoga, petting an animal, or doing relaxation exercises to lower your stress levels. According to the Mayo Clinic, relaxation techniques can reduce fatigue and improve concentration and mood.

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Get enough sleep. Getting adequate sleep protects your store of energy. Fatigue brings on cognitive problems, so save your hard thinking for more rested times. Take frequent breaks from mental tasks.

Train your brain. Exercising your mind is an important part of staying healthy with MS, and there’s some evidence, as published in the journal Neural Plasticity in May 2015, that computer-assisted cognitive training programs may help.

But these programs are not the same as commercially available “brain-training” games sold online, some of which may help, and some of which likely do not. The creators of Lumosity, for example, agreed in January 2016 to pay $2 million to settle Federal Trade Commission charges alleging they deceived customers with unfounded claims of reducing or delaying cognitive decline. On the other hand, a study of the Nintendo game Brain Age, published in Neurorehabilitation and Neural Repair in June 2015, suggested it might improve cognitive function and cognitive fatigue.

Engaging in a variety of non-computer mental activities, such as reading, playing Scrabble, or doing arithmetic in your head can also help keep your mind healthy.

Seek cognitive rehabilitation. Talk to your doctor about seeing a rehabilitation specialist for an evaluation. Depending on the results, you may be referred for treatment to a neuropsychologist, occupational therapist, or speech language pathologist.

Try medication. Ask your doctor about Ritalin (methylphenidate) and Provigil (modafinil). Both have been shown to improve attention and energy in various conditions, including MS.