Long COVID brain fog and sensory overload: what actually helps?
Sounds are too loud. Light is too bright. Following a conversation with two people at once is no longer possible, and a trip to the supermarket wipes you out for the rest of the day. Many people also describe a restlessness or anxiety in the body, “while your rational mind is asking: what is this even about?” Symptoms are often at their worst in the morning.
If this sounds familiar: you are not imagining it, and you are not weak. Brain fog and sensory overload are among the most common and most underestimated symptoms of post-COVID syndrome. On this page I will walk you through what is happening in your brain, what helps according to current knowledge (all the options, not just mine) and what you can start doing this week.
What is happening in your brain
A healthy brain filters constantly. Of all the stimuli coming in (sound, light, movement, information, emotions) only a fraction reaches your conscious attention. After COVID, this filtering system can become dysregulated: the stress system stays in a heightened state of alert (elevated arousal), stimuli come in unfiltered, and your nervous system sounds the alarm faster than necessary.
That explains three things that confuse many people: why you get exhausted by things that used to be effortless (filtering now costs conscious energy), why your body feels anxious or restless for no apparent reason (the alarm system is set too sharp), and why “pushing through” makes things worse instead of training you. This is not a character flaw and not a psychological problem. It is a dysregulated filtering and alarm system, and a dysregulated system can learn to regulate again.
What helps according to current knowledge
Honesty first: a proven treatment for post-COVID sensory overload does not yet exist. The scientific evidence for every intervention is still limited. What does exist is a broadly supported step-by-step approach, and I will describe it in full.
1. Understanding what is happening (psycho-education)
Clinical guidelines deliberately put this first. Once you understand that your symptoms come from a dysregulated stress system, and not from permanent damage or “making it up”, you stop fighting your own body. That alone lowers the alarm level.
2. Energy and stimulus management (occupational therapy)
For symptoms lasting longer than three months, guidelines recommend occupational therapy: structuring your day around what your system can handle (pacing), dosing stimuli instead of avoiding them completely, and building up activities step by step. Dosing is the key word. Total avoidance feels logical but keeps the hypersensitivity in place, while too many stimuli crash your system again and again.
3. Calming the stress system itself
Restoring sleep, breathing exercises, relaxation training and gentle movement in a low-stimulus environment (walking, preferably in the morning) lower the physiological alarm level. This is not wellness advice but stress physiology: a nervous system that regularly experiences safety gradually recalibrates its filter.
4. Complementary: training arousal regulation with ReAttach
In my practice I combine occupational therapy with ReAttach: a brief, low-burden therapy that trains information and stimulus processing while arousal is actively kept low. That makes it particularly suitable for people who are still too overstimulated for talking therapies. Here too I am honest about the evidence: ReAttach is promising and research is ongoing. In 2025 I published a research protocol with prof. dr. Aida Mehrad (Universitat Internacional de Catalunya) on ReAttach for persistent post-concussion syndrome, a symptom profile that strongly overlaps with post-COVID sensory overload. Read more on my page about persistent post-concussion symptoms. In more than thirty years of neurorehabilitation I have not seen a method that gives overstimulated people back their grip so quickly, and that is exactly why I am researching it.
5. Further steps if recovery stalls
If psychosocial factors play a role: a psychologist. If recovery stalls: referral to a rehabilitation physician, neuropsychologist or neurologist. A good clinician knows the limits of his field and refers on time. That applies to me as well.
What you can do this week
My father used to say: it is not about what people say, it is about what people do. So no theory, but five actions:
- Start your day with a short walk before the stimuli begin: many people with post-COVID notice it “takes the sharp edges off”, especially with morning restlessness.
- Work in blocks of no more than 15 minutes with a real stimulus break in between: eyes closed, no phone, no sound.
- Plan your day in advance and alternate: one demanding activity, then one rest moment. Not everything first and then collapse (the “boom-bust cycle”).
- Dose instead of avoid: pick one stimulus situation per day that you deliberately seek out briefly and leave on time. Short and successful is the norm, not long and exhausted.
- Tell yourself: “I do not feel well right now, it will be different later.” Symptoms come in waves. Knowing that keeps you out of panic, and panic is exactly the fuel your alarm system does not need.
The healing power is already yours. My job is to activate it, not to take it over.
Working with me
I am Sieto Reitsma, occupational therapist with more than thirty years of experience in neurorehabilitation, based in the Netherlands. In my practice, and partly online in English, I support people with post-COVID symptoms, persistent concussion symptoms and burnout, combining occupational therapy with ReAttach. An introductory conversation is free of obligation.
Dutch speaker? Read this page in Dutch: overprikkelde hersenen na COVID.
Frequently asked questions
How long does sensory overload after COVID last?
It varies widely. For some people symptoms fade within months, for others they persist longer. Guidelines advise professional support once symptoms last longer than three months and limit daily functioning. Persistent symptoms do not mean recovery is impossible: recovery is almost always gradual and comes in waves.
Is post-COVID brain fog psychological?
No. It arises from a dysregulated filtering and stress system in the brain. Anxiety and low mood can amplify the symptoms, because the alarm system is already on edge. That is why an approach that starts from the body and stress physiology often works better than talking alone.
Should I avoid stimuli or seek them out?
Neither extreme. Complete avoidance keeps the hypersensitivity in place; too many stimuli crash your system. The art is dosing: short, planned exposure with recovery afterwards, built up in small steps.
What is ReAttach and is it evidence-based?
ReAttach is a brief therapy that trains stimulus and information processing while arousal is actively kept low. It is low-burden: you do not need to talk extensively about problems, which makes it suitable for people who are too overstimulated for that. Research is ongoing, with promising early studies, and I contribute to it with my own scientific work. I use ReAttach as a complement to guideline care, never as a replacement.
Do you offer online sessions in English?
Yes. Part of the support, including psycho-education and energy management, can be done online in English. Get in touch to discuss what is possible in your situation.
