Every January, our inbox fills with the same worried messages: “I’m having more migraine attacks than usual.” “My fatigue is crushing.” “Is my condition getting worse?”

If you’re reading this through brain fog while wrapped in three blankets, wondering why your normally manageable symptoms have gone haywire, you’re not imagining it. January really is harder for people with neurological conditions.

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It’s the perfect storm

January comes with a unique set of conditions that specifically mess with neurological function:

• The holiday hangover is real. Even if you paced yourself, December demanded more than usual.
• Winter storms create rapid pressure changes that can trigger everything from migraine attacks to neuropathy flares.
• Cold weather increases inflammatory markers in your body.
• Reduced sunlight levels may cause low vitamin D levels, which can affect mood, nerve function, inflammation, and pain processing.
• Going from overheated stores to freezing parking lots can add a lot of strain on your autonomic nervous system.
• It’s dark when you wake up, dark when you leave work. This impacts your circadian rhythm.
• Cold causes blood vessels to constrict. Less blood flow to the brain means more fog, more dizziness, and slower processing.

Lesser-known January stressors

• The “New year, new you” pressure. Everyone’s suddenly talking about health goals while you’re just trying to maintain baseline.
• New deductibles, prior authorizations starting over, and pharmacy confusion add to the chronic illness administrative burden and anxiety.
• Social hibernation guilt from watching everyone else “starting afresh” while you’re canceling plans.
• Dry, forced-air heating dehydrates you, irritates your sinuses, and creates temperature inconsistencies throughout your living space.

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Here’s what helps in January

• Track the patterns. Note which January factors hit you hardest. Knowing your specific triggers helps you prepare next year.
• Light therapy. Use it daily at the same time, preferably within an hour of waking. 10,000 lux for 20-30 minutes. Position it at an angle that is not direct (as with sunlight).
• Microdose outdoor environment. Stand on your porch for 2 minutes. Sit by a window. If possible, take a walk around your home or apartment.
• Layer like it’s your job. Heated blanket under, regular blanket over. Fingerless gloves indoors. Neck warmer even inside.
• Hydrate aggressively. Winter dehydration is sneaky. You don’t feel thirsty, but heating systems and cold air are sucking moisture from your body.
• Supplement strategically (with your doctor’s approval):
• • Vitamin D3
  • Magnesium
  • B12
  • Omega-3s
• Front-load the year. If possible, schedule important things for spring/summer/fall. Give January permission to be your low season.
• Build in buffers. Whatever energy you think you have in January, cut it by 30%. Plan for 70% capacity and be pleasantly surprised if you get more.
• Adjust your baseline expectations. Your 100% in January might look like your 60% in May.
• Find your winter squad. Connect with others who get it. Online support groups are particularly active in January because we’re all struggling together. Your Neura Care Coach can also help!

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Note from the author

Three years of tracking taught me that January will always be harder. Not accepting this made it worse. I’d panic about disease progression, push too hard to “overcome” it, and crash harder.

Now I plan for January every year. I expect less from myself. I increase support. I stop comparing January-me to September-me.

Some strategies that actually help:

• Book a telehealth check-in for late January.
• Refill all meds well in advance.
• Meal prep and freeze whenever I can.
• Lower all commitments January-February.
• Plan something, anything, for March to look forward to.

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If you’re reading this while dealing with your third flare-up this week, or you’ve been in pajamas for 72 hours, or you just canceled plans again, you’re not alone. Thousands of us are right there with you, wrapped in heating pads, working through the brain fog, waiting for spring.

Be gentle with yourself.

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