Niebla mental: el síndrome real detrás de tu cansancio | Aarón Fernández del Olmo, neuropsicólogo

The Brain Shapes How We Experience Reality

Aarón Fernández del Olmo opens by asking the audience to imagine waking up in a familiar home but feeling that it is not theirs, and seeing loved ones as convincing impostors. This resembles Capgras syndrome, in which a person recognizes someone’s appearance but does not experience the familiar emotional response and concludes that the person has been replaced.

He uses this and other neurological cases to show that perception, recognition, emotion, memory, and identity depend on brain systems working together. When those systems are disrupted, a person’s experience can feel completely real to them—even when it conflicts with what others see.

Neuropsychology Should Focus on the Person, Not Only the Diagnosis

Drawing on the case-based work of Oliver Sacks and Alexander Luria, Fernández del Olmo argues for understanding the whole person: how a condition affects daily life, relationships, and the ways someone adapts. A diagnosis or test result matters, but so does the person’s story and the practical difficulties they face.

He illustrates this with Alicia, an older woman who came to believe her husband and daughter were impostors. Her family’s attempts to prove her wrong did not undo the belief and could intensify distress. The clinician’s role also includes helping relatives understand the condition and respond in ways that reduce conflict.

Stroke: Recognize Symptoms and Act Quickly

A stroke occurs when the brain’s blood supply is interrupted or an artery bleeds. Brain cells deprived of oxygen can be damaged or die, and the effects depend on the location and duration of the event.

Possible signs described in the talk include:

• Sudden difficulty speaking or understanding speech.
• Weakness or loss of sensation, often on one side of the body.
• Changes in movement, coordination, or consciousness.
• Less dramatic symptoms, such as brief dizziness or subtle changes in speech or movement.

Because the effects can be subtle as well as severe, the speaker stresses taking warning signs seriously and seeking urgent medical assessment. Time matters: rapid treatment can limit damage. He also mentions that vascular health is influenced by habits such as diet and physical activity.

Age-Related Changes Are Not Automatically Dementia

The speaker distinguishes ordinary changes with age from neurodegenerative disease. Occasional word-finding or memory lapses can happen without indicating dementia; persistent, worsening changes that interfere with everyday life merit professional assessment.

Different diseases can affect different abilities. Examples discussed include:

• Alzheimer’s disease, often associated with significant difficulty retaining new information.
• Primary progressive aphasia, in which language progressively declines.
• Parkinson’s and Huntington’s diseases, which can affect movement.

A neuropsychological assessment can help identify a person’s pattern of strengths and difficulties rather than assuming that every dementia is Alzheimer’s.

Neuroplasticity: The Brain Changes with Experience

Neuroplasticity is the brain’s capacity to change through experience. Learning to dance or drive, for example, involves building and strengthening connections until a skill becomes more automatic. The speaker also cautions that abilities that are not used or exercised can weaken.

After brain injury, recovery can occur as the brain adapts and as temporarily disrupted connections regain function. He describes patients whose speech comprehension or other abilities improved after an initially severe impairment. Recovery is variable, however: some abilities return, while others require ongoing rehabilitation and support.

Word-Finding Problems: Frequency and Impact Matter

Having a word “on the tip of the tongue” can be a normal experience, especially as the brain changes with age. More concerning signs include frequent, worsening difficulties that interfere with conversation and daily life.

The speaker distinguishes ordinary access problems—when a person knows the word but cannot retrieve it—from more serious language changes, such as losing the meaning of familiar words or repeatedly breaking down the sounds of words. These difficulties can lead people to withdraw from conversations. A neuropsychological evaluation can help clarify the pattern and whether it fits a broader condition.

Attention and Mental Overload

Attention is not one single ability; it includes processes that help us select relevant information, ignore distractions, sustain focus, and shift attention. Brain injury can impair these controls, making ordinary background noise and competing stimuli overwhelming.

The speaker also challenges the idea that ADHD means being unable to focus on anything. Highly stimulating, fast-paced activities can capture attention automatically, while tasks such as listening to a lesson require more deliberate attentional control.

Brain Fog

Brain fog is described as difficulty processing information efficiently, rather than a single isolated problem with memory, language, or attention. A person may manage familiar, automatic tasks but become overwhelmed by new information, conversations, or complex everyday demands.

The talk discusses brain fog in connection with conditions such as COVID-19 and head injury. A head impact can sometimes disrupt connections across the brain without producing an obvious, localized deficit, slowing information processing and making the person fatigue easily. Helpful support can include reducing unnecessary stimuli and adjusting demands to the person’s processing capacity.

Memory Is Reconstructive and Comes in Different Forms

Memory does not work like a computer file copied without change. Experiences are encoded through a person’s existing knowledge and perspective, and memories can be altered when retrieved. Even vivid, emotional memories may contain distortions.

The speaker distinguishes among:

• Episodic memory: memories of events and experiences.
• Semantic memory: knowledge of meanings and concepts.
• Procedural memory: learned skills and routines, such as motor abilities.

These systems can be affected differently. In the case of a woman who could not form new memories, the speaker used written reminders and repeated associations to help her locate information. The example illustrates that support can draw on abilities that remain intact, rather than relying only on the impaired memory system.

Alzheimer’s Risk, Cognitive Reserve, and Prevention

The speaker says Alzheimer’s has genetic components, but inherited risk does not determine every person’s outcome. He describes cognitive reserve as the capacity built through factors such as mentally stimulating activities, education, physical habits, and diet. This may help the brain remain functional for longer as disease develops. He emphasizes quality of life and healthy aging rather than promising that disease can always be prevented.

The Value of Neuropsychology and Teamwork

Neuropsychologists assess how brain conditions affect cognition and behavior, and work with patients and families on rehabilitation and adaptation. Fernández del Olmo argues that this work is most effective as part of a multidisciplinary team, alongside professionals such as neurologists and speech therapists. He also notes that neuropsychology does not have a formally recognized specialty pathway in Spain, despite growing demand.

A case involving a nine-year-old initially labeled with ADHD and dyslexia illustrates why careful assessment matters. The child’s unusual movement, reading, and visual-memory difficulties led the team to investigate further and identify a neurological cause. The case underscores that a diagnosis should fit the full pattern of evidence, and that coordinated treatment can produce meaningful gains.

Main Practical Lessons

• Treat sudden or persistent changes in speech, strength, sensation, movement, or awareness as reasons for urgent medical evaluation.
• Seek professional assessment when cognitive or language changes are frequent, worsening, or disrupting daily life; isolated lapses do not by themselves establish a diagnosis.
• Look at how a difficulty affects everyday functioning, not just test results or diagnostic labels.
• Reduce distractions and simplify the environment when attention or information processing is impaired.
• Use reminders, written cues, routines, and preserved skills to compensate for memory difficulties.
• When someone has a fixed delusion, arguing or trying to prove it false may not help; families should seek guidance on how to respond compassionately and safely.
• Support people with brain conditions as individuals, and coordinate care across relevant professions.

Speakers and Sources Featured

Speakers

• Aarón Fernández del Olmo — neuropsychologist and principal speaker.
• José Antonio — audience member asking about stroke.
• Maria — audience member asking about neuroplasticity.
• Alejandro — audience member asking about identity and perception after brain injury.
• Elena — audience member asking about attention.
• Alba — audience member asking about brain fog.
• Manuela — audience member asking about Alzheimer’s and heredity.
• Unnamed audience members — asked about dementia after retirement, word-finding, memory, and how to find neuropsychology services.

Sources and Figures Referenced

• Joseph Capgras — psychiatrist associated with the syndrome discussed.
• Oliver Sacks — neurologist and author of The Man Who Mistook His Wife for a Hat.
• Alexander Luria — psychologist and author of The Man with a Shattered World.
• Nuccio Ordine — philosopher and author of The Usefulness of the Useless.
• René Descartes — philosopher cited in relation to dreams and reality.
• V. S. Ramachandran — neuroscientist cited in discussion of recognition and phantom-limb treatment.
• Fernando Cuetos — language researcher cited in discussion of word-production errors.
• Jesús Martínez — neurosurgeon mentioned as an example of multidisciplinary work.