Today’s post is on executive function/dysfunction. It will address common questions we receive on this topic, including, “Is executive function disorder the same as ADHD?” and “How can I improve executive function if I am an adult with ADHD?” But first, let’s start with a basic definition and some context:

What is executive function/dysfunction?

Executive function is the set of processes that allow a person to manage themselves and their resources effectively in order to achieve a goal. People who have difficulty accomplishing goals due to struggles with emotional management, cognitive rigidity, impulsiveness, short-term memory, procrastination, and/or disorganization are said to have executive dysfunction.

Executive function is associated with the front part of the brain. While the back part of the brain serves as long-term storage for learned information, the front part (specifically, the prefrontal cortex) must call up and use that information in just the right way for a person to be effective. The prefrontal cortex determines which stored information will be used, when and how it will be applied, and what emotions will come with it.

When someone is executively dysfunctional, they may struggle to follow directions, misplace personal items, miss deadlines, or behave inappropriately. This person will likely also experience poor performance at work or school—along with low self-confidence—due to their executive functioning challenges.

Is executive function deficit disorder the same as ADHD?

If you are an adult with attention-deficit hyperactivity disorder (ADHD), the definition above may have sounded familiar. As you’ll see later in this article, there is indeed a great deal of overlap between symptoms of executive dysfunction and those of ADHD. Should you come across the term “executive function deficit disorder” online, you may wonder whether you have that instead of ADHD (or in addition to it).

The most important difference between ADHD and executive function disorder is that executive dysfunction isn’t technically a disorder at all. It’s not in the Diagnostic And Statistic Manual of Mental Disorders, Fifth Edition (DSM-5), which is the diagnostic manual used in the United States. Since it’s not in the DSM-5, you can’t get an official diagnosis for it. So-called “executive function deficit disorder” is nothing more than a term people use to talk about executive dysfunction.

It is also significant to note that executive functioning problems aren’t exclusive to ADHD, even though they correlate most strongly with ADHD.[i] Other conditions—including depression, anxiety, bipolar disorder, obsessive-compulsive disorder, and autism—are also associated with some level of executive dysfunction. That said, people with ADHD tend to struggle most with executive dysfunction because their neurology works differently than neurotypical people.

How to improve executive function in ADHD

For adults (and children) who need to improve executive function, self-monitoring is a necessary skill. We recommend working with an ADHD specialist to practice this skill, but you can get started right now by simply asking yourself some self-reflective questions. We’ve provided some below. This exercise can help you determine which aspects of executive functioning you’re good at and which need to be cultivated or supported:

When you get upset, how hard is it for you to bounce back?

During heated discussions, do you quickly lose your temper? Do you lash out in anger, saying things you regret later? When you make a mistake, do you tend to ruminate about it and put yourself down? If your emotions tend to “spike” (versus slowly build), you may need to work on the emotional control executive functioning area.

Do you rely on predictability?

When you encounter last-minute changes, does it throw you off-balance? Do you like being able to control your environment, especially when you’re feeling anxious? If you tend to get stuck on a certain task and struggle to transition to the next thing, we recommend learning skills to assist in the shifting executive functioning area.

Do you have a habit of acting without thinking?

Do you take action before you’ve consciously decided to? Do you say things without considering the consequences? Do you find certain activities—such a checking social media or playing your favorite game—too tempting to ignore, even when you’re supposed to be doing something else? Characteristics like these may signal problems with the inhibition executive functioning area.

Is it hard to visualize or retain information in the short term?

Are you unable to listen and take notes at the same time without missing things? Do you often make mistakes or take too long when manually copying information? Would it be hard to remember all seven digits of a phone number long enough to dial it? Are you bad at interpreting maps/directions? If any of these scenarios sound familiar, you might benefit from accommodations to support your working memory skills.

Are you a chronic procrastinator?

Is it hard to getting started on a task, even though you know you have to get started? Does anxiety about how you will perform cause you to put off unpleasant responsibilities? Does the temptation of short-term enjoyment pull your attention away from longer-term goals? If so, your initiation skills may be weaker than others.

Are you a poor planner?

Do you get overwhelmed by large assignments? Is it hard to come up with appropriate benchmarks to stay on track? When you sit down to complete a task, do you sometimes realize too late that you don’t have everything you need? Do you sometimes focus on the wrong things? You may also find that your physical environment is a total mess and you’re constantly losing things. These are all signs of deficiencies within the organization executive function area.

Do you lack self-awareness?

Does your self-assessment of your performance sometimes differ from that of others? Do you fail to take your emotional state into account when making decisions? Have you ever lost track of your progress when working on a long-term project? If you lack self-monitoring skills, learning how to monitor yourself accurately will be a necessary first step toward improving any other executive functioning skills you may struggle with.

Once you identify which executive functioning areas you want to work on, you can find ways to improve them through research and professional guidance. You can also identify environmental changes that might help.

Get Neurodiversity-Affirming Support for Your ADHD

Working with an adult ADHD specialist can help you address your executive functioning struggles in a way that works with neurotype instead of against it. Book a free 20 minute phone consultation with Dr. Jenifer Goldman or Dr. Crystal Lee to see how we can help.

 

[i] Silverstein, et al, 2020