Executive Dysfunction - Why Sometimes You Just Can’t!

Ever get that feeling when you want to be doing something, or maybe even should to be doing something, and for whatever reason you just can't? You can do literally anything else, or you are frozen in place at the idea of doing it? That feeling can be much worse when it is something that you actively want to do, but your brain just says no, not today! Well, that feeling may be what is called executive dysfunction.

What is Executive Dysfunction?

To understand executive dysfunction, let's look first at executive function - what our brain is supposed to be doing. In short executive function is our brain's ability to manage our working memory, flexible thinking, and self-control. Working memory is short-term “here-and-now” aspects of your life that are needed more often than we realize. Flexible thinking is our ability to think on the spot, adapt to changing plans, or be creative and imaginative. Lastly, self-control, often referred to as inhibition, is our brain's ability to curve our behaviour and thoughts, for example not saying what you think when somebody is being rude, or paying attention when driving and not daydreaming.

Therefore, executive dysfunction is when our brain does not allow us to manage our actions, emotions, and thoughts. This can come in many different forms, such as the example given above, but can also show as struggles with:

• Fixating on activities or emotions
• Following directions or a sequence of steps
• Forgetting what you just heard or read
• Losing track of belongings
• Organizing our thoughts
• Panic in response to sudden change
• Prioritizing tasks
• Starting and/or completing tasks
• Switching between activities
• Time management

The extent to which executive dysfunction impacts our lives varies from person to person, and from day to day. It could be that you occasionally find yourself frozen with indecisiveness, but it can also impact our every day, our every interaction, and become quite debilitating.

What are the causes of executive dysfunction?

There has been a lot of research into executive dysfunction and what causes it, but as yet nobody knows exactly what causes it. However, we do know that some people are more susceptible to executive dysfunction than others. People who have higher susceptibility often fall into the following groups:

Neurodivergent (Autism, ADHD, Dyspraxia, Tourettes, and more)

Brain damage (Alzheimer’s, Dementia, Huntington’s Disease, and more)

Conditions that impact brain function (Addiction, Depression, and more)

Additionally, you can struggle with executive dysfunction and not be in one of these groups – we all struggle with it at times.

How to manage executive dysfunction?

Like so many aspects of our brain not doing what it is that we want it to do, executive dysfunction does not have a single easy fix or solution, but that is not to say there is no hope for those who experience executive dysfunction. Some people, such as those with ADHD, can be prescribed medication that can lessen the symptoms associated with executive dysfunction such as attention and focus. There are other practical things you can do and help you can access, including counselling.

What can I do about executive dysfunction?

Given that executive dysfunction is such a varied struggle, it can be helpful to narrow down what aspect of executive dysfunction you want to try and work on, as executive dysfunction is too big and vague a topic to be tackled as a whole. Here are some suggestions…

Task Management

A big part of executive dysfunction is task management, be that prioritizing, starting, switching, or managing time around tasks. For a lot of task management, we can use planners/organizers/alarms to help take away some of the struggle. Digital calendars, like the ones built into many email services, can be a great visual indicator of time, and allow for notifications that something needs to start or change. It might feel like a simple suggestion but structuring around a system like this can help take the edge off some of the day-to-day struggles. In addition, it can be helpful when possible to ask for written instructions, so you have a reference in case you forget, for me this is asking managers to email me requests not just ask them in passing, so I have an email as a reminder to schedule the time in my calendar to complete the task.

When looking at an individual task it can be helpful to break down big tasks into smaller manageable tasks, not only will this help you feel you have accomplished more, but it means when you do not finish a whole task you can still recognize the progress that has been made, and coming back to the task becomes less overwhelming.

Managing our environment can also have a big impact on how we manage our time. If possible having separate spaces for work, relaxation, sleep, etc. is very important, more so now with the increase in working from home. This allows our brain to get accustomed to doing certain tasks when in certain areas. This is the reason it can feel weird when we eat in the bathroom, for example, the location and the task are not a combination our brain is used to. So if you stop allowing distractions in the work space the brain will seek them less often, making it easier to stay focused.

Emotions and Thoughts

Our emotions and our thoughts can often be our biggest challenges, be that negative thoughts or strong emotions that just will not leave our mind, taking up all our ability to focus on the task at hand. There are many ways to tackle these struggles on your own, but my favourite way is journaling. Journaling works on the principle that writing forces us to slow down our thoughts enough to write them down. Journaling is an excellent way to get some of what is in your head out, and as far as the brain is concerned you have done something with that thought, so we can come back to it later. There are many different forms of journaling, so finding the best fit for you is important.

Talking to someone

Often we can find ourselves with thoughts and emotions too great to tackle on our own, and in times like those I would recommend talking to somebody else, be that a professional or a trusted friend. Counselling can help you explore the feelings, and perhaps even the sources of executive dysfunction in more depth to gain a better understanding of yourself and your influences. This can also be a good place to explore and understand preferences and solutions to help manage your executive dysfunction. The counsellor may use CBT techniques to help you manage behaviours and help replace negative behaviours with more positive ones. Help can be hard to ask for, but is worth it when you find the right help.