How to Manage Life When You Have Poor Executive Function

How to Manage Life When You Have Poor Executive Function
Photo: Shawn Hempel, Shutterstock

Even if you’ve never heard the term “executive function,” you may be painfully aware of how important it is for everyday life. Executive functioning is often described as the management system of the brain: This is the portion responsible for planning, prioritising and executing tasks.

“Executive function is the CEO of the brain,” said Jessica McCabe, host of the YouTube channel How To ADHD. “Executive function is a set of cognitive processes that help us self-regulate so that we can effectively plan, prioritise, and sustain effort for our long-term goals.”

What does executive functioning control?

Carrying out tasks to completion requires a significant number of mental skills, including the ability to accurately predict what is needed, the ability to problem-solve when issues arise, and the emotional self-control to follow through, even if the task turns out to be harder than anticipated. It is the bedrock of many different skills, including the ability to focus, make and execute plans, identify priorities, follow tasks to completion, understand multiple points of view, regulate emotions, and keep track of what you are doing.

“We’re talking about converting intentions into action,” said Ari Tuckman, a clinical psychologist who specialises in treating ADHD. Going from intending to do something to actually finishing it requires a combination of working memory, flexible thinking, and self-control.

In real life, issues with executive function can look like losing your keys on a daily basis, missing appointments because you keep forgetting about them, struggling to finish projects at work, getting slammed with late fees because you forgot to pay your credit card bill on time, or being unable to stay organised. “That affects every aspect of our lives,” McCabe said.

Executive functioning can be impacted by depression, anxiety, and disorders like ADHD. Stress and sleep deprivation can also lead to short-term impairments.

Strategies for dealing with executive function issues

The biggest challenge when it comes to dealing with executive functioning issues is that all of the solutions also require executive function to carry out. “As lovely as it is to suggest making lists to someone with ADHD, they’ve probably made lists. They’ve lost them. Or they weren’t sure how to prioritise them,” said McCabe, who was diagnosed with ADHD when she was younger.

It’s for this reason that dealing with executive function issues is so challenging — it’s needed for pretty much everything you do, and impacts just about every facet of your life. For conditions like ADHD, the most effective way to improve executive functioning is to seek treatment — the main strategy is often medication. ADHD is a neurodevelopmental condition, which is thought to be due to a shortage in the neurotransmitter dopamine. However, as McCabe points out, although medication can help improve the underlying cause, “pills don’t teach skills.”

Medication can help address the underlying neurobiological cause, but it won’t teach you the life skills needed to reach your goals. For that reason, the most effective course of treatment is generally medication combined with therapy, which can help develop the necessary skills.

Limit (further) impairments to executive function

If you have executive function issues, it helps to support it in any way you can, which includes lifestyle. Stress and sleep deprivation can lead to short-term impairments of your executive function, while diet and exercise can help it perform at its best.

“It doesn’t make you Superman, it doesn’t make you better than you are, but it at least enables you to bring the best of what you got,” Tuckman said. Of course, as with so many of these strategies, the double whammy is that when you are overwhelmed, prioritising sleep, diet, and exercise requires significant executive function. “This kind of makes a bad situation worse,” Tuckman said.

Introduce strategies one at a time

There are going to be a hundred different strategies and tricks that can potentially help with your executive function issues. However, as McCabe notes, “a lot of the support we need is in implementing these strategies. Every time we add something new to our plate, to support our executive function, that throws things off for us.”

Instead, McCabe suggests being selective about introducing new strategies, and allow a period of time to get used to it. She also strongly recommends thinking about what has worked in the past and using that as a guide for what can help now. “Don’t start from scratch,” she said. “That’s hard on executive function.”

One of the most important things you can do to support your executive function is to make sure that you are spending your time on what matters, rather than trying to do everything. “Staying on top of everything isn’t realistic for most people, let alone those with executive function challenges,” McCabe said.

Potential strategies can include minimalism, automating things, or picking your battles wisely. “If you want to do more, do less, because the more we’re trying to do, the more we have to keep track of, the harder it is for executive function to stay on top of all that,” McCabe said.

Understand this is a work in progress

Improving and supporting your executive function is a lifelong process. What helps today may not work a year from now when circumstances may have changed — and there are going to be good days and bad days.

“Focus on the long game,” Tuckman said. “Focus on finding better systems and strategies, and then just keep showing up and applying them. If today was a bad day, show up again tomorrow and start over.”

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