Executive Dysfunction: Why everything feels overwhelming
September 15, 2022
Have you ever been faced with a task you knew you needed to do but no matter how hard you tried you just couldn’t make a start on it? Ever felt like the smallest thing on your to-do list was like pushing a boulder up a mountain? Ever procrastinated so much your quality of life started to be affected? Ever found yourself thinking ‘Why can’t I just get it together and do it?’ Perhaps you’re a parent and you just don’t know why your teenager can’t tidy their room or a teacher who can’t understand why that really bright pupil hasn’t handed in homework yet again this week?
The reason might be executive dysfunction. So what is it, how does it affect people, and what can be done about it?
NHS Psychology Cumbria describes executive function as:
Executive Function (usually automatic) abilities that, for example, allow us to:
- Make decisions
- Solve problems
- Plan/ organise
- Have motivation
- Start new tasks/switch tasks
These complex abilities are usually taken for granted, they are involved in everything we do often without us realising.
Executive Dysfunction is therefore a breakdown in the ability to do these things. For a teenager or young person executive dysfunction can affect personal hygiene, school or college attendance, punctuality, paying attention in class, handing in homework on time, and interaction with friends and family. According to Parents Action For Children a younger child with executive dysfunction might behave in the following ways:
- Becoming easily frustrated and throwing things instead of asking for help.
- Forgetting what to do or seeming not to follow instructions.
- Having tantrums over things that seem fairly minor.
- Misbehaving instead of expressing their feelings.
- Being stubborn about the way they do things.
Just as executive function is something that happens without people being conscious of it, the same can be said for executive dysfunction.
So who is likely to be affected by executive dysfunction and in what way? Executive dysfunction is a broad spectrum symptom affecting people with a wide range of mental health issues as well as people with ADHD, autism, dyspraxia, and people who have brain damage. It can affect people in a variety of ways but is still misunderstood by professionals.
One of the most obvious ways it can affect people is in the area of self care. A decline in self care can be one of the earliest signs that someone may be struggling with their mental health and is cited as a symptom in numerous disorders including depression, PTSD, and psychosis.
So why then do people still associate it with laziness? According to Margarita Tartakovsky, MS, child psychologist J Weber says teenagers in particular are often labelled as lazy prior to being diagnosed with depression. Such labelling is unhelpful and, if anything, more likely to create further mental health issues.
What will help with executive dysfunction? Strategies involving time management are often suggested. These may include:
- Breaking down tasks into more manageable chunks. Take any big task. Now break that down into three or four smaller tasks. Then approach each one individually.
- Set timers and schedule breaks. It can be tempting to carry on until a whole task is completed but this can often be counterproductive as it is easy to lose concentration that way and lead to feeling overwhelmed. Breaks are important.
- Use planners, memos, or sticky notes. These are to help with memory and, more importantly , to stay focused on task.
- Teenagers and young adults who live independently and experience executive dysfunction might find systems such as FlyLady and Clutterbug useful as they help with day to day living and organisation.
So that is why everyday tasks can seem like an uphill battle to people with mental health issues. It is important to remember that it is not a choice.