My Mental Health: Executive Dysfunction

Start by doing what’s necessary; then do what’s possible; and suddenly you are doing the impossible.

Francis of Assisi

Executive Dysfunction has been rocking my life lately. I haven’t been able to plan and execute much of anything, let alone my writing schedule. My brain bounces from one idea to the next, one topic to the next. I keep finding myself stuck in a seemingly never-ending cycle of closing and refreshing the same 3 apps, over and over again; waiting for that next small shot of dopamine because I can’t focus long enough to get it anywhere else.

Executive Dysfunction can be a life ruiner. It has stolen entire days and, eventually, it even wrested away my dreams. It’s the reason I haven’t taken a shower in 3 days and it’s the reason I have no long-term (or short-term) goals. It makes me seem flighty and it steals away my ambition. Executive Dysfunction has been behind the loss of friendships and the loss of jobs. It has pinned me to the bed for days at a time.

I had never heard of Executive Dysfunction before a little over a year ago. No one had ever talked to me about Executive Functioning or what it means to each human being. As soon as I read the name, I knew that I had it. I had known something was wrong long before that Google search; being messy was one thing but being physically unable to make yourself take a shower? It made no sense. Something had to be wrong. Executive Dysfunction seemed a likely culprit.

Executive Function

To understand Executive Dysfunction, you much first understand Executive Functioning (EF). Executive Function is a set of mental skills that every person has; they make up the “management system” of the brain. This is where we set goals, plan, and get things done. Some of these skills include:

• Paying attention
• Remembering information
• Multitasking
• Organizing, planning, and prioritizing, oh my!
• Maintaining focus from start to completion of a task
• Understanding other and different points of view
• Emotional Regulation
• Keeping track of what you’re doing and what should be done next

The 8 main Executive Functions are:

• Emotional control
• Inhibition – your ability to control your thoughts and actions
• Working memory (also called short-term memory)
  • verbal working memory – your “inner monologue” or your innermost thoughts
  • non-verbal working memory – your ability to hold information in your mind
• Initiation (also called activation) – the ability to start a task
• Planning and prioritization
• Cognitive flexibility (also called flexible thinking) – the ability to “go with the flow”
• Organization
• Self-monitoring, including self-control

It’s the set of mental skills that you use to do almost anything. Every action from the time you wake up until you go to bed relies on Executive Functioning skills. So what happens when these skills don’t work?

Executive Dysfunction

Executive Dysfunction is the impairment of executive functioning skills, causing cognitive, behavioral, and emotional difficulties. Executive Dysfunction can cause issues with self-regulation; for example, self-awareness, self-restraint, non-verbal working memory, verbal working memory, emotional regulation, self-motivation, and planning and problem-solving.

Symptoms of Executives Dysfunction include:

• time-blindness
• difficulty meeting long-term goals (we can often see the big picture, but not the little steps needed to get there)
• trouble with organizing and scheduling
• trouble controlling emotions and/or impulses
• difficulty analyzing and processing information

People with executive dysfunction may struggle with analyzing information, organizing, scheduling tasks, prioritizing tasks, and completing tasks. Executive dysfunction can result in situations like misplaced materials, prioritizing incorrectly, and becoming overwhelmed by large-scale projects or tasks.

Executive Dysfunction and Me

For the last several weeks, my ADHD has been in high gear. My brain is an endless cycle of fast thinking, but I’m not thinking about anything, all at the same time. I can’t focus on one idea for more than a few minutes and it makes progress move slowly. ADHD seems to be a collection of executive dysfunctions, most days, and I have been floundering in my daily life.

It started immediately after I returned from my grandmother’s funeral. Though my grief didn’t storm the gates like I thought it would, my brain hasn’t been quite the same since. I noticed as soon as I got home that I was dealing with a total and complete lack of ability to plan my days and focus on what is important to me. My planner has been blank, save for the days that I’ve managed to fire off a post for publication. I keep coming back to my planner but, try as I might, I can’t seem to get a schedule back in place.

I have struggled with task activation and completion and I can’t order my ideas. On top of that, I’ve missed a couple of appointments that I was fully capable of going to, but also wasn’t capable of going to. I never miss appointments these days, but I just couldn’t get myself together enough to go. I was at least together enough that I was able to cancel and didn’t just no-show, which is growth in my book.

I’ve also been struggling with some important phone calls. One of the most prominent ways that my executive dysfunction presents itself is in my utter inability to make simple, everyday phone calls. This time, my inability has resulted in my not having one of my medications for over a week now. It’s an error by either the doctor or the pharmacy, but I know they will expect me to be the middle man who fixes the issue and I have not been able to bring myself to get it worked out.

The problem is, I’ll wait until the medicine is completely out of my system and I start having horrid panic attacks, and then I’ll have to start all over again. I’ve played this game a time or two. When they start putting up roadblocks to my care, I tend to stop seeking the care that I need. I’ve gone completely off medication on multiple occasions simply because I didn’t feel like dealing with the red tape.

I get overwhelmed at the sight of a messy room or a pile of laundry and can’t activate myself to complete the task. Then, of course, the mess gets worse which makes the overwhelm worse and…you see the problem. I have poor working memory; prone to misplacing things and forgetting what I am saying in the middle of a sentence.

Poor executive functioning is the reason that my eating is disordered; I often forget to eat or I get overwhelmed with the idea of preparing food so I just don’t eat. It’s also the reason that I binge eat after my medicine wears off in the evenings. I alternate between binge eating and not eating and I’m always either gaining or losing 40 pounds. Cooking is not in the cards with me…poor planning causes me to overcook food and I can never get the timing right to get everything to finish around the same time.

I still haven’t been able to implement many, if any, of the tasks for my new daily routine; which means I’m still wading through a sea of unstructured time…it’s not good for me. I was at least able to sit down and plan out exactly how I would like to spend my days, but applying the plan to my life feels like an impossible feat when I’m drowning in my own executive dysfunction.

In conclusion

I go back to the doctor in a couple of weeks for a med check; my ADHD meds are still little to no help. Hopefully, once they get my meds adjusted again, I’ll finally be in a place physiologically where I can gain some kind of control over my brain. Executive dysfunction is a side effect of more than one of my disorders, but I feel like I’m having a distinctly ADHD issue right now. Yet another talking point for therapy, I suppose.

I hope this post found you well and I hope that you learned something new about executive dysfunction. It is a cross to bear that makes life so hard for many of us struggling with ADHD and mental illnesses.

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