Executive Function

What's the deal with

Executive Function

and ADHD?

Executive function can be described as “the management system of the brain.” This “management system” consists of a set of mental skills we use every day to work, learn, and manage everyday tasks. Executive function deficits are a core feature of ADHD, making it difficult to plan, focus, regulate emotions and actions, remember things, and adapt to changes.

“Commonly, executive functions are compared to the skills of effective leaders, such as those of a corporate executive or an orchestra director. For example, the executive has to remember the overall company goals and make decisions that meet the goals without getting distracted by other agendas. But with EF, we are leading ourselves in our daily lives. You could say that executive functions are self-leadership skills.” —Lidia Zylowska, MD, The Mindfulness Prescription for Adult ADHD

What it looks like:

Executive function challenges in ADHD can manifest in various ways:

Difficulty organizing tasks and managing time effectively
Struggles with initiating and completing tasks
Problems with prioritization and decision-making
Challenges in regulating emotions and controlling impulses
Difficulty shifting between tasks or adapting to new situations
Struggles with working memory, leading to forgetfulness
Problems with self-monitoring and self-awareness
Difficulty with planning and breaking down long-term goals
Challenges in maintaining focus and ignoring distractions
Struggles with metacognition (thinking about one's own thinking)
Difficulty with verbal fluency and information processing

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The science:

There are several differences between typical brains and ADHD brains which may cause executive function challenges:

Brain activity: The prefrontal cortex, the primary brain region responsible for executive functions, often shows reduced activity in individuals with ADHD.
Brain chemicals: Dopamine and norepinephrine are two brain chemicals or “neurotransmitters,” which play key roles in executive functioning. In ADHD, there are often lower levels of these chemicals.
Delayed brain development: Research suggests that the brain's development, particularly in areas responsible for executive functions, may be delayed in individuals with ADHD.
Brain connectivity: In order to carry out these executive functions correctly, several different parts of the brain must be able to communicate efficiently. Studies have shown differences in the way several key brain regions are connected in ADHD brains, meaning they function and communicate differently.

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References:

https://www.healthline.com/health/executive-dysfunction

https://my.clevelandclinic.org/health/articles/executive-function

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What you can do:

“When you learn a practice like being mindfully aware, you activate and then strengthen the executive circuits of the brain responsible for such things as attention, regulating emotions, being flexible in your responses, insightful, empathic, and even being wise.” —Lidia Zylowska, MD, The Mindfulness Prescription for Adult ADHD

Improving executive functioning for people with ADHD typically involves identifying strategies and tools which can support skill deficits or alleviate symptoms. Since ADHD can impact the brain in so many different ways, and every person with ADHD experiences different symptoms and severity of symptoms, enhancing executive functioning is a very personal and individualized process. Depending on your symptoms, you may find the following useful places to start:

Time management strategies:
- Using visual timers or time-tracking apps
- Breaking tasks into smaller, timed chunks (e.g., Pomodoro Technique)
- Creating and following structured daily schedules
Organization techniques:
- Implementing color-coding systems for files, notes, or tasks
- Using digital or physical planners to track appointments and deadlines
- Designating specific places for important items to reduce misplacement
Task prioritization:
- Utilizing to-do lists with clear prioritization markers
- Employing the Eisenhower Matrix to categorize tasks by urgency and importance
- Setting reminders for important tasks or deadlines
Memory aids:
- Using smartphone apps or digital assistants for reminders and alerts
- Creating mnemonic devices for important information
- Keeping a centralized note-taking system (digital or physical)
Attention regulation:
- Practicing mindfulness meditation to improve focus
- Using noise-cancelling headphones or white noise machines to minimize distractions
- Creating a dedicated, clutter-free workspace
Impulse control strategies:
- Implementing a "pause and reflect" routine before making decisions
- Using visual cues or reminders to reinforce desired behaviors
- Practicing cognitive behavioral techniques to recognize and manage impulsive thoughts
Emotional regulation:
- Engaging in regular physical exercise to manage stress and mood
- Learning and practicing relaxation techniques like deep breathing or progressive muscle relaxation
- Keeping a mood journal to identify triggers and patterns
Medication management:
- Working with a healthcare provider to find the right medication and dosage
- Consistently taking prescribed medications as directed
- Regularly reviewing and adjusting treatment plans with medical professionals
Environmental modifications:
- Reducing clutter and organizing living/working spaces
- Using visual aids like calendars, whiteboards, or sticky notes for reminders
- Creating routines and habits to automate common tasks
Skill-building exercises:
- Engaging in brain-training games or apps designed to improve executive functions
- Practicing task-switching exercises to enhance cognitive flexibility
- Working with an ADHD coach or therapist on specific skill deficits

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Go deeper:

ADHD & Motivation: Overcoming Executive Dysfunction

What is Dopamine & Where Do I Find It

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Attention Dysregulation

Emotional Regulation

Rejection Sensitivity (RSD)

Procrastination

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