When I first started researching ADHD I kept coming across the term ‘executive function‘ and quickly skipping by it. It sounded far too boring to waste my precious, and very limited, focus on with its connotations of business meetings and suits. However, I soon realised that in order to fully understand ADHD (and therefore myself) I had to get to the bottom of what executive function, and in the case of ADHD, executive dysfunction was.
The analogy I have liked best is, “Executive function can be thought of as the brain’s conductor which tells different parts of the brain to perform or be silent and coordinates their activity.” To be more specific the prefrontal cortex in our brain is the conductor and the orchestra are the many tasks that we carry out throughout daily life using a set of mental skills.
These skills fall into 3 categories:
Working memory – which is the ability to keep information in your mind and then use it in some way. For example, memorising chunks of text to use in an exam.
Flexible thinking – means being able to see things in different ways and so be able to come up with alternative ways to solve a problem when your first attempt didn’t work.
Inhibitory control (self-control) – the ability to ignore distractions, resist temptation and regulate emotions.
The skills themselves include: starting tasks and staying focused on them; organising and planning; paying attention; managing emotions and keeping track of what we are doing.
From this list, it is obvious where ADHD fits into this and where executive function becomes executive dysfunction; as to put it mildly, these are not my strong points.
Anyone with ADHD will have problems with all or most of the executive functions and for this reason, ADHD is classed as an Executive Function Deficit Disorder (EFDD). However, while everyone with ADHD will display symptoms of EFDD not everyone with EFDD has ADHD, the impairments can be caused by other factors, for example, brain injury.
So in the case of ADHD our problems with impulsivity (of action or emotion), time-keeping, getting started on tasks and being unable to block out distractions etc. all stem from impairments in our executive functions. There are different parts of the brain related to each of the three categories, listed above, and whereever you have impairment you will have associated difficulties.
By being aware of where your weaknesses lie you can start to build a plan to manage them better. This may involve counselling or an ADHD coach; medication; help from friends and family; reading some of the many books and articles out there about improving executive functioning. For example, Thriving with Adult ADHD: Skills to Strengthen Executive Functioning. By letting the people around know of your impairments and what can be done to make things easier for you, you can start to form a support system.
In his book, Scattered Minds, Dr Gabor Matè offers a very positive outlook for ADHD stating that these impairments can be reversed, as they are due to developmental delay rather than disease. The book is well worth a read for many reasons but if you want to find help managing and perhaps reversing your executive dysfuntion this could be a good place to start.