What’s up, What’s Up Yukon readers? (See what I did there?) In this column submission I’d like to talk about a frequently used but perhaps not completely understood term: executive functions (EF). What are they and how do they affect people with Attention Deficit Hyperactivity Disorder (ADHD)? I will also give you a glimpse into some of the complex EF challenges that some folks with ADHD face.
When it comes to ADHD, we often focus on the three main challenges: inattention, hyperactivity and impulsivity. However, ADHD is so much more than those three difficulties. One major aspect that is often overlooked is something called executive functions.
What the heck is that? you ask. Well, you’re full of great questions! A renowned professor of psychiatry and neurology, Dr. Russel Barkley, describes EF as “the cognitive process that organizes thoughts and activities, prioritizes tasks, manages time efficiently and makes decisions.” https://www.additudemag.com/7-executive-function-deficits-linked-to-adhd/
Some pretty important stuff, eh? Dr. Barkley goes on to say that “executive function skills are the skills that help us establish structures and strategies for managing projects and determine the actions required to move each project forward.”
People who struggle with executive functions or “executive dysfunction” may find it difficult to “analyze, plan, organize, schedule and complete tasks at all—or on deadline. They misplace materials, prioritize the wrong things and get overwhelmed by big projects.”
In other words, EF helps us to create a goal, develop a plan and follow through on that plan. How important is that really, though? Well, without even realizing it, we create goals, all throughout the day, which require EF. Making breakfast? That’s a multi-step process that takes mini goals to finish. Getting ready for work? You bet that there is a whole process in order to get ready. These are two relatively simple examples of “goal + follow-through” (you may be starting to see how important EF skills really are).
As a person with ADHD and EF challenges, myself, I can attest to how difficult and oftentimes how insurmountable some of life’s “simple tasks” can be. Tasks, such as making a doctor’s appointment, paying bills on time or grocery shopping, take a lot of planning, organizing and motivation to accomplish.
Here’s an example of my own EF struggles. For the past, oh, I don’t know … three months, I’ve had a cheque waiting for me at the bank. All I have to do is make an appointment and deposit it … That’s it! However, this is a major task for me because there are multiple steps involved: look up the bank’s phone number, call the bank, find a mutually agreeable time that works with my workday (this is very difficult for me), make sure the car is available and, finally, remember to actually go to the appointment! Often, just thinking about the number of steps involved is overwhelming enough to make me shut down and not do it. I’ve actually already scheduled one appointment that I had to cancel, so now my internal dialogue says See, I told you this was too hard, and it becomes even more difficult to accomplish. Problem solving, making plans and scheduling have always been difficult for me, so instead of simply calling and making an appointment, I’ve chosen to ignore it. Is this serving me well? Absolutely not! Do I feel shame and guilt for not being able to do this? You betcha! As life gets complicated, these seemingly “small” obstacles begin to mount and we can see how difficult and debilitating this disorder can be.
The biggest issue with us pushing these tasks to the side is that we then become unbelievably self-critical, and that terrible self-talk takes over—How come everyone else can do this but me? Will I ever be able to do anything? and Ugh, I’m such an idiot!
In my humble opinion, having an awareness of the connection between EF and ADHD is an incredibly important aspect to not only “living” but also to thriving with ADHD. Once we are able to find strategies to help overcome these tasks, the feeling of relief and the ability to relieve that burden is huge.
Are you starting to wonder if you struggle with executive dysfunction? Here’s a bit more detail: most folks with ADHD struggle with some or all of these functions. Dr. Russel Barkley explains that EF is “judged by the strength” of these seven skills:
- Self-Awareness: This is self-directed attention.
- Inhibition: Also known as self-restraint.
- Non-Verbal Working Memory: This is the ability to hold things in your mind—essentially, visual imagery (how well you can picture things mentally).
- Verbal Working Memory: Self-speech, or internal speech. Most people think of this as their inner monologue.
- Emotional Self-Regulation: This is the ability to take the previous four EFs and to use them to manipulate your own emotional state. This means learning to use words, images and your own self-awareness, to process and alter how you feel about things.
- Self-motivation: This is how well you can motivate yourself to complete a task when there is no immediate external consequence.
- Planning and Problem Solving: Experts sometimes like to think of this as self-play—how we “play” with information in our minds to come up with new ways of doing something. By taking things apart and recombining them in different ways, we’re planning solutions to our problems.
ADHD is a complex and highly misunderstood disorder. However, when we are able to better understand how it affects us individually and to be aware of not only the hyperactivity, impulsivity and inattention, but also of the many EF struggles we deal with, we are then able to “check in” with ourselves and target the barriers that are stopping us from accomplishing our goals.Guess what! In the process of writing this article and externalizing the steps that I needed to do, I finally called the bank to set up an appointment to deposit my cheque. So, thank you for reading, but also thank you for helping me with my EF troubles!