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What is Executive Dysfunction?

Executive dysfunction,

Many people give little thought to their ability to accomplish the things they need to do. They put a task on their to-do list, set aside the needed time to accomplish the activity, plan out the steps they will need to take, remember all of the various details required, and potentially multitask until the project is complete. It seems simple enough; however, some people struggle with some or all of that process because they experience executive dysfunction

At Highland Hospital in Charleston, West Virginia, we treat children, adolescents, and adults who experience difficulty with executive function as part of other mental health concerns. We can help them and their loved ones learn to manage this frustrating and often misunderstood problem.

What is Executive Dysfunction?

Executive dysfunction is when your brain struggles with executive functions, which commonly fall into these categories:

  • Working memory – allows a person to store and process information temporarily. It’s used for tasks the person is currently completing. It also helps with planning, prioritizing, and organizing. A person who struggles with this might have difficulty: 
    • Remembering dates
    • Being on time
    • Following instructions
    • Recalling where they put something important
  • Inhibition/impulse control – also known as self-control or self-restraint, it helps people to manage their emotions, thoughts, and actions. A deficit in this area might lead to:
    • Inability to resist distractions
    • Blurting out inappropriate comments
    • Interrupting someone who is talking
    • Struggling to regulate big emotions
    • Struggling to manage their diet because they cannot resist the urge to snack
  • Set shifting – the ability to change tasks easily without getting derailed. This requires flexible thinking and the ability to adapt quickly to change, so problems in this area usually look like this:
    • Difficulty with multitasking
    • Rigid thinking
    • Focusing too much on one thing
  • Higher-level executive functions – when a person struggles in the areas listed above, it is difficult for them to engage in activities that require a combination of those skills, such as:
    • Planning – the ability to map out the actions required to reach a goal
    • Reasoning – applying critical thinking skills or breaking down something complicated into smaller, more manageable pieces
    • Problem-solving – using planning and reasoning to apply what you know and overcome obstacles.

Executive dysfunction does not mean that a person is unintelligent or lazy. Many highly intelligent and hard-working people struggle with it sometimes. 

Executive Dysfunction in Children

People of any age can struggle with executive function, but it may present differently in children, whose symptoms might include:

  • Tantrums
  • Failing to complete schoolwork 
  • Not turning in assignments that have been completed
  • Struggling to follow directions that are not written down
  • Leaving needed items for a class in their locker
  • Spacing out during class

What Causes Executive Dysfunction?

When various parts of the brain don’t work together effectively, due to injury or chemical imbalances, people often struggle with executive dysfunction. Injuries can include head injuries, a stroke, or epilepsy, but executive dysfunction can also be caused by mental health conditions, including:

How is Executive Dysfunction Diagnosed?

Executive dysfunction is not a stand-alone diagnosis, but several different tests can help to determine how severely a person’s executive functioning has been impaired. 

Managing Executive Dysfunction

Many people who struggle with this condition cope by: 

  • Taking medications that may include stimulants, antidepressants, or antipsychotics to manage the mental health conditions that could be contributing the executive dysfunction
  • Attending therapy, especially cognitive-behavioral therapy (CBT) to manage mental health and improve coping skills
  • Practicing mindfulness activities to help reduce stress and improve concentration, memory, and emotional regulation
  • Engaging in physical activity to improve blood flow to the brain, further develop executive skills, and improve emotional well-being:
    • Aerobic exercise
    • Yoga
    • Soccer
    • Basketball
    • Martial arts
  • Developing coping strategies to help them get things done:
    • Breaking things down into smaller, more manageable tasks; more potential “wins,” can fuel ongoing motivation
    • Using technology and visual aids to manage time and organization
    • Changing things up periodically by redecorating the work area, working in a different location, or using a new app or tool to do the work
    • Reviewing checklists, calendars, and schedules several times per day
    • Obtaining both written and oral instructions for tasks
    • Keeping spaces decluttered and orderly
    • Troubleshooting problems with someone else or just working alongside another person for a body-doubling effect

At Highland Hospital, we treat a variety of conditions that can cause executive dysfunction. How the symptoms present vary from one person to the next, so we customize our approach to fit each individual and their support systems. 

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