ADHD affects executive functioning – the cognitive abilities needed to achieve goals.
A person with ADHD may have trouble organizing, remembering instructions, staying on track, and following through with a task. These are signs of executive dysfunction, in which the brain struggles with memory, attention, and self-regulation.[1]
But ADHD is not the only cause of executive function disorder. Other medical issues, such as autism, depression, multiple sclerosis, and dementia, are also associated with executive function challenges.[1]
So, if you have ADHD, you’ll likely notice problems with your executive function. But if you struggle with executive function, this does not mean you have ADHD.
Keep reading to learn more about the relationship between adult ADHD and executive function disorder.
What Is Executive Dysfunction?
Executive dysfunction is a range of behavioral symptoms that change how a person regulates emotions, thoughts, and actions.
It most commonly affects people with specific mental health disorders, including ADHD and mood disorders.[1]
A person with executive dysfunction may note the following symptoms:[1]
- Struggle to plan and organize activities
- Difficulty prioritizing and sequencing steps to complete a task
- Failure to meet deadlines
- Difficulty staying focused
- Trouble regulating emotions
- Late to appointments, events, meetings, or social activities
- Lose important items and forget details
- Struggle to switch between tasks
- Problems with motivation
- Impulsive and make poor decisions
- Difficulty multitasking
- Mentally rigid and/or inflexible
Someone experiencing executive dysfunction may show some or most of the signs above. But if you only have trouble with one or two of them, it’s unlikely that you have executive function disorder.
What Are Executive Functions?
Executive functioning refers to a set of mental processes and skills that helps you prioritize, plan, organize, and adapt to reach a goal.
You need executive functions to accomplish day-to-day objectives like cooking dinner or getting to work on time. They’re also essential for long-term goals like finishing a degree or starting a business.
Executive functioning can be split into the following components.
Working Memory
Your working memory is a limited-capacity system that enables you to store and process information temporarily. It’s involved in the tasks you are working on at any given moment.[1]
It comes into play when you’re trying to process sentences in a conversation or recall digits like a phone number or a one-time password.
Working memory is also vital for high-level functions. You use it to store and process the information needed for planning, prioritizing, and organizing.
With an executive function disorder, you may find it difficult to remember dates and instructions or where you placed important items.
Inhibition control
Inhibition control, also known as self-control or self-restraint, regulates your emotions, thoughts, and actions. It’s the ability to hold back a natural, automatic, or learned response that might not be appropriate in a given situation.[1]
The following are some ways inhibition control works:
- Attentional: The ability to resist distractions around you and steer your focus onto tasks that will help achieve your goals.[2]
- Behavioral: The ability to keep yourself from doing things you know you shouldn’t do. For instance, inhibitory control keeps you from blurting out something inappropriate or having a chocolate donut right before dinner if you decide to go on a diet.
- Emotional: The ability to regulate your emotions, influencing how you behave and respond.
Set Shifting
Set shifting is another way of saying task switching.
This function falls back onto your working memory to remember instructions and details related to your current goal. It also involves inhibition control to prevent yourself from being distracted by other tasks.[1]
Set shifting also involves flexible thinking and adapting to changing situations.
People with executive dysfunction may struggle with multitasking, problem-solving, and switching tasks. They may also seem rigid in their thinking.[1]
Higher-Level Executive Functions
These higher-level functions rely on the basic components of executive functioning we discussed earlier, such as working memory, task switching, and attention regulation.
Some examples of higher-level executive functions include the following:
- Planning and organizing
- Decision-making or reasoning
- Problem-solving
- Time management
Though executive dysfunction can pose a unique set of challenges, adults who receive proper support and treatment can often overcome them and reach their daily goals.
Executive Functions and ADHD
Many experts agree that executive function challenges represent some of the core ways ADHD affects a person.[3]
If you have ADHD, you may notice that you struggle with problems related to executive functions, such as memory, attention, and organization.[4]
Some overlaps between ADHD and executive function disorder include:
- Getting distracted when completing tasks
- Struggling to organize a schedule, activities, and work materials
- Forgetting important dates, meetings, or appointments
- Showing up late to meetings and appointments
- Losing essential items needed for work or daily activities
- Lacking the motivation to do certain tasks
A person with ADHD will likely experience some or more of the above symptoms.
Though they overlap in many ways, executive function disorder is not the same thing as ADHD. For instance, ADHD is an official diagnosis that a specialist can make. Meanwhile, executive function disorder isn’t a stand-alone diagnosis – it can be caused by many conditions.
Other differences between the two include how they’re detected and managed.
For example, ADHD appears in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V), a globally-recognized guide that helps mental health professionals make more accurate diagnoses.
In the DSM-V, ADHD is considered an official medical disorder with a specified set of criteria a person needs to meet to be diagnosed. In contrast, executive function disorder is not in the DSM-V.
Executive Function Disorder Diagnosis
Since executive function disorder isn’t a stand-alone medical condition, you cannot get a diagnosis for it. However, your doctor can investigate to find out the underlying cause behind it. They may also assess the severity of it and how significantly your daily life is impacted by any executive dysfunction.
Your specialist may ask you about the symptoms you experience, specifically around planning, organization, multitasking, problem-solving, impulsivity, or focus.[1]
Apart from that, your specialist may also carry out executive functioning tests that assess specific skills like working memory or inhibition control.
For instance, the Barkley Deficits in Executive Functioning Scale (BDEFS) can be used to evaluate the executive functioning of adults over a period of time.[5]
Executive Function Disorder Treatment
The type of treatment recommended for executive dysfunction depends on its underlying cause. It’s important that you consult a mental health specialist who can recommend a management plan that suits you best.
If you have ADHD, getting treated often improves executive functioning. Your specialist may recommend stimulant or non-stimulant medications for ADHD, depending on your medical history and symptoms.
Cognitive behavioral therapy (CBT) is another non-drug option for managing executive function disorder.[6]
CBT empowers you to identify unhealthy thinking patterns and habits and replace them with helpful ones that get you closer to your goals. This form of therapy may help improve your time management, organization, prioritization, and other executive functions.[6]
Executive Function Challenges and ADHD Go Hand-In-Hand
If you’ve been diagnosed with ADHD, you don’t have to give up on your goals. The right support and treatment can help you start making progress – getting organized, planning for the future, and focusing on what matters.
You can talk to your doctor about current medication plans or the possibility of getting cognitive behavioral therapy (CBT). An adult ADHD coach can also help you improve specific areas, such as time management and prioritization.
Understanding the unique ways your ADHD brain works, you can experiment with new approaches to organizing your life. Simple strategies and tools can help you get things done and stay on track. For instance, you can:
- Use visual schedules or work flow aids (to-do lists, journals, Google Calendar, etc.)
- Break bigger projects into smaller chunks
- Request written instructions for complex tasks
With a proper management plan, you’ll set yourself up for success in your career, academics, and relationships!
If you aren’t sure whether ADHD is responsible for your executive function challenges, take the ADDA Adult ADHD test. This questionnaire provides a better understanding of ADHD and can give you the confidence to take the next step – speaking to your doctor about diagnosis and treatment.
References
[1] Rabinovici, G. D., Stephens, M. L., & Possin, K. L. (2015). Executive dysfunction. Continuum (Minneapolis, Minn.), 21(3 Behavioral Neurology and Neuropsychiatry), 646–659. https://doi.org/10.1212/01.CON.0000466658.05156.54
[2] Tiego, J., Testa, R., Bellgrove, M. A., Pantelis, C., & Whittle, S. (2018). A Hierarchical Model of Inhibitory Control. Frontiers in Psychology, 9. https://doi.org/10.3389/fpsyg.2018.01339
[3] Roselló, B., Berenguer, C., Baixauli, I., Mira, Á., Martinez-Raga, J., & Miranda, A. (2020). Empirical examination of executive functioning, ADHD associated behaviors, and functional impairments in adults with persistent ADHD, remittent ADHD, and without ADHD. BMC psychiatry, 20(1), 134. https://doi.org/10.1186/s12888-020-02542-y
[4] Silverstein, M. J., Faraone, S. V., Leon, T. L., Biederman, J., Spencer, T. J., & Adler, L. A. (2020). The Relationship Between Executive Function Deficits and DSM-5-Defined ADHD Symptoms. Journal of attention disorders, 24(1), 41–51. https://doi.org/10.1177/1087054718804347
[5] Kamradt, J. M., Ullsperger, J. M., & Nikolas, M. A. (2014). Executive function assessment and adult attention-deficit/hyperactivity disorder: tasks versus ratings on the Barkley deficits in executive functioning scale. Psychological assessment, 26(4), 1095–1105. https://doi.org/10.1037/pas0000006
[6] Puente, A. N., & Mitchell, J. T. (2015). Cognitive-Behavioral Therapy for Adult ADHD. Clinical Case Studies, 15(3), 198–211. https://doi.org/10.1177/1534650115614098
