How Does ADHD Affect Executive Function?

Attention deficit hyperactivity disorder (ADHD) can impact a person in many ways, with impeded executive function skills being one of the main areas of symptoms that people with ADHD typically have to deal with. Due to the nature of executive function and how it impacts our ability to complete everyday tasks, understanding how ADHD can affect it is important when considering methods to manage the condition effectively.

In this article, we’re going to look in more detail at how ADHD can affect executive function, how executive dysfunction presents itself, and how it can be managed.

What is executive function?

Executive function is a role that is performed by the frontal lobe area of the brain. It is responsible for lots of different things that help you with your behaviour and day-to-day tasks. It’s like the brain’s self-management system. Some key executive functions include:

• Time management
• Organisational skills
• Multitasking
• Working memory and remembering things
• Planning
• Prioritising tasks
• Paying attention
• Regulating emotions
• Self-censoring

Executive functioning skills are essential for understanding how what you say and do can impact certain people or scenarios in the future, as well as for managing tasks and projects efficiently and ensuring you’re able to avoid saying the wrong thing or taking the wrong action at a crucial time. With this in mind, executive functioning plays a role in not just work and education, but in social scenarios, too.

What is executive dysfunction/executive function disorder?

Executive dysfunction occurs when a person has problems with performing some of their key executive function skills. It’s important to note that executive dysfunction is not an independent diagnosis or a recognised disorder on its own; rather, it is a symptom of other mental health health conditions including but not exclusively ADHD.

People who experience executive dysfunction may have issues with core executive function tasks like time management, organisation, and maintaining social relationships. This can mean they have trouble academically, at work, and interpersonally. It also means that meeting goals can be hard and adapting to new situations can be tricky.

People with executive function impairments might find that they encounter the following scenarios:

• Get distracted easily
• Struggle to focus on just one thing, or focusing too much on one thing
• Daydreaming or zoning out
• Struggle to find the motivation to start something
• Trouble going from one task to a different one
• Poor impulse control
• Find it hard to verbalise thoughts
• Have issues with verbal working memory
• Struggle to think before saying something

What causes executive dysfunction?

There are several factors that can lead to executive dysfunction. One reason is brain damage caused by trauma, such as through an accident. Another reason is because of degenerative brain diseases, such as dementia. Some of the most common conditions that have been linked to executive dysfunction include:

• Alcohol or substance abuse
• Mental health disorders such as obsessive-compulsive disorder (OCD), schizophrenia and depression
• Autism spectrum disorder
• ADHD
• Stroke
• Multiple sclerosis
• Huntington’s disease
• Concussion
• Traumatic brain injuries (TBIs)
• Cerebral hypoxia

As mentioned, executive function is not a health condition on its own, it is a symptom of other health conditions. If you notice that you show signs of executive function problems and don’t have a medical diagnosis, make an appointment with your GP as it’s possible that it could be caused by an underlying condition.

ADHD and executive dysfunction

Executive dysfunction is a symptom of ADHD, although not everyone with executive dysfunction has ADHD. There are a number of overlapping symptoms between ADHD and executive dysfunction, largely because many ADHD symptoms directly correlate and stem from executive function symptoms.

As such, people with ADHD may struggle with:

• Self-control/impulse control
• Maintaining focus
• Organising their schedule
• Completing tasks
• Getting motivated
• Feeling overwhelmed

Executive functions take time to develop, usually starting at around age two and finishing at around age 30. However, people with ADHD tend to be approximately 40% behind their peers in terms of executive function transitions, meaning they sometimes think and act like someone younger than themselves. This in itself can cause issues in people with ADHD at any age, especially in adulthood.

For example, by age 30, the problem-solving executive function is typically fully developed, but someone who is 30 years old with ADHD that impedes problem-solving may find that they are somewhat behind their peers and struggle with this. This is because problem solving involves looking at a problem from more than one angle, but executive dysfunction in this area can cause problems with flexible thinking, meaning it’s hard to look at something from more than one angle.

This can cause issues in the workplace or in independent living. In turn, this can result in people with ADHD feeling frustrated, overwhelmed, ashamed, misunderstood, and generally unhappy as they struggle to keep up with their peers and adapt to new situations.

Common types of executive dysfunction with ADHD

There are several main ways people with ADHD may struggle with executive dysfunction. They include:

Motivation

If you have ADHD and struggle with motivation, you’ll know that this is an issue for you, but it can be difficult to know how to fix it. It might feel like you’re watching a video and it keeps cutting out at the same part every time. You’ll have an urge to fix it, but because you don’t know where to begin, you keep putting it off instead.

Socialising

If you find that you struggle to verbalise your thoughts or think before you speak, you might feel anxious to speak with new people or attend social functions in case you say the wrong thing. In fact, almost half of adults with ADHD have anxiety, with around 3 in 10 having social anxiety.

Multitasking

Being able to do more than one thing at a time is important throughout your life, but the ability to multitask can be hindered if you have executive functioning problems. For example, you might know that you need to take notes whilst listening in a meeting at work, but being able to listen to what the person is saying and take it in, whilst taking notes at the same time, can seem impossible, no matter how hard you try.

Emotion control

Some people, particularly children with ADHD, can have behavioural issues caused by not being able to regulate and control their emotions. This can result in disproportionate responses to situations and conflicts within interpersonal relationships. It can also lead to issues at school and at work.

Not everyone with ADHD executive dysfunction will experience executive function deficits across all areas of executive functioning, but most will experience issues with the majority of executive functions. Any of these issues can lead to stress and anxiety, both of which can also impact executive functioning.

Treating executive function issues

ADHD and executive dysfunction as a whole can present lots of challenges in your life. Whether poor time management leads to you being late to work one too many times and being fired, or a lack of organisation results in bills not being paid on time and services being restricted, the impact ADHD and executive dysfunction can have on your life is not to be understated.

However, there are several things you can do to minimise the impact of executive dysfunction and alleviate ADHD symptoms to help you navigate life a bit easier.

Medication

If you have been diagnosed with ADHD and struggle with things like staying focused, medication can help. Studies show that more than 80% of people with ADHD benefit significantly from medication. These medications are usually effective and well tolerated and have been used for many years in clinical practice. However they need to be prescribed safely by a mental health professional or a GP.

Organisation tips

If organisation is something you struggle with, there are a number of things you can do to make it easier, such as:

• Break tasks down into smaller, more achievable steps
• Use visual aids such as colour-coding and labels to help you
• Make use of alarms and alerts for upcoming events
• Get into the habit of making a daily to-do list
• Ask for written instructions and verbal instructions if you can

Time management

Time management can be tricky for lots of people, but there are plenty of ways you can improve your time management skills:

• Setting timeframes for each chunk of a task, e.g., spend no more than one hour on section one of task A.
• Make use of alarms and set them earlier than needed, e.g., if you need to be out of the house by 9am at the latest, set an alarm at 7am to wake up, one at 7:30am to be showered, one at 8am to have eaten breakfast, and one at 8:30am to leave. This way, if you get distracted part way through any task in the morning, you still have a 30-minute leeway window to ensure you’re not late.
• Look to get more organised ahead of time, e.g., get your clothes ready the night before so you don’t lose time looking for a pair of socks or ironing a shirt.

ADHD treatment at The ADHD Centre

At The ADHD Centre, we have a team of medical professional specialists who have worked with ADHD patients for decades. We understand the challenges the condition can bring and the way executive dysfunction can impact your life. Whether you’re an adult, a student, or the parent of a child with ADHD, we can offer support and treatment to help manage and cope with the challenges ADHD can bring, including executive functioning issues.

Please call us on 0800 061 4276 or email us at enquiries@adhdcentre.co.uk to find out more.