Discovering executive dysfunction changed the way I view my ADHD

You can call me lazy and messy, but just know I can’t easily control it.

I spent many of my childhood and adolescent years consumed by a burdening sense of hopelessness. And before you put this article in the box of ‘delusional sob stories by another privileged White girl’, let me clarify that this sob story is more common than society likes to acknowledge. Like me, you might be struggling with it and not even realise it.

Growing up, my mum was the archetypal type A personality. In other words, she got shit done. Her tax return was always filed immediately, she was bang on time for every appointment, and somehow, in between work, raising two kids, and running a household, she never forgot her twice-yearly dental checkups.

In need of some advice? Head to our Life section.

Naturally, she tried to instil these same qualities in me. “Being on time is the most important first impression you will ever make” was one of her favourites. Mum’s advice worked a treat for my younger sister, who was offered part-time jobs with little to no experience and dived straight into an arduous law degree after graduating high school with a near-perfect ATAR score.

To give credit where credit is due, I also made it to university. Yet throughout my three-year course, I only managed to submit one single assignment by the deadline. My ‘poor organisation’ often saw me rummaging through an indissoluble floordrobe in search of my keys or wallet, and it trapped me in a constant cycle of ‘yep I’ll get to that’ which, shockingly, I rarely did.

As desperately as I wanted to live up to the organisational standards my mum had brought me up with, I couldn’t seem to shake off the disorganised chaos. Last year, approaching my 22nd birthday, I was finally diagnosed with Attention Deficit Hyperactivity Disorder, or ADHD. Being medicated for ADHD changed my life. It increased my focus and allowed me to hit deadlines I was convinced were impossible for me to achieve.

But it wasn’t the miracle cure I thought it would be. While the medication allowed me to focus on my work for longer periods, I realised I still lacked many of the organisational skills I assumed this magic pill would fix. I still struggled to schedule my time and commitments, and when I did, I had no idea what to prioritise first, or how to get it all done in an eight-hour workday.

The feelings of shame and inadequacy that I ruminated on pre-diagnosis were stuck in my mind like old gum under a classroom table. That was until three weeks ago, when I stumbled upon a video from a mental wellness coach on everyone’s favourite distraction app, TikTok. The video described my experience with disorganisation in a way I had never been able to verbalise. It was my entire life story condensed into two words: executive dysfunction.

There was a name for my experience, and ultimately, it changed the way I viewed myself and my attention disorder. Executive dysfunction felt like a long-lost twin I was reuniting with for the first time. It was the missing piece of the puzzle, a part of my identity I had, for years, mislabelled as a giant flaw in my character.

@megmoxieexecutive dysfunction. #executivedysfuntion #adhd #neurodivergent #mentalhealth #McDonaldsCCSing♬ original sound – Megan Griffith

Executive dysfunction sounds complicated. What is it?

Dr Maddi Derrick is a clinical psychologist and director of a specialist ADHD clinic in Hobart. She describes executive function skills as “brain processes that allow us to control ourselves so we act in ways that help us meet our longer-term goals”.

Others describe it as the CEO of the brain, controlling processes like planning, problem-solving, emotional self-regulation and time management. Dr Derrick says that, for people like me, executive function skills are often impaired.

“In people with ADHD, the areas of the brain that do a lot of those executive functions are a bit different. They haven’t grown at the same rate, they are structurally a bit different and there are different levels of chemical activation in those areas of the brain,” she explains.

While people with neurodevelopmental or mental health conditions like Autism Spectrum Disorder (ASD) or ADHD “struggle more often with their executive function”, Dr Derrick says executive dysfunction is not exclusive to the neurodivergent population.

“Executive functioning is affected under a lot of circumstances with a lot of neurological conditions, a lot of mental health conditions. [But] It’s also affected when we‘re sick and run down or when we’re stressed or tired. Even if we’re hungry or thirsty” she continues.

So it appears anyone can struggle with executive function at certain times in their lives. But for certain individuals – those with ADHD, ASD, or traumatic brain injuries – executive dysfunction is constant.

They tend to have trouble completing tasks or meeting deadlines, often lose their train of thought or have trouble following conversations, find it hard to keep track of personal belongings, and have problems remembering steps in a multi-step process. You get the gist.

I think I struggle with executive dysfunction. How can I manage it?

By now you might have worked out if you struggle with executive dysfunction. If you’re like me, it’ll feel like a weight has lifted off your shoulders, and you can rip the unwarranted label of ‘lazy and incapable’ off your chest.

If you aren’t like me, chances are, you’re thinking about someone in your life who is. And the good news for folks with executive dysfunction is that we aren’t doomed to a life of unmet potential. Dr Derrick says treating executive dysfunction is “a lot about changing the environment, and having strategies to externalise and prop up the brain’s executive functions”.

For that, there are professionals like Executive Function Coach Amanda Lecaude, who says altering executive dysfunction habits is all about “finding the right tools that will work for you”.

“[People] don’t set out to fail. I don’t think anyone has a set idea in their head that they’re going to do something terrible or just not succeed, so it’s just about giving them the tools to get them from A to B” she tells me.

“The big one is having a plan, or a diary, or a checklist, just something to help you follow what it is you need to do…To manage your time, you need to be able to see time, and to do that you really need to be using some form of a planner, whether that’s on paper, or electronic.”

Amanda says other helpful techniques to improve executive function include using timers to complete work efficiently, having visual aids like checklists, and breaking up large bodies of work into smaller sub-tasks.

 

View this post on Instagram

 

A post shared by Jessi R.| ADHD Squirrelpreneur (@adhdfemaleentrepreneurs)

Executive dysfunction has really damaged my self-esteem. How can I regain confidence in myself?

While it’s valuable to implement processes to help you out, Dr Derrick says for people with executive dysfunction, treatment geared towards healing unhelpful habits and beliefs is just as important for realising future success.

“There’s a lot of self-esteem repair we do, a lot of unravelling of maladaptive coping mechanisms… People with ADHD can get very hyper-vigilant to criticism because they are often criticised so much, and then they can develop some ways of coping that aren’t helpful, whether it’s being overly reactive, or being avoidant or being a people pleaser. We’re often trying to help the person re-train their automatic responses to situations so that they’re looking after themselves more and being fairer to themselves.”

Dr Derrick says communication with doctors and specialists is key for people who struggle with executive function skills, particularly women, who often face misdiagnosis. “Often by adulthood [females] are getting diagnosed with anxiety and depression instead. A lot of years can be lost and a lot of trauma and damage can happen when you aren’t getting to the real source of the difficulty” she tells me.

Clinical neuropsychologist Dr Hannah Korrel agrees and says “there’s no harm in flagging any issues you have with your GP… express that you have some issues, that it’s taking you longer to do things than it should be, or you might feel like a scatterbrain. Just express that something doesn’t feel right. Your GP will be able to narrow down why that is the case,” she says.

Dr Derrick notes that, while working with a specialist is a great way to tackle an individual’s struggles of executive dysfunction, medication is also a beneficial approach to take.

“It’s important to note that medication is an important part of the treatment package to consider. If we’re looking at executive function due to something other than ADHD, there are obviously mental health conditions and issues to address there. But if we’re looking at it in the ADHD context, it’s a really significant consideration.”

Without knowing I had executive function challenges, I’m unsure if I would have been presented with the tools to help manage my dysfunction. But what was most important to me, more than realising that there was a solution to my problem, was the validation I received from those two words I found on Tiktok.

For the first time, my inability to complete ‘simple’ tasks wasn’t because I was lazy or tactless. It wasn’t because I wasn’t trying hard enough or didn’t have the discipline to complete them. It was executive dysfunction. And it wasn’t something I could easily control.

To learn more about executive dysfunction, head here.