ADHD is often associated with problems with concentration, impulsivity and hyperactivity. However, for many people with ADHD, executive dysfunction, a difficulty with performing a wide range of tasks related to daily functioning (e.g., planing and regulating attention) poses an equally tough challenge.
What Is ADHD, Actually?
What exactly is ADHD? The abbreviation stands for Attention-Deficit Hyperactivity Disorder, and refers to a neurodevelopmental disorder marked by psychomotor hyperactivity and attention deficits. ADHD primarily results from dysfunction in the prefrontal cortex and the reward system of the brain. These irregularities manifest as challenges with executive functions, including maintaining attention and inhibiting impulses.
The disorder stems from dopamine dysregulation, meaning that even highly enjoyable tasks and activities fail to produce sufficient dopamine. This deficiency leads to fluctuating attention, distractibility, and a tendency to quickly lose interest—not due to laziness or lack of willpower but because reduced dopamine levels make it inherently harder to stay engaged.
ADHD is categorized into three main subtypes:
- Predominantly Innattentive Presentation
- Predominantly Hyperactive-Impulsive Presentation
- Combined Presentation
Attention and focus difficulties can manifest as inattentiveness and forgetfulness, such as losing important items, being disorganized, or struggling to plan daily tasks and responsibilities. Psychomotor hyperactivity might appear as physical restlessness and a constant need to move, but it can also involve a racing mind, with a thousand thoughts per minute and continuous task-switching.
What are Cognitive Functions?
Executive functions are the skills that enable us to plan, organize, prioritize, manage time, and make decisions. They also support self-control and flexibility in adapting to changing circumstances. Executive dysfunction refers to difficulties with these processes, which often result in chaos in daily life, challenges in the workplace or school, and, quite simply, frustration.
How Does the Executive Dysfunction Manifest in ADHD?
While the term itself, executive dysfunction, tends to be used most commonly when we talk about ADHD, it can be experienced outside of it. Other groups in whom it may manifest are children and elderly because it can be connected to the natural changes the brain goes through as it ages.
While executive dysfunction is commonly associated with ADHD, it can also occur in other conditions or as part of the natural aging process. In ADHD, executive dysfunction may manifest as:
- Working Memory Challenges: Difficulty retaining information, especially under stress.
- Cognitive Inflexibility: Struggles with problem-solving and adapting to new scenarios.
- Self-Control Issues: Trouble managing impulses or delaying gratification.
It may also lead to:
- Time management difficulties.
- Procrastination and trouble initiating tasks.
- Decision-making paralysis.
- A sense of being overwheming due to complex or multi-step tasks.
Stress and overstimulation can worsen executive dysfunction. When tasks feel too complicated or involve many steps, they may seem insurmountable, further increasing feelings of anxiety and paralysis.
Ok, So What Now?
One of the most important steps in managing executive dysfunction—like all other challenges stemming from dopamine and norepinephrine deficiencies (which, biologically speaking, are at the core of ADHD)—is understanding: what exactly am I dealing with?
Imagine if you could place your ADHD on a couch next to you and ask it, What’s going on with you, really?
If you’d like to explore the situations where you experience executive dysfunction, here’s an exercise to try:
Think about a recent time when you had a task ahead of you—perhaps seemingly simple—that almost paralyzed you.
- What was that situation like?
- Where did it happen?
- What thought or physical sensation alerted you that something was off—that even though you wanted to act, you couldn’t?
- What happened next?
- What was the positive intention of your state?
- What brought you even a little relief?
If you’re curious about my experience with executive dysfunction, you can read about it in my COMIC.
For further exploration, please check the exercises included in the free email mini-course I prepared for you!
