How To Tell If You're Struggling With 'Executive Dysfunction'

Do basic tasks sometimes feel like climbing a mountain? You could be facing 'executive dysfunction.'

By Mark Travers, Ph.D. | October 18, 2024

Imagine trying to finish a task but never getting around to it. For instance, you've been meaning to take out the trash for days. Every time you walk past it, you think, “I should do that now.” But instead, you get sidetracked by something else, like scrolling on your phone or reorganizing a shelf. Hours go by, and the trash is still there. You're aware of it, you want to do it, but your brain just won't let you take that first step.

It's like knowing there's something important you need to do, but feeling physically stuck, as if your body's on pause while your mind is in overdrive. And when you finally get it done, instead of feeling accomplished, there's only guilt and frustration that it took so long, knowing others don't have to fight this hard to finish simple tasks.

If this is something you've dealt with before, you might be experiencing executive dysfunction.

What Is Executive Dysfunction?

Executive functions are higher-level cognitive processes that enable us to plan, organize, make decisions, control impulses and manage our emotions. These skills are essential for goal-directed behavior and help us adapt to new situations, solve problems and carry out complex tasks. They include:

• Planning and organization. Structuring tasks, setting goals and creating strategies to achieve them.
• Task initiation. Finding motivation to begin a task that feels challenging or unappealing.
• Working memory. Holding and manipulating information in mind over short periods.
• Inhibition and self-control. Resisting impulses and regulating behavior.
• Cognitive flexibility. Adapting to changing circumstances and shifting attention between tasks.
• Emotional regulation. Managing emotions and preventing frequent mood swings, outbursts, or inappropriate emotional responses in social situations.

Executive dysfunction occurs when these cognitive processes are impaired, making it difficult to manage daily activities and responsibilities. This can range from mild to severe, affecting how efficiently and effectively a person can function.

If you've ever found yourself knowing exactly what you need to do—like taking out the trash, sending an important email, or even something as simple as getting out of bed—but you feel almost physically stuck or end up getting distracted by unrelated things, this could be a sign of executive dysfunction.

This isn't just frustrating; it can be exhausting and impact your daily life, making even small tasks feel like monumental challenges.

What Causes Executive Dysfunction?

Experts aren't sure exactly what causes executive dysfunction, but there are a number of possible causes, including:

• Brain conditions. Alzheimer's, stroke, traumatic brain injury and similar conditions can lead to executive dysfunction.
• Learning differences. ADHD, autism and dyslexia are linked to executive functioning challenges.
• Mental health. Anxiety, depression and trauma can impair executive functions.
• Substance abuse. Alcohol and drug use disorders can contribute to executive dysfunction.
• Genetics. Genetic factors may play a role in these cognitive difficulties.
• Sleep deprivation. Lack of sleep negatively affects executive functions.
• Environmental stress. Stressful environments and hectic schedules can worsen symptoms.

Harvard Medical School researchers did a longitudinal study on 9845 preadolescents. They found that poor executive function at the start predicted an increase in general mental health issues over two years.

Conversely, having more mental health issues at the start also predicted a decline in executive function over the same period. This shows a two-way relationship, meaning executive dysfunction can both lead to and result from mental health problems.

These findings were consistent across different types of mental health symptoms, such as anxiety, depression, ADHD and other behavior problems, suggesting that executive dysfunction affects a wide range of mental health conditions.

Since executive function impacts so many aspects of mental health, improving it might help prevent or reduce mental health problems in young people.

Executive dysfunction is rooted in cognitive impairments. Even people without a history of mental health issues can experience executive dysfunction in daily life if certain brain areas, like the orbitofrontal cortex (OFC), are impaired or show structural differences, as mentioned in a 2012 study published in Brain Structure and Function.

Imagine lying in bed, scrolling through your phone. Your mind is screaming at you to get up and start that project or pay bills, but you're stuck. You tell yourself, “Just five more minutes,” but you never move.

You can't talk yourself out of executive dysfunction. People who struggle with it often need practical tools, external support and strategies to help regulate their nervous system to break out of this cycle and start functioning again.

How To Overcome Executive Dysfunction?

Since executive dysfunction can stem from various causes, such as brain injuries, neurodivergence or mental health conditions, its treatment is dynamic and personalized. Instead of being a standalone issue, executive dysfunction is often a symptom of an underlying condition.

Therefore, effective treatment focuses on addressing the root cause to improve daily functioning and cognitive skills based on the individual's unique needs. Here are some strategies to overcome executive dysfunction:

• Goal management training (GMT). This cognitive rehabilitation program uses techniques like mindfulness and strategy training to improve planning, problem-solving and self-regulation. Additionally, combining GMT with external cuing, such as reminders, can help individuals implement learned strategies in real-life situations, improving executive functioning even in chronic conditions.
• Optimizing lifestyle. This includes improving sleep quality, reducing substance use, engaging in regular cardiovascular exercise and managing chronic pain. Minimizing the use of medications that impair cognitive function can further support optimal brain performance.
• Problem-solving therapy. This therapeutic approach helps individuals develop structured strategies to tackle daily challenges, enhancing executive functioning and reducing vocational disability. It's helpful in tackling executive dysfunction linked to depression.
• Cognitive Behavioral Therapy (CBT). Behavioral and emotional regulation strategies, such as cognitive-behavioral therapy, can help individuals with executive dysfunction manage emotions and cognitive processes more effectively. These strategies are particularly useful for people recovering from brain injuries.

Recognizing executive dysfunction as not a personal failure but rather a cognitive challenge is crucial. With professional support, individuals can effectively manage these difficulties, turning daily struggles into opportunities for growth and improvement.

Wondering if your procrastination is more than just a habit? Take this test to measure your procrastination levels: General Procrastination Scale

A similar version of this article can also be found on Forbes.com, here.