Executive Function and ADHD: A Close Relationship

Executive Function and ADHD

You’re staring at a blank document screen, watching the cursor blink. You have a paper due tomorrow, and you know you’d better start working on it. But somehow, it is impossible to actually start working.

Your brain feels stuck, as if there’s some kind of blockage preventing you from actually working. On top of that, it feels overwhelming to even know where to start. You become frustrated and slam your laptop shut.

Does this sound familiar? If you live with ADHD, these situations may happen because of an executive function deficit.

Executive functioning is an important set of brain functions that allows us to complete advanced tasks like working towards goals and sustaining attention. ADHD causes adults to have problems with executive functioning, which can make life difficult when the symptoms are left untreated.

So what is executive functioning, exactly, and what does ADHD have to do with it?

What Is Executive Functioning?

The term executive functioning refers to a set of cognitive processes and skills that allows us to make decisions, prioritize tasks, work toward goals, and more. These skills are a result of teamwork that happens between several different areas of the brain, but it’s the prefrontal cortex that’s primarily responsible for them.

In some ways, executive functioning is like the CEO of the brain. Other parts of the brain help us do things like move our muscles in the way we want or to know when we’re in pain. But our executive functions are what allow us to plan, set goals, keep track of things, and see the big picture. Other brain functions can focus solely on what they are responsible for. Our “brain CEO” is able to oversee everything going on, prioritize, and make decisions accordingly.

Imagine a small child sitting in front of a piece of chocolate cake. The child is told, “Don’t eat this piece of cake. If this piece of cake is still here when I return in 5 minutes, you can have the cake and a popsicle.”

If the child hasn’t developed strong executive functions yet, they may eat the piece of cake that’s in front of them. Their “brain CEO” is absent, and they may react impulsively. Or they may not even remember what they were told — and simply eat the cake because it’s cake, and it’s in front of them.

Someone with strong executive function can see the big picture. They can have self-control and wait for the popsicle if they really want it. Or, they may think, “I don’t really like popsicles, and I’m starving now. It isn’t worth it to me to wait. I’ll just have the cake now.”

The point is that either way, their executive functioning allows them to remember the instructions, see the big picture, prioritize their needs, and make the best decision.

Executive functioning skills can be divided into three main areas of brain function:

Working memory
Flexible thinking
Inhibitory control (or self-control).

Within those 3 broad areas, there are 6 essential executive functioning skills. These skills were identified by Dr. Thomas Brown, a researcher in the area of ADHD and executive functioning.

The 6 essential executive functioning skills that Dr. Brown identified include:

Organizing, prioritizing, and activating for tasks
Focusing, sustaining, and shifting attention to tasks
Regulating alertness, sustaining effort, and processing speed
Managing frustration and modulating emotions
Utilizing working memory and accessing recall
Monitoring and self-regulating action

There are certain conditions that cause some people to have impaired executive functioning. Some people, like people with ADHD or learning disabilities, are born with weak executive function. Others may develop a brain injury or disease that causes poor executive functioning later on in life.

Executive Function and ADHD are linked – what about other disorders?

ADHD is a common cause of poor executive functioning, but other disorders that affect these functions include:

Traumatic brain injury
Dementia
Schizophrenia
Depression
Autism
Neurocognitive diseases
Alzheimer’s disease and dementia

People who have poor executive functioning, like people with ADHD, have a difficult time prioritizing tasks and seeing the big picture. They may struggle with planning and problem-solving, or become overwhelmed when having to make important decisions.

How does ADHD affect executive functioning?

Neurodevelopmental disorders, including ADHD, affect the brain’s executive functioning. In fact, many ADHD symptoms are simply a result of the way this disorder impairs executive functions. The relationship between ADHD and executive functioning is so closely related that we could have easily named ADHD executive function deficit disorder.

If you live with ADHD, you may have looked at the list of 6 executive functions above and recognized them right away. That’s because most people with ADHD struggle with all of these executive functioning skills.

Working memory

Working memory is the executive function that allows you to recall both verbal and non-verbal information. One of the principal symptoms of adult ADHD is forgetfulness; if you live with ADHD, you already know this. Forgetfulness may lead you to misplace objects, miss deadlines, or forget about important dates and meetings. You might also forget instructions you are given almost immediately after hearing them.

This isn’t because you aren’t intelligent — it’s because of the way ADHD affects your executive functioning. Without access to working memory and recall, it can be extremely difficult for people with ADHD to remember things.

Organizing and prioritizing

Organization is one of the main areas of struggle for people with ADHD. This can show up in both your mind and your physical space. Your home, office, or car might be messy and disorganized, and this might cause you to misplace things constantly.

But disorganization can also show up in tasks. Maybe you’ve had the experience that, when faced with a big project with multiple steps, you just can’t seem to figure out what to do first.

This is an executive function deficit. You aren’t a “slob,” nor are you an unprofessional person.

Sustaining and shifting focus

Inattention and distractibility are key characteristics of ADHD. Typically, people with ADHD have a difficult time sustaining attention on one thing, especially if that thing is tedious or uninteresting.

But people with ADHD also experience hyperfocus, which is when their attention gets so locked onto one thing that you don’t notice anything else going on around you. This is because it’s also difficult for people with ADHD to regulate and shift their attention from one task to another.

Regulating effort and alertness

Many adults with ADHD experience daytime drowsiness. You might feel totally alert when you’re doing something that interests you, but be overwhelmed by sleepiness as soon as you need to complete a boring or tedious task. This may be related to an executive function deficit.

Even if you don’t experience drowsiness, you might find it challenging to sustain effort and keep working at something, especially if it bores you. For example, you might have a long-term goal of finishing a college paper. But you might have a hard time continuing to work on the paper, step by step, in order to reach that goal.

Regulating emotions

One symptom of adult ADHD that isn’t often talked about is impulsive emotional outbursts. Adults with ADHD tend to have a low tolerance for frustration and boredom. They also have a high level of impulsivity. This can cause them to have emotional outbursts when they’re angry or frustrated. Does this ever happen to you?

Having a hard time regulating emotions is caused by a deficit in executive function. You may not consider yourself to be a particularly emotional person, but still find it hard to contain your emotions when they come on. It might feel very difficult to use coping skills to calm yourself down.

Monitoring and self-regulating action

Being able to self-reflect, and motivate yourself to work toward your goals, is an essential executive functioning skill — one that many people with ADHD have a hard time with. You might know exactly what you want to achieve, and even have a clear understanding of what you need to do to get there — but somehow, you still can’t seem to force yourself to actually start working.

This might have caused other people in your life to label you as “lazy” or “wasting your potential.” In reality, that’s far from the case. But the executive function deficit that comes with ADHD makes it very hard to motivate yourself into action.

Trusted Online ADHD Treatment for Adults with Focus Partners

On top of the effects of the deficits themselves, having trouble with executive functioning often makes people with ADHD feel ashamed and embarrassed. They may feel like they’re not living up to their full potential, or that their peers are more accomplished than they are.

An executive function deficit does not make you stupid, lazy, or irresponsible. And with the right treatment, ADHD symptoms can become a lot easier to manage. Focus Partners can help with out telehealth-based online ADHD treatment for adults, and we’re here to listen to you and help unlock the full power of your potential. Get started by taking our initial online ADHD assessment and find your focus now. Our team currently provides ADHD treatment services online in Ohio, Illinois, Michigan and New York.

Let’s Talk About Adult ADHD

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Let’s talk about adult ADHD

Attention-deficit hyperactivity disorder, or ADHD, is often thought of as a children’s disorder. When most people think of ADHD, they imagine a hyperactive little boy running amuck in the classroom, unable to pay attention to his teacher.

But this is a very limited view of ADHD. Although some children do outgrow ADHD, many don’t — which means that children with ADHD will grow up to be adults with ADHD.

Over 4% of U.S. adults are diagnosed with ADHD. That’s over 10 million people! And that’s not even considering the many adults with ADHD who are overlooked or misdiagnosed.

Adult ADHD is highly misunderstood because of the idea that ADHD is a disorder that only occurs in children. This has left so many adults with ADHD struggling unnecessarily with ADHD symptoms that can easily be treated. At Focus Partners, one of our goals is to spread awareness about what adult ADHD looks like so you can recognize its signs and get treatment.

What is adult ADHD?

First of all, what is ADHD, exactly?

ADHD is a behavioral and neurodevelopmental disorder that usually begins in childhood. Although some children grow out of ADHD (or learn to manage it well enough where it’s no longer disrupting their lives), it’s considered a chronic condition. That means that there is currently no cure for ADHD, and people live with it their entire lives.

Adult ADHD isn’t a separate condition from ADHD in children, but it’s often differentiated from childhood ADHD because it comes with its own stigma and challenges. ADHD is often diagnosed in childhood, but we’re learning now that many children with ADHD, especially girls, are overlooked by both teachers and medical providers. It isn’t until they reach adulthood and seek help themselves that they’re finally given the correct diagnosis.

ADHD can be particularly difficult for people who were never appropriately diagnosed as children, because they never received the treatment that could have helped them manage their symptoms. If this describes you, you may have gotten to adulthood without any treatment or support for your ADHD symptoms.

Since you didn’t know that ADHD is interfering with your functioning, you may have blamed yourself for the ways ADHD got in the way of your life. For example, if school was difficult for you, you may have labeled yourself as “not smart enough.”

Once you’re correctly diagnosed with ADHD as an adult, you can start to understand how the things you’ve struggled with your whole life may have been caused by ADHD. It isn’t your fault, and there are ways to manage your symptoms so you can live well with this condition.

What does ADHD look like in adults?

For both children and adults, ADHD has three different presentations: the predominantly inattentive type, the predominantly hyperactive/impulsive type, and the combined type. ADHD can look very differently depending on where you fall on this continuum.

Predominantly inattentive type adult ADHD

Adults who live with the predominantly inattentive type of ADHD struggle to regulate or maintain their focus. They may find their attention wandering off during long or boring meetings. They may be very forgetful, or constantly misplace things. These are the people who miss important meetings (even though they’re highly professional and responsible), or often appear to be in a daze.

You may have predominantly inattentive type adult ADHD if you:

Are constantly misplacing your keys or phone
Have a hard time paying attention during long meetings or lectures
Forget important meetings
Miss deadlines
Need to make lists to stay organized with their tasks
Lose your train of thought in the middle of a sentence
Need to ask people to repeat themselves often because your mind has wandered off
Have difficulty remembering to pay your bills on time
Avoid any task that you know is going to require prolonged attention and effort
Frequently make careless mistakes that aren’t a reflection of your true abilities
Are able to pay attention when something captures your attention — but may lose interest in those same things very quickly
Have trouble starting or finishing projects

Predominantly inattentive ADHD tends to be more common in women — which contributes to women with ADHD being overlooked as children.

Hyperactive-impulsive type of adult ADHD

Other adults with ADHD have the hyperactive-impulsive type. This is the type of ADHD that’s usually associated with hyperactive little boys. Hyperactivity may look differently in adults. Instead of running around, adults with this type of ADHD may feel restless or have trouble winding down, even when they’re tired.

You may have hyperactive-impulsive adult ADHD if you:

Find it nearly torturous to wait in line
Interrupt people frequently while they’re talking
Have a hard time waiting your turn in a conversation
Feel like you need to get up and walk around in the middle of meetings, or not being able to sit still for long periods of time
Have been told that you talk “too much”
Have intense emotions, or have frequent angry outbursts that subside quickly
Have “no filter” or blurt things out often without thinking about how they’ll come across
Are always fidgeting

Combined type of adult ADHD

Adults may be diagnosed with the combined presentation of ADHD if they have both hyperactive-impulsive and inattentive symptoms. This is the most common type of ADHD.

It’s important to note that only a licensed provider can diagnose you with ADHD. Diagnosis is a lot more complex than reading a list of adult ADHD symptoms. If you haven’t been diagnosed with ADHD, you can schedule an assessment with us.

What can trigger ADHD in adults?

More and more people are first getting diagnosed with ADHD as adults, including many of our members. Does this mean that ADHD can start developing in adulthood?

The answer to this question is complex. There is increasing evidence that supports the existence of “late-onset ADHD.” Although ADHD is primarily a condition that starts in childhood, some people may not start developing symptoms until young adulthood. A new study has found that late-onset ADHD may be a distinct disorder from childhood-onset ADHD, and around 70% of their young adult participants didn’t have ADHD symptoms in childhood.

In these cases, it’s important to understand that ADHD that comes on in adulthood may be more complex than being simply a continuation of childhood ADHD, as adult ADHD used to be understood.

But often, adults did have ADHD symptoms in childhood — they were just misdiagnosed or overlooked. This happens often with girls and women, who commonly have the predominantly inattentive type of ADHD. Since ADHD is still misunderstood by teachers and other professionals as primarily being a disorder of hyperactivity, girls (and other children) with the predominantly inattentive presentation of ADHD may not be identified. Girls with inattention may also work harder to mask their symptoms.

On top of that, inattentiveness doesn’t usually cause problems in the classroom the way hyperactivity does. If you had the predominantly inattentive type of ADHD as a child, you may have sat in the back of the classroom zoning out while the kids with hyperactive-impulsive ADHD talked out of turn and got out of their seat. As the saying goes, the squeaky wheel gets the grease — and your teachers may not have noticed you if you weren’t causing any trouble for them.

Get Online ADHD Treatment for Adults with Focus Partners

Whether you’ve known you have ADHD since you were a child or you’re newly diagnosed, you deserve treatment. Although ADHD is a chronic condition, it doesn’t need to stop you from living a successful, happy, and fulfilling life.

Focus Partners provides telehealth-based online ADHD treatment for adults, and we’re here to listen to you and help unlock the full power of your potential. Our team currently provides ADHD treatment services online in Ohio, Illinois, Michigan and New York. Get started by taking our initial online ADHD assessment to start your ADHD treatment journey today.

ADHD in Women: A Reality

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ADHD Myth #1: Women aren’t affected by ADHD

Let’s talk about the #1 myth about ADHD in adult women!

We don’t know who started this, but it’s time to end it.

Not only are 50-75% of women with ADHD undiagnosed, but women aged 26-34 are the fastest growing population undergoing treatment for ADHD.

Why do so many women live with undiagnosed ADHD?

More than a few reasons, but here are a few main ones:

ADHD symptoms in women as children tend to be more internalized (inattentiveness) vs. externalized (hyperactivity or impulsivity).
Inattentive ADHD symptoms are more likely to be incompletely diagnosed (or even misdiagnosed) as simply anxiety and/or depression.
Women are more likely to employ coping strategies to cover up their ADHD symptoms and forego seeking an ADHD diagnosis. (This is at least partly because women are, for better or worse, historically more societally conditioned to be “people pleasers,” which includes efforts to push themselves to look “put together” to others, masking their ADHD symptoms to outsiders.)

Since we’re on the subject, what might a Predominantly Inattentive ADHD patient struggle with?

Inattentive-Predominant ADHD patients can struggle with starting, maintaining effort on, and completing tasks – in any or all areas of their life – whether it’s a chore within the home, a project for work or an essay for school.

The disorganization of an ADHD brain can overwhelm us when there’s decision to make or an action to start – often causing us to either shut down or make mistakes.

Some very common scenarios for Inattentive-Predominant ADHD are:

If we start a task and we can’t complete it, we can beat ourselves up for “failing”.
If we start a task and we make mistakes because we can’t maintain our focus on it, we can feel things like frustrated, embarrassed, or “incompetent.”
And, if we can’t get ourselves to start until the last minute – regardless of how long we had – we stress ourselves out, often using guilt and shame as motivators.

All of these can create feelings of anxiety and/or leave ourselves mentally (and sometimes physically) exhausted.

Are there any groups of women more likely to be diagnosed with ADHD?

In general, those undergoing stressful life events or other big life changes – even positive ones, like getting a promotion! When we change our environment or add more responsibility onto our plate, our coping strategies that we have trained our brains to use to overcome our ADHD symptoms cannot always keep up. This is a very common time for patients to do some self-reflection on their ADHD symptoms – which have often been around for years – and decide to reach out.

Some common groups of women seeking out a diagnosis for ADHD include:

Women starting graduate school
Women changing or starting new jobs
Mothers of young children, particularly those who have recently gone back to work
Mothers whose children were recently diagnosed with ADHD

How can we help reduce instances of undiagnosed ADHD?

Normalize ADHD. Not only in women but in everyone. Help end the stigma around it.

ADHD is a neurological disorder – it isn’t a choice. So don’t be afraid to seek help if you feel yourself struggling with it.

Take our ADHD Assessment and sign up for an ADHD evaluation with Focus Partners. Our ADHD specialists provide online ADHD treatment services via telemedicine to our members located in Ann Arbor, Chicago, Cincinnati, Cleveland, Columbus, Dayton, Toledo and throughout the states of Illinois, Michigan and Ohio.

Welcome to Online ADHD Treatment at Focus Partners

Intro to our trusted online ADHD treatment and evaluation services

Allow us to introduce ourselves in this inaugural blog post. We are Focus Partners, the Midwest’s premier independent membership-based medical practice dedicated to treating adults living with attention-deficit/hyperactivity disorder (ADHD). We provide the best online ADHD treatment services available to you. Our providers at Focus Partners listen to you to empower you to reach your full potential. We will provide some honest and candid commentary in this blog. We plan to work together with all of you to continue breaking the stigma of adult ADHD so that people get the assistance they need.

Focus Partners began as a simple start-up medical practice to help those that were either too afraid to bring up the conversation of ADHD with their primary care providers (PCPs) or that were brave enough to bring it up only to be dismissed (“adult ADHD isn’t real”). Or that faced 3-6 month wait times to schedule an appointment with an ADHD specialist that could help. We are solving this issue one patient at a time, now working with members in Ohio, Illinois and Michigan. We have members in Chicago, Columbus, Dayton, Cincinnati, Cleveland, Ann Arbor and have some big expansion plans in the works for 2022.

ADHD diagnosis and treatment online

The advantages of providing online ADHD diagnosis and treatment services for adult ADHD are (or should be) clear to everyone. Focus Partners makes it even easier. Our program is one flat monthly fee that covers your initial consultation, automatic electronic refills and any follow-up appointments or questions that you have. There are no extra fees if you want to check in with questions or just let us know how you’re doing.

The initial consultation is risk free. If we are not able to establish a treatment plan, you will not be charged. As of this post, the monthly program fee is $65 per month. We can’t guarantee this won’t go up for new members, but your rate won’t as long as you are a continuous member of Focus Partners. You also don’t have to worry about us running a special for a reduced consultation fee the week after you sign up either, which we have heard is done by certain online ADHD treatment services.

Other online ADHD treatment services

We receive a lot of questions about how we differ from some of these online ADHD treatment companies like Donefirst, Cerebral, Klarity ADHD, etc. The key difference is that Focus Partners is a real medical practice that is backed and managed by physicians. We are invested in our members’ well-being. Our goal is not to see an infinitely high volume of patients, which might sacrifice your experience and care. With fully licensed physicians, there are no limitations on ADHD medication management like you might see with other ADHD treatment services (ex: not able to prescribe Schedule II stimulants).

We work with several members that switched over from one of these other online ADHD treatment services. Focus Partners does not charge a separate fee for the initial consultation. We can help whether you are looking to get an ADHD diagnosis for the first time or transfer your ADHD medication management to our ADHD specialists. Please schedule an appointment with us today.

If you have any questions or think we can help manage your ADHD, please visit the rest of our site, shoot us an email or leave a comment below. We appreciate your feedback and are always learning from each other and our members. We will be adding more states for online ADHD treatment throughout 2022. Good luck to all – make yourselves a great day.