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Executive Function and ADHD: A Close Relationship

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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: 

  1. Working memory
  2. Flexible thinking
  3. 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:

  1. Organizing, prioritizing, and activating for tasks
  2. Focusing, sustaining, and shifting attention to tasks
  3. Regulating alertness, sustaining effort, and processing speed
  4. Managing frustration and modulating emotions
  5. Utilizing working memory and accessing recall
  6. 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.