So what exactly are Executive Functioning Issues and how are they connected to untreated ADHD?
Contrary to popular belief Executive Functioning Issues aren’t necessarily the same thing as ADHD, although they do go hand in glove. To be specific, Executive Functioning Issues crop up when there are weaknesses in the brain’s self-management system.
I think the first step in understanding why ADHD is so often left undiagnosed is to educate people about the skill set required for executive functioning. This gives people a better understanding of the roots of Adult ADHD, which is the key to getting treatment.
So I’m taking a moment to go through 8 executive functions to illustrate how they impact people in their daily lives…
…and how easy it can be to confuse executive functioning issues with other challenges!
8 Executive Functions
I think it’s interesting that executive functioning has only recently become a “buzzword”. It’s an integral part of the study of neuropsychology so it’s not a new term.
In a nutshell, executive functions are the neurological processes we use to exert mental control and manage our behaviors. Dr. Goia and his colleagues compiled a checklist to give people a concise synopsis of executive functioning. This should help to clarify what it is we are looking at.
Dr. Gioia is a pediatric neuropsychologist and the Chief of the Division of Pediatric Neuropsychology at Children’s National Medical Center, where he directs the Safe Concussion Outcome, Recovery & Education (SCORE) Program.
Dr. Goia's Checklist:
This is the split second it takes to consider the consequences of your actions. Someone with executive functioning issues acts on impulse. If you have a deficit in this area you speak without a filter, move forward without thought and may even engage in risky behaviors. If you have a tough time managing your impulses – it’s downright dangerous.
Life is constantly changing – just like your brain. So inevitably there are situations that require you to shift gears. People with executive function issues find transitions tough. I’ve heard it referred to as leaky brakes. The result may be inflexibility and an inability to cope with everyday changes. This makes life draining and complicated for people who have ADHD. The thing is, this is a skill that many of us take for granted so it may be hard to understand from the outside.
Most of us are able to moderate our emotions. If you have executive function issues, an emotion like anger may be overwhelming or difficult to contain. You may also find it tough to handle criticism or manage your feelings. As you can imagine this poses a number of problems in day to day life.
One of the most common issues when it comes to executive function is commencing tasks. Do you have a tough time creating strategies and generating ideas independently? It’s difficult to start a project when everything seems like it’s coming at you all at once. This is an area that impacts relationships, career progression – virtually every aspect of your life.
This is the ability to retain information for the multi-step processes we encounter daily. People with executive functioning issues have difficulty remembering things like directions. They may also get lost when they’re working on a project. Once again, this is another area that causes problems in every aspect of life.
After a certain age, most of us are able to tell when we are acting out of context with our peers. Someone with Executive Functioning Issues may not be able to assess their own actions according to social norms. People with deficits in this area may be surprised by things that seem obvious to someone else.
Planning & Prioritization:
Everyone has to figure out how to manage events that are coming down the pipeline. If you have executive functioning issues it is difficult to organize areas of your life and plan for the future. Career and relationship progression is deeply hindered by the lack of these sort of skills.
Are your papers in folders labeled by subject, well then it’s clear your executive function in this area is in working order. Someone with executive functioning issues is disorganized and works in an inefficient manner. This is typically a red flag in school and university and prevents students from achieving academic success.
Now that you know what Executive Functions are you can see how important this set of skills are to living a happy, healthy, and well balanced life.
So what happens when they malfunction and no one takes note?
Common Executive Functioning Issues
That Are Often Overlooked
All too often executive functioning issues are overlooked, whether that be at school or later in life.
With learning disabilities such as dyslexia or color blindness, there are simple tests that diagnose the problem once and for all. In fact, Executive Function Disorder often accompanies learning disabilities so there’s quite a bit of overlap.
Unfortunately, a simple executive function diagnosis without a learning disability isn’t always as cut and dried. This is often the case with adults who have undiagnosed ADHD.
Sadly, many parents and loved ones have to deal with a lack of due process when it comes to a diagnosis of ADHD…
…and some people don’t get an official diagnosis until later in life – if at all.
Did you know that symptoms of ADHD/ADD may actually flare up after midlife! Lots of people erroneously believe these are childhood issues but that’s just not the case.
In fact, some people who have common executive functioning issues chalk them up to the normal signs of aging.
"The trouble for many adults with undiagnosed ADHD is that it can look like a lot of other mental health conditions, especially when it’s severe. “What we're discovering is that with many patients, before ADHD is recognized, they have already been given a range of other diagnoses and they're not always appropriate or correct,” says Philip Asherson, a professor of molecular psychiatry at King’s College London. “Some of the most common ones are personality disorder [and] bipolar disorder, and the other common ones are anxiety and depression.” BuzzFeed News, Missed Diagnosis ADHD
Things Aren't Always as They First Appear
If you’re involved with someone with executive functioning issues there might be moments when you think they’re simply lazy or not living up to their abilities.
They may even appear to be rude, forgetful, irresponsible, disinterested or self-absorbed.
Ugh…there are so many potential problems that face people with executive functioning issues. Relationships with parents, children, teachers, friends, and doctors are impacted. Not to mention the fact that inaccurate mental health assumptions are also often made before executive function deficits are identified.
That’s why education is so important. With a little more information the number of Adults with undiagnosed ADHD will substantially decrease. Thus enabling a plethora of people to get the help they need to live a more fulfilled life.
To get a better understanding of how these characteristics come up every day, let’s take a look at some things that are affected:
The Impact of Executive Functioning Issues On daily Life
An inability to plan and strategize for the future:
If your thoughts are scattered and you’re unable to prioritize things it will be difficult to realize your full potential. Work, relationships, and self-care all hinge on one’s ability to plan for the future.
Acting on impulse, without regard to the consequences:
People with this trait, often lose friends, injure themselves, find interpersonal relationships difficult or fail academically. This is one of the most dangerous qualities because it’s often connected to risky behavior such as drug and alcohol abuse. This actually impacts your mortality!
It’s difficult if not impossible to complete tasks if you’re distracted by other less important things in your immediate environment. Without the ability to prioritize life is very difficult. Thankfully there are ways for you to mitigate the negative impact of such deficits.
If you have a hard time with emotional control and switching gears, life probably isn’t easy for you. This often shows up as inflexibility and stymies your work progress and social life. If people are unaware of your executive functioning issues they may misinterpret your reactions as stubbornness.
If you can’t prioritize, organize and/or complete tasks you will have a tough time living a streamlined and complication free life. Maintaining your house, bills, employment, family and social life all require executive function skills to work properly.
"It is common for children and adolescents living with ADHD to develop unhealthy behaviour patterns at school and have difficulty doing well in their studies. Students may have a hard time understanding instructions, remembering what was learned, showing concern for others, sitting still in a classroom, and controlling impulse responses, among other challenges." ADHD & You, Impact of ADHD on Life
Education & Executive Function Issues
Now that you know a little bit more about the most common executive function issues and how they crop up for people who have them, I bet you can see why so many aren’t diagnosed early.
Let’s face it, these are qualities that many of us have or symptoms of other mental health or substance abuse issues. That’s why assessment and proper diagnosis is so important.
Sadly there is also a lot of misunderstanding. In fact, some even believe that the complications connected to executive functioning can be remedied by simple self-discipline.
This just isn’t the case. There are targeted therapies and medications that are life altering but it’s not a question of choice.
To be frank, nothing could be further from the truth.
Executive functioning issues are a real problem for many adults and no amount of “buckling down” is going to help without some intervention. There are solid brain-based reasons for these difficulties.
That being said, the good news is, the brain is plastic, which means there is help on the horizon!
But before you find help I think it's important to share the red flags. This will help you identify potential issues and seek help as soon as possible. Because there ABSOLUTELY is help!
Red flags Connected to Executive Functioning Issues
& a clear Path for Action
Untreated ADHD is far too common.
Part of the problem is there’s not a systematized way to diagnose it. Checklists are passed out in school and everyone from guidance counselors to pediatricians is given the authority to make recommendations.
In a perfect world, ADHD would only be diagnosed by a specialist who has a vast amount of experience in the field. I’d love to see educators and families well trained in the warning signs with a definitive path of action when they suspect executive functioning issues.
Frustratingly, there’s a general lack of awareness in schools and in homes of the red flags for executive function issues.
I feel confident with a little education and some changes in the mental health field, we’ll treat individuals who are living with untreated ADHD.
Holistic Neurodevelopment Can Help!
There is truly light at the end of the tunnel! Because of the principles of neuroplasticity, people with executive function issues can indeed retrain their brain.
Holistic Neurodevelopment will teach you some simple tools that will help manage adult ADHD and ADD!
You don’t have to accept a life with the executive functioning issues I described above. What if told you that scattered thinking, disorganization and impulsive behaviors could be a thing of the past?
Well then, it’s your lucky day, because, with dedication and some hard work, you can change your brain. Don’t continue to live with undiagnosed adult ADHD or ADD. Give Holistic Neurodevelopment a call today!
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