In an ultra-viral TikTok video, a woman lies on her couch. “I’m tired. I should shower so it’ll wake me up; if I shower, I should exercise first so I don’t have to shower twice,” intones the voiceover. “If I’m going to exercise, I should eat first; if I’m going to cook, I should have coffee first so I have energy to cook,” it continues. The video – which has almost 5m views – bears the caption: “What executive dysfunction looks like.”
Hundreds of videos have circulated through social media, pinning people’s various struggles on “executive dysfunction”. Each video follows similar themes: showing people failing to initiate tasks, growing overwhelmed by household chores or theorizing why they’re never on time.
But what is executive dysfunction? Why do people experience it, and what can be done to mitigate it? Additionally, what is executive function? We asked experts to explain.
What is executive function?
Executive function is the ability to manage and organize tasks on a daily basis, says Mai Uchida, a pediatric psychiatrist at Massachusetts general hospital and an associate professor of psychiatry at Harvard Medical School. This includes planning, prioritizing and thinking about how long a task will take you before you need to move on to the next thing. But it also includes the ability to break down larger tasks into smaller ones, being able to shift attention from one task to another, and maintaining working memory.
What is executive dysfunction?
“Executive dysfunction”, on the other hand, is not really a term used by mental health professionals. You’re much more likely to hear a professional say that a person “has difficulties with executive functioning” or “has poor executive function”, says Kristin Carothers, a clinical psychologist based in Atlanta and New York. These professionals don’t want to label anyone as “dysfunctional”, she says.
But the idea of executive dysfunction does get at a real experience that some people live with.
The obvious hallmarks of poor executive function include difficulty initiating tasks, missing or running up against deadlines, being late, and losing things. But it can also include patterns such as poor impulse control and overspending, difficulties in following through on promises, and overestimating your ability to follow through on commitments, says Carothers.
Critically, “poor executive function” and “executive dysfunction” are not diagnoses, says Uchida. You cannot be diagnosed with either of these terms, but poor executive function could be a symptom that accompanies a genuine psychiatric condition. Most often, poor executive function is associated with ADHD, she says, though “there are plenty of people with ADHD who don’t have executive functioning difficulties”. It has no relationship to intelligence. Executive functioning difficulties can also accompany anxiety and depression.
What has a negative effect on executive function?
Like most other human traits, executive function exists on a spectrum. “It’s on a bell curve, where most people are somewhere in the middle,” says Ari Tuckman, a clinical psychologist in Westchester, Pennsylvania. Executive function can also change over your lifetime. For example, “adults have better executive function than kids”, he says. It can decline a bit as a consequence of normal ageing, and those going through menopause will also likely see a greater degree of change as a side-effect of hormonal changes.
Life circumstances can also affect executive function. “If you have a bad night’s sleep or if you have the flu”, your executive function will take a hit, Tuckman says. Bouts of depression or anxiety, stress, intoxication, head injuries and being busier than usual are also influential factors.
If you normally don’t struggle with executive function but are having trouble because of temporary life circumstances – such as getting poor sleep, or being busier than usual – things should return to normal afterward. But if you have chronic, persistent trouble with managing daily tasks, to the point that it’s affecting your personal and professional life, that might be a sign that there’s an underlying issue, and you might want to see a professional, says Carothers.
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Are there ways to improve executive function?
If your ability to manage and organize tasks is made worse because of existing anxiety or depression, treatments such as therapy or medication to alleviate those psychiatric conditions will also lead to improved executive function, says Tuckman.
For ADHD, however, while taking medications for the condition can help people avoid distraction and improve concentration, executive functioning skills like “organization, prioritization, and time management are not really treated by the medication”, says Uchida.
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While there are no real treatments explicitly for poor executive function, there are strategies and workarounds that professionals recommend to help make time management easier. Many are tried and true organizational strategies, says Tuckman: “You don’t have to reinvent the wheel.” For example, set up multiple reminders and alarms for yourself, and write out on paper checklists of things to do, even for tasks that are extremely small and easy.
Reflect on and try to recognize the patterns that get you into trouble. If you have a work deadline approaching, and you know you tend to lose track of time when you open up and scroll through Instagram, try temporarily removing the app from your phone. Essentially, avoid putting yourself into situations that require more impulse control than you are able to muster, says Tuckman.
If you get overwhelmed by the size of a task and have trouble getting started, Uchida recommends finding a small amount of time you can commit to. Maybe that’s 15 minutes; maybe it’s just five. Then dedicate just that small amount of time to the task. “When the bar is low, it’s a lot easier to get started,” says Uchida, “and sometimes it’s just getting started that’s difficult.” You might find that after that first 15 minutes, you have the ability to keep going. Or you might need a break before you commit to another 15. You have to find and adapt strategies that work for you, she says.
Carothers also recommends turning to community to help you understand where you might need assistance. “Sometimes other people have more insight into your behavioral patterns than you do,” she says. “Ask a trusted friend, colleague, romantic partner for areas where they’ve noticed you struggle.” Then ask them to help you brainstorm workarounds for those specific circumstances – they might have ideas that you never learned or considered. “Strong social connections are important,” Carothers says. “Learn from the people around you.”
