Executive Dysfunction: Why You Feel Stuck (and How to Move Forward)

Do you seem to be having trouble with the following recently: difficulty with planning or organization, poor judgement and/or decisions, problems with multitasking, a short attention span, obstacles with problem solving, mental rigidity/inflexibility, and impulsivity?

If some of these resonate, you may be struggling with executive functioning.

According to an article on the NLM website that focuses on different areas of executive dysfunction, executive functioning can be divided into four components: working memory, inhibition, set shifting, and fluency (Rabinovici, Stephens, & Possin, 2015). These components affect cognitive abilities that drive goal-oriented behavior. Additional important factors include generating ideas, updating and processing information, focusing on goals, self-monitoring, and adjusting and planning behavior based on the present moment.

In executive dysfunction, these categories might show up as:

Working memory: Difficulty with decision-making, remembering a phone number, and active listening.
Inhibition: Being easily distracted, impulsiveness, repeating what you’ve just heard, and interrupting others.
Set shifting: Trouble staying on a current task, difficulty multitasking, rigid thinking, and ruminating (especially on negative things).
Fluency: Difficulty communicating in a clear, linear thought pattern, trouble finding the right words, and disorganization.

In therapy, executive functioning is commonly affected by depression, anxiety, OCD, bipolar disorder, schizophrenia, and ADHD though issues with executive functioning are not limited to these conditions.

So, what can you do to help improve your executive functioning?

Planners

Planners can help you stay on task and keep things organized. Missing deadlines or important dates can affect your quality of life, especially when job security or stability is at stake. Using a planner (or any organizational tool) helps you show up on time and consistently for what matters most.

Removing distractions and setting time limits

Removing external stimuli can help you stay focused. If the TV distracts you from finishing a task, turn it off while you work. Setting a timer can also be useful—for example, a 30-minute study timer that allows only studying helps you dedicate specific time to a single task.

Simplifying your life

Life’s complexities can feel overwhelming. Packing your schedule with unnecessary tasks can lead to decision paralysis and fatigue, to the point where you don’t want to do anything at all. When everything seems like a priority, it’s hard to know what truly matters.

Sit down with yourself and think about what you need or want to complete today. Visualize the next 24 hours. Is everything feasible? Do you actually want to do those things? Use your planner or notebook to write a list of priorities for the day, and simplify them by setting clear steps to achieve them.

Acceptance

Last but equally important is genuine acceptance. Give yourself grace. Maybe you plan to clean the bedroom but end up cleaning the bathroom instead. That’s okay—it’s not something to be disappointed or angry about. Sometimes we get bored and want to switch things up. You’re still working toward your goal of cleaning, right? Jumping around can keep things interesting.

While some level of executive dysfunction is normal, it’s important to recognize when it becomes perseverative and affects daily functioning in multiple areas. This could indicate a more serious condition, including (but not limited to) ADHD, Alzheimer’s disease, or dementia. Executive dysfunction can also occur comorbidly with anxiety, depression, and other mental illnesses. To rule out more serious issues, talk with your primary care provider or another trained medical professional for screening.

Therapy and coaching are also excellent ways to manage and improve executive functioning. Through therapy, clients can learn strategies to stay on task, focus on what matters, and change thought patterns that perpetuate barriers in the present. Please reach out to our therapist if you feel we can help you reach your goals and remove the barriers holding you back!

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References:
Rabinovici, G. D., Stephens, M. L., & Possin, K. L. (2015). Executive dysfunction. Continuum (Minneapolis, Minn.), 21(3 Behavioral Neurology and Neuropsychiatry), 646–659. https://doi.org/10.1212/01.CON.0000466658.05156.54