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What Exactly Is Executive Dysfunction?

Let’s explore this symptom common in ADHD, autism, depression, and many other mental illnesses.

Dirty dishes and food wrappers pile up on my coffee table. My sink overflows with cups, plates, and silverware that desperately need washing. Unclean laundry spills out of the top of my hamper and onto the hardwood floor.

These are all things I keep meaning to do. Logically, I know I should do them, and soon. The time during which it’s socially acceptable for my apartment to look like this is running out. Or maybe it already has run out. To my brain, that time seemingly has no endpoint.

Having a mental illness, especially multiple comorbid conditions as I do, means waging a constant battle against your own mind. I have to fight my brain when it tells me I should cry because I randomly start missing a friend from high school who turned out to be an asshole. I have to fight my brain when it tells me to have a panic attack because I have a doctor’s appointment in two weeks. I have to fight my brain when it tells me that nothing is worth focusing on and that scrolling through the same three apps all day is a productive use of my time.

But the hardest fight of all is the one wherein my brain actively prohibits me from simply doing. It becomes nearly impossible to just start. My brain viciously works against itself to prevent me from… well, anything.

If I had to give this paralyzing inconvenience, this unproductive nightmare a name, it wouldn’t be something scientific like “executive dysfunction.” But that’s exactly what it is.

And it’s hell.

I choose to picture executive dysfunction like it’s a video game.

Imagine saying to yourself, “Okay, I need to do the dishes.” So you head over to the kitchen sink, but you’ve reached a roadblock — you have to be level 8 to do this task. You’re currently at level 7, so you decide to grind for a while by doing something else to gain enough experience points to level up. By the time you do that, you return to the sink, which now says you have to be level 9 to do dishes. So, you grind some more, only now the sink says you need to be level 10.

And so it goes, on and on, forever.

You know that it’s a part of your own brain that’s doing the blocking, subconsciously deciding what level you need to reach to accomplish certain tasks, and preventing you from starting this simple chore. But you just can’t get past it. There are no cheat codes for this game.

You look around at other people who can do the dishes whenever they want or need to. They’re always at the exact level they need to be at, a level you could never reach.

It’s like everyone else has mastered the game, but you can’t get past the tutorial.

It doesn’t just happen with chores like doing laundry or washing the dishes. I have the potential to get “stuck” doing just about anything, even things I love and look forward to doing.

Sometimes I tell myself, “You know what? I bought that game ages ago, so I might as well start playing it.” But then I just get stuck somewhere along the way, and I just. Can’t. Start.

It gets to the point where I hate my brain for not letting me do what I want and need to do. I start wishing that I could be normal for once.

So, why exactly do some people have trouble getting around to doing certain tasks like this?

The frontal lobe is responsible for executing tasks like organizing, planning, time management, and paying attention to small details. So, when a mental illness negatively impacts this part of the brain, it results in various difficulties performing these tasks.

ED may present itself in other ways, such as:

If you’ve ever visited a friend who has one of the aforementioned mental illnesses, you may have noticed that their place can look a little disorganized, to say the least. Mine certainly does.

People with ADHD often forget to clean. We’ll place something down on a rapidly growing pile on our desk, chair, or bed, proclaiming we’ll “get around to it later,” but later never comes.

Of course, sometimes we also mean to tidy up, but ED keeps us from getting around to it.

Growing up, my parents would see my pigsty of a bedroom and ask how I could live like this. But after inhabiting it so long, I could no longer see a problem with it.

Moreover, telling me to “just clean my room” as a child got me nowhere. “Cleaning my room” was too nebulous a task; there was no clear starting point, no steps for me to follow. As such, I essentially never did it. I guess that’s why I spent so much of my childhood grounded.

My story has a happy ending, at least for now. Last summer, I visited my primary care doctor with concerns that I might have ADHD. I’d been unable to focus on my work for more than a few minutes at a time, and I was downright sick of battling my own brain just trying to do my job.

He had me fill out a self-evaluation sheet, which was enough for him to formally diagnose me and prescribe me Vyvanse.

This medication has turned my life around.

Now, when I think something like, “I need to sweep the kitchen,” I can usually just do it. No needless deliberating, no stewing in my own self-imposed guilt, no fighting my own brain. I just get up and accomplish the task.

I finally feel like a normal person, someone at peace with their own mind.

I realize that at times, ED can seem like this insurmountable Hydra-like beast. As soon you come close to defeating it, two more hurdles grow in its place. However, I wholeheartedly believe that it can be overcome with enough determination.

It’s not going to be easy. Let me get that out of the way right now. You’re actively fighting against your own brain’s inefficiency. You’re essentially trying to make your brain function in a way that it normally doesn’t.

But don’t let that deter you; it can be done. Here are some tips I’ve found that may help:

When your to-do list contains nebulous tasks like “clean my apartment” or “do my taxes,” that trips up the brain that suffers from ED. Tasks like these are too general for our minds to plan out.

Instead, it helps to break down these items into more manageable mini-tasks. I’m talking as mini as you can make them.

When I need to sweep my apartment, I don’t put those exact words on my to-do list. I instead break it up into specific chunks like:

This way, my brain sees each step that goes into accomplishing a certain task. It doesn’t get overwhelmed by some imprecise item like if I’d just written “clean” on my list.

Whatever you need to get around to doing, break it down into as many tiny steps as you need for your brain to understand it.

That’s where alarms come in. I would recommend setting the alarm and hitting the “snooze” button until the task is actually accomplished. That way, you’ll be reminded every few minutes or so. You might get so annoyed by the sound of the alarm that it prompts your brain to motivate you to do the task.

I’m the kind of person who likes creating schedules and itineraries. I don’t like surprises, so I enjoy planning out my days.

It’s often easier to get around to cleaning/paying bills/making phone calls/etc. if I incorporate some time for it into my daily schedule. For example, if I plan on washing the dishes from 3 to 3:30, then by the time 3 rolls around, I’ll feel awkward and weird if I don’t do the dishes. I’ll feel strange that I didn’t stick to my schedule.

I realize that not everyone has easy access to mental healthcare. I know I’m fortunate to have a job that provides me with health insurance and makes my ADHD medication more affordable. But if you can, I would highly recommend talking to a primary care physician about your ED. They might be able to give you some basic tips.

Contrary to what you may have heard, executive dysfunction is more than just “being lazy.” People with ED are often actively fighting against their own brains just to get basic household chores done. Believe me, if it were as easy as “stop being so lazy,” I would have overcome my ED years ago.

There is no one-size-fits-all solution when it comes to powering through ED. Everyone’s brain is beautifully different. These are just some tips that helped me. It may take some trial and error to determine the best strategy for you, but once you're able to conquer your own brain, I promise you it will be worth it.

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