What is Executive Dysfunction?
Not many people may have heard of executive dysfunction, I had not heard about it until I was researching further into my depression and after many tests by my psychologist. Now I know my inability to master the art of brushing my teeth or washing the plates and cutlery can be placed into this dysfunction.
It is a symptom of depression, and it affects the front of the brain. Executive dysfunction is more pronounced in those with neurological disorders and can impact daily life to such an extent the basics we all know, go out of the window. As a result, you cannot perform the simplest tasks.
I, for one, suffer from this, and I have to have lists, because my memory is so poor, and my cognitive abilities have been impacted by some serious medication over the years. So I’ve had all the brain scans and psychological assessments, and there is a reduced functioning in my ability to plan and achieve tasks based on executive dysfunction.
So What Is Executive Dysfunction?
Executive dysfunction is the inability to plan, organise, set goals, manage one’s self and solve problems, I am impaired when it comes to goal setting and planning, I used to think it was laziness, but it is not; I have a problem which is invisible and looks like laziness but is in actual fact a dysfunction in the prefrontal cortex of the brain.
Normally in a healthy brain, you can plan your day, find it easy to pop to the bathroom to brush your teeth and so on. But with executive dysfunction, these things are a mountain to climb. If you combine this with mood disorders and the fact depression can cause ED because of the lower levels of neurotransmitters such as serotonin and dopamine. You can see why it would impact daily life severely.
In a study looking into ED the researchers found:
Executive dysfunction can accompany mood disorders as well as other psychiatric conditions. Patients may misrepresent their symptoms as related to memory, even though the primary problem is in attention and executive functioning. Screening for depression should be included as part of the neuropsychological evaluation…NCBI
With depression because of the decline in neurotransmitters, when a person says they can’t get out of bed, it is not because they are lazy. It is because they have executive dysfunction.
How Can You Cope With It?
After I had my tests from the psychologist and my results came back, she had provided me with pages and pages of ways in which I can help myself, and in a nutshell, that took me a long time to crack, it turns out to be lists. And using SMART goals, which stands for Specific, Measurable, Achievable, Realistic and Timely.
My whole day is spent working from a list, not to say it is a perfect system. It is not as you need your brain to function to a certain extent to plan the list and understand the concept of what you are trying to achieve. This is a problem when my depression is very severe. However, when it is just lingering in the background or stable with my bipolar, I can work from the list.
Executive dysfunction is a burden on my life, however with my medication for depression and bipolar disorder, therapies in various colours and shades, my lists, I can get through the day, Not like the average person, but in my own way.
If you know of someone who also suffers from this or who experiences brain fog, then the following will be of use to them, and if it is yourself, then I hope my experiences and knowledge will help you.
- Use SMART goals to break down the day into bite-sized chunks. For example, the goal could be to brush your teeth. There a lot of steps in this process, so you need to break it down. The Specific is to brush the teeth, so they are clean and fresh. The Measurable is they will look clean and feel clean with a swipe of the tongue. The Achievable is the act of doing it. The Realistic is that this can be done and is not pie in the sky thinking. Finally, the Timely is you set your phone’s stopwatch to two minutes to achieve it in.
- Your list will look something like this: 1. Go to the bathroom. 2. Check your toothbrush is charged if electric, check you have enough toothpaste, organise what you need onto the bathroom sink. 3. Add toothpaste to the brush. 4. Set your timer. 5. Begin to brush until 2 minutes has elapsed. This may sound very simple to a person without executive dysfunction, but it is necessary if you suffer from it. Sometimes just getting out of bed or off the sofa needs to be planned!
- To make a list easier, you can add it to something you enjoy; for instance, there might be a two-minute song you love, so brush your teeth in tune with the song. Or, if you need to do the dishes, put some music on or set your phone up to watch a video while washing the pots and pans. It helps you stop thinking about the task at hand and releases feel-good chemicals in the brain, which helps alleviate some dysfunction.
- Also, think of alternatives, I for one, use wipes a lot if the process of having a bath is too much for me. I have packs of wipes in the bathroom and by the side of my bed. I have many problems with baths, not just because of my executive dysfunction, but I also have arthritis in my feet, and it can be painful getting in and out of a bath. Sometimes I have to wipe everywhere to stay clean; it works for babies, so why not me.
- Also, remember it takes time to get out of depression, and you need to be kind to yourself, don’t throw too much at yourself; even if you have only cleaned your teeth today, then give yourself a well done as this is a huge effort and a goal achieved. Be patient and kind to yourself.
I hope this article has helped you understand what executive dysfunction is and how best to cope with it. I know it is not easy to admit that the simplest of decisions can be difficult, but depression has this effect to a lesser or higher degree on anyone who actually suffers from it.
If you have any questions or you would like to share your thoughts please leave in the comments section below.
Peace & Blessings