Eli5 What is executive disfunction?
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I’m going to speak from ADHD since that’s what I have. Executive Functions are your brain’s self control motors. It’s your ability to motivate yourself to do a task, your ability to focus on a specific thing and tune everything else out, it’s your ability to assess a situation and determine what you’re supposed to be doing. Emotional regulation, impulse control, inhibition are also examples of executive functions. It’s all the things your brain is doing moment to moment to control your behavior to be aligned with your desires and goals.
In ADHD patients, all of these (and more) are impaired. People with ADHD struggle to begin tasks, we get bogged down in distractions and details, we get overwhelmed when presented with something too complicated to do as our brains fail to break it down into smaller chunks for us. We have poorer emotional control so our emotions are very intense and disproportionate to situations, we lack the ability to resist impulses that we know are harmful, we have trouble inhibiting ourselves during conversation. Etc etc. “Executive dysfunction” is how we describe the breakdown of these processes, a person experiencing it will not be able to perform actions they want to perform. Sometimes for days or weeks despite planning and making time for it every single day. The example I like is homework, when I was in school I’d get a math worksheet right? And I knew the math, I could work equations, I could look at a problem and come up with the right answer in my head. But translating that to the paper? Picking up my pencil? Focusing my thoughts to what I actually need to show for credit? Putting my pencil on the paper and actually *writing* it all? All of those tiny steps felt insurmountable. They all took an inordinate amount of effort because my unconscious brain wasn’t helping with it, it was like I’m out of gas but need to turn the engine myself. It’s *stressful* and people with ADHD often take multiple times the mental effort in order to do simple things as other people because our brains are not helping us do them. And it’s not a motivation problem. It’s not a knowledge problem. A psychologist I saw give a lecture once said it best, ADHD is not a problem of knowing what to do. It’s a problem of *doing what you know.* And that’s why reminding us, trying to motivate us, giving us things that “work for you” are unhelpful and often frustrate us. Because we know everything. We’re motivated to do it. We *want* to do it. But none of those things are what our problem is. Our problem is the *doing.* Our brains provide nothing that your brain does to help you *do* things without you even noticing. That’s executive dysfunction.
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