Executive Dysfunction in Depression & Anxiety - Do The Work!
Executive Dysfunction in Depression and Anxiety

Executive Dysfunction in Depression & Anxiety

I just can’t do the things I know that I need to do…

Sound familiar?

It’s something I hear time and time again. Something I’ve repeated myself regularly. Executive dysfunction hits those of us who live with anxiety and depression, and it hits us hard.

What is Executive Dysfunction?

First off, we all know I’m not a medical professional. You know that right? Not a doctor.

That said, I’ve lived with this shit for years, and a lot of them were years when I’d no clue what was going on. No idea that what was happening to me every day wasn’t normal. Wasn’t my fault.

Coz that is a big thing. We’ll come back to that one.

Executive dysfunction is a term for the range of cognitive, emotional and behavioural difficulties. Executive functioning is an umbrella term for many abilities including:

  • Planning and organisation
  • Flexible thinking
  • Monitoring performance
  • Multi-tasking
  • Solving unusual problems
  • Self-awareness
  • Learning rules
  • Social behaviour
  • Making decisions
  • Motivation
  • Initiating appropriate behaviour
  • Inhibiting inappropriate behaviour
  • Controlling emotions
  • Concentrating and taking in information

Source: https://www.headway.org.uk/about-brain-injury/individuals/effects-of-brain-injury/executive-dysfunction/

Depression and anxiety have been found to be associated with dysfunction in these executive processes, and an inability “to generate or implement adequate performance strategies has been postulated in depressed participants”.

Source: https://jnnp.bmj.com/content/66/2/162

Insomnia is a common symptom for both depression and anxiety, and sleep deprivation makes executive dysfunction even worse.

Some Coping Strategies for Executive Dysfunction

I know, you’re sick of hearing about it. But in all honesty, my Bullet Journal (what’s a Bullet Journal?) has been the absolute saving of me with regard to coping with executive dysfunction in my own life.

If you’re dealing with this recognised medical difficulty or disorder, please understand that it is not your fault.

Please don’t beat yourself up for not being able to do the simplest of things. The things you know you “should be doing”. Or “should be able to do”.

Stop that. Try this.

Here are some tips based on those from the U.S. National Center for Learning Disabilities:

  • Take a step-by-step approach to work.
  • Rely on visual organizational aids.
  • Use tools like time organizers, computers, or watches with alarms.
  • Make schedules and look at them several times a day.
  • Ask for written and oral instructions whenever possible.
  • Plan for transition times and shifts in activities.

To improve time management:

  • Create checklists and estimate how long each task will take.
  • Break long assignments into chunks, and assign time frames for completing each one.
  • Use calendars to keep track of long-term assignments, due dates, chores, and activities.
  • Write the due date on the top of each assignment.

In short, I manage my executive dysfunction by writing everything down. And I mean – EVERYTHING. I store and organise all that written stuff mostly in my Bullet Journal, which is a useful system for doing that. But any analogue planner that you like will work just as well. I just love the complete flexibility of the Bullet Journal.

I also have huge wall calendars, digital calendars with notifications set to give me plenty of time to work in stuff I’ve forgotten, and a series of phone alarm reminders that tell me things like “Take a Walk”, “Eat Lunch”, “Tech Off at 10pm”, and “Take Your Meds”.

My best advice though, is to start where you are, right now, and take a tiny step forward. You don’t have to get all this figured out right now. Go easy on yourself?!

Pick just one thing that you know will improve your life if you’re doing it every day, and pick a sensible time at which to do it. Transition times are a good idea – see this post for more on developing good habits.

Now, do it for 2 minutes. Seriously. Just 2 minutes – but do it every day. For a week. For 2 weeks. Just for 2 minutes, every single day.

If you miss a day? That’s ok. Just start again the next day, and rebuild your streak. Mark it on a calendar. Tick a box in your Bullet Journal. Cross it off a daily to do list. Whatever works for you to show your progress.

Because every single time you do that small 2 minute thing, you’re telling yourself that this is something you can do. You’re rewiring your brain to understand that this is something that you do. Every day.

Don’t worry about not seeing progress by only doing the thing for 2 minutes. You’re moving in the right direction. You’re 2 minutes better off than you were yesterday.

You are the type of person who can do this thing.

Take THAT, executive dysfunction.

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