E is for Executive Dysfunction

Executive functions include the ability to make and follow plans; to control our behaviour and emotional reactions (not our actual emotions, but how we express them); and to manage our time and keep ourselves organized.

If you look at the diagnostic criteria for ADHD in the DSM-5, you will see a list of things that indicate that we have poor executive functions:

  • Doesn’t follow through on instructions and doesn’t finish projects or tasks.
  • Struggles to organize tasks and activities.
  • Loses important/necessary materials.
  • Forgets things on a daily basis.
  • Fidgets a lot.
  • Gets up and moves around when expected to sit still.
  • Makes a lot of noise.
  • Talks a lot.
  • Says things without thinking.
  • Doesn’t wait turns very well.
  • Interrupts in conversations.

In addition to these things, Executive Dysfunction often includes difficulty in getting started (initiation) as well as in switching tasks (inertia).

Some things can be learned: for example, ADHDers benefit from learning to use a planner and lists to keep track of tasks and to break down larger tasks into smaller steps.

Some things can be adapted, such as using a timer to remind yourself that you need to switch tasks.

But many things either can’t be dealt with independently or can’t be adequately managed, even with outside help. And that just ends up being really frustrating, for everyone.

One thing that ADHDers need from the non-ADHDers in their lives is support.

We need support to learn those things we don’t know how to do (and to find a method that will work for us, because often the linear structure of non-ADHD functioning just doesn’t work with our brains), and sometimes we need support to be able to do accomplish the things we can’t accommodate in other ways.

That might mean someone to do things with us.

It might mean someone to encourage us and keep us on task while we work.

It might mean someone to help us work out the steps for a big project.

And it might well mean someone to actually do the work for us, because we cannot do it ourselves consistently enough.

What’s your biggest challenge with regard to Executive Dysfunction?

D is for Disability

ADHD isn’t always a disability. It always causes difficulties for the people who have it, and part of the diagnostic criteria is that the symptoms cause distress in two or more areas of life. But no, it’s not always a disability.

Except when it is.

And that’s not me saying it’s horrible and evil and wrong or whatever, it’s me stating an objective fact.

If I cannot meet my work deadlines because my ADHD-skewed sense of time means I don’t start things until too late, that’s a disability.

If I don’t have clean clothes to wear on a regular basis because my ADHD-provided executive dysfunction means I almost never do the laundry, that’s a disability.

If I can’t maintain friendships because I always say the first thing that pops into my head and it usually offends people, that’s a disability.

If I don’t eat regular meals because I forget to eat even when I’m hungry, or because I forget I’m cooking food and ruin my meals, that’s a disability.

If I can’t maintain friendships because I keep forgetting to reply to e-mails, that’s a disability.

Many ADHDers are not disabled by their ADHD once they are receiving appropriate treatment and have found the thing they are able to hyperfocus on consistently enough to make a career in it.

Some ADHDers are disabled enough that they require support staff in order to maintain their homes and keep a job.

Both types of ADHDer (and everyone in between) are valid and worthwhile.

Don’t shy away from admitting that ADHD is often disabling. Don’t lie about it. Don’t add to the stigma of disability. Rise above that impulse and promote the idea that we are all worthy as we are, regardless of how much support we require. Push the narrative that “success” is as individual as we are, and that we should define our success ourselves and decide how we’re going to get there based on our personal abilities and disabilities.

Is your ADHD disabling? In what way(s)?