You have probably heard the term ADHD (short for Attention Deficit Hyperactivity Disorder), but do you understand what it actually means? Many of us may have heard the term used flippantly in casual conversation, i.e. “Oh, I totally have ADHD” when talking about getting distracted. However, ADHD is a real disorder that can have serious academic, professional, emotional and relational consequences.
In my experience as a therapist, I have worked with many clients who have ADHD. Some were diagnosed as a child and prescribed medication and some learned about their diagnosis as an adult after years of struggling with work and school. In my experience, few have received support identifying behavioral strategies to boost up and compensate for impairments in their executive functioning.
So what is executive functioning, exactly?
At its core, ADHD is caused by impairments in our executive functioning.
Executive functions are a group of brain processes that allow individuals to regulate the way they interact with their environment. They are not the same as intelligence. Intelligence is the ability to understand concepts and how different concepts are related to one another.
The neuroscience related to ADHD is complex and research is constantly developing. Because ADHD research is still in early stages, there is not yet an official list of executive functions that are agreed upon, but a list of 6 to 12 that scientists have identified.
Executive functions distinguish humans from other animals. In the presence of stimulus, our executive functions stop our automatic reactions and allow us to think about our next step. For example:
In the animal world: stimulus > response
Example: Food > eat
With executive functioning: Food > I will save this for later when I’m ready for a snack
Some examples of executive functions include (not an official or complete list):
Sustained attention- the ability to focus on an intended task, in spite of distractions, internal or external, for an effective duration of time
Working memory- the ability to hold information in awareness even while performing complex tasks
Response Inhibition- Also referred to as impulse control, self-control and delay of gratification. A response to a stimulus, where the response is inhibited. For example, the ability to think before you speak or act
Planning- Developing a well-thought-out strategy before starting a task.
Organization- Developing and maintaining a system to keep track of materials and plans
Task initiation- Being able to independently start tasks, i.e. sit down to begin studying
Time management- Being able to use time efficiently to complete tasks
Metacognition- Having self-awareness about our own thinking, knowing what we know and what we don’t know
Flexibility- Being able to adapt to change. That includes going with the flow when something doesn’t go our way and problem-solving to figure out a different strategy when plan A doesn’t work out.
Perseverance- The ability to keep working until the completion of a goal.
If you struggle with some of the executive functions on this list, you may have ADHD. The first step to find out if this is an appropriate diagnosis for you is to set up an appointment for neuropsychological testing. If you are diagnosed with ADHD, there are many helpful interventions that may make your life easier, including medication, therapy and ADHD coaching.
In my next blog, we will dive into the real life consequences of untreated and misunderstood ADHD and the many impacts that this can have on our academic and career achievement, self-concept, mental health and relationships.
If you are someone struggling with managing life with ADHD, I can help. Contact me today to schedule an appointment.
Written by: Kate Loewenstein, LCSW
Sources:
Scully, K. 10 Executive Functioning Skills: The Ultimate Guide. Pathway 2 Success..https://www.thepathway2success.com/10-executive-functioning-skills-the-ultimate-guide/
Niederman, J. Providing Effective Therapy for Adult ADHD. Simple Practice Learning. https://learning.simplepractice.com/learn/course/providing-effective-therapy-for-adult-adhd/course/course-slides