Executive dysfunction is a symptom that happens with conditions that disrupt your brain’s ability to control thoughts, emotions and behavior. It’s common with conditions like ADHD, but can also happen due to brain damage or degenerative brain diseases. Depending on why it happens, it may be treatable with medications, psychotherapy or both.
Executive dysfunction is a behavioral symptom that disrupts a person’s ability to manage their own thoughts, emotions and actions. It’s most common with certain mental health conditions, especially addictions, behavioral disorders, brain development disorders and mood disorders.
To better understand what executive dysfunction is, it helps to know more about executive functions. The main executive functions are:
Working memory is the kind of memory that involves whatever you’re doing right now. If you’re reading, taking notes or having a conversation, then your working memory is part of the process.
Also known as fluid or flexible thinking, this refers to how well your brain can shift and move from one topic to another. The more flexible your thinking, the better you can adapt to whatever is happening around you. This also helps you react to unexpected changes in your situation.
People who are better at flexible thinking are often very creative and imaginative. This ability lets them connect concepts and ideas that might not ordinarily seem linked, which also helps with creative problem-solving.
Inhibition control is your ability to steer or manage your thoughts, emotions and actions. This is a huge part of executive function, and we’d be unable to control our impulses and thoughts without it. There are two main ways that inhibition control works:
Working memory, cognitive flexibility and inhibition control are the foundation of executive function. There are also higher-level processes that can happen, including:
Because executive functions involve so many processes inside of your brain, executive dysfunction can take many forms. Some examples of executive dysfunction include:
Experts don’t fully understand why executive dysfunction happens, or why it can take so many different forms. However, experts have linked this issue to several conditions that affect the way your brain works, including:
Executive dysfunction can also happen if there’s damage to or deterioration of the areas of your brain that contribute to executive function abilities. Some common examples of conditions or circumstances that can cause damage or deterioration include:
In general, the treatments for conditions that cause executive dysfunction can vary based on the condition itself and a person’s circumstances, health history and preferences. Because a variety of options is available, your healthcare provider is the best person to tell you what treatments are available and most likely to help you.
For the most part, mental health conditions that cause executive dysfunction are treatable, but this can vary from case to case.
When executive dysfunction happens because of a mental health condition, the goal is usually to treat the underlying condition causing it. That’s because executive dysfunction is often just one of the many symptoms that happens along with these disorders.
By treating the underlying disorder, it’s often possible to reduce the impact of executive dysfunction. With treatment, the effects of executive dysfunction are often minimal or barely noticeable. The most common treatment methods for mental health conditions that cause executive dysfunction include:
The treatments for executive dysfunction from brain damage or degenerative brain conditions can vary widely. For some of these conditions, direct treatment or supportive care can help. For others, the underlying condition may improve on its own without treatment. Unfortunately, some of these conditions aren’t treatable. Your healthcare provider is the best person to tell you what kind of treatments are available and what results you can expect.
It’s not possible to self-diagnose and treat conditions that cause executive dysfunction on your own. Because of this, you should see your healthcare provider if you suspect you have symptoms of executive dysfunction. They can either offer you treatment recommendations, such as medication, or suggest providers who can help you with other treatment options.
Executive dysfunction isn’t preventable when it happens because of mental health conditions or degenerative brain diseases.
The only ways to prevent executive dysfunction involve avoiding brain injuries that can cause it. Ways you can avoid this kind of damage include:
If you notice this symptom and it’s disrupting your life and usual activities, then you should talk to your healthcare provider. You should also talk to your child’s pediatrician if you notice they’re showing signs of executive dysfunction, especially the symptoms that overlap with ADHD or any other mental health conditions.
Procrastination doesn’t happen because of an issue or problem with part of your brain. It’s a conscious choice to delay doing something.
When you have a condition that causes executive dysfunction, the parts of your brain that control self-motivation, planning and inhibition control don’t work as they would in a person without this condition. That means it’s not something you can easily control, if you can control it at all. Because of this, executive dysfunction isn’t procrastination, laziness or simply not caring.
Yes, executive dysfunction is one of the key symptoms of ADHD. Research shows that the parts of the brain involving executive functions tend to be smaller, less developed or less active in people with ADHD. That’s why ADHD nearly always involves this symptom. It’s also a common feature among many conditions that affect people who are neurodivergent.
People who have executive dysfunction are often very — even painfully — aware of the dysfunction. How it feels can take different forms, depending on what people are doing when they experience it:
A note from Cleveland Clinic
Executive dysfunction is a symptom that experts are still researching and trying to better understand. What experts do know is that executive dysfunction disrupts some of the key functions of your brain that help you manage and control your thoughts, emotions and actions. On the outside, a person with executive dysfunction might seem careless or indifferent, but many people who experience this are uncomfortably — even painfully — aware of their struggle.
If this is something you face, then talking to your healthcare provider can be the first step to managing or even overcoming this issue. A trained provider can offer suggestions and resources that can help you. If you have a loved one who struggles with executive dysfunction, then patience, listening, understanding and support can make a big difference. With the right support and treatment, many people can learn to manage this symptom and reduce the disruption it has on their lives.
Last reviewed by a Cleveland Clinic medical professional on 06/05/2022.
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