executive dysfunction
executive dysfunction

What Is Executive Dysfunction And How Can You Manage It?

Posted on August 30, 2023 by Henry Ford Health Staff
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Do you struggle to stay on task? Find yourself daydreaming in the middle of an important meeting? Have a hard time motivating yourself to complete long-term projects? Maybe you’ve left your keys in the refrigerator when you pulled out a snack to take on the road.

While some of these mishaps may be a sign of an overtaxed mind or cognitive decline, they could also indicate a problem with what mental health professionals call executive functioning.

“Health professionals use the term ‘executive dysfunction’ to describe weaknesses in the inner workings of the brain that organize our thoughts, prioritize tasks and make decisions,” explains Lisa MacLean, M.D., a psychiatrist with Henry Ford Health.

What Are Executive Function Skills?

Executive function skills describe complex processes in the brain that enable us to plan, focus, problem-solve and multitask. “These skills direct our actions, control our behavior and motivate us to reach our goals,” says Dr. MacLean.

Beginning at age 2, children develop one skill at a time, building on them in a sequence. By age 30, when the brain’s prefrontal cortex is fully developed, most people have the three key executive functions:

  • Working memory: Short-term memory allows you to focus on instructions and conversations.
  • Flexible thinking: The ability to shift between topics and adapt to your environment also allows quick reactions to unexpected changes and transitions.
  • Inhibition control: The ability to control impulses also impacts how we manage thoughts, emotions and actions.

Higher level executive functioning includes:

  • Planning: Mapping out how you’ll achieve a goal
  • Reasoning: Critical thinking that breaks down something complicated into manageable tasks
  • Problem-solving: Applying stored knowledge to solve problems you’re facing now

“A person who struggles with executive functioning may find it difficult to process their thoughts and regulate their behaviors in ways that help them achieve long-term goals,” Dr. MacLean says. “Their bedrooms and workspaces are often messy and disorganized. They tend to misplace personal items. They can get easily frustrated.”

Other signs of executive dysfunction include:

  • An inability to make decisions
  • Being easily distracted
  • Difficulty managing multiple tasks simultaneously
  • Difficulty paying attention and staying on task
  • Difficulty remembering and following instructions
  • Having trouble regulating emotions
  • Struggling with impulse control

What Causes Executive Dysfunction?

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Scientists aren’t sure what causes executive dysfunction. People who have conditions such as attention deficit hyperactivity disorder (ADHD), autism spectrum disorder and certain mental health conditions may experience delays in developing executive function skills, particularly memory, planning and emotional regulation. Executive dysfunction can also arise in children who were exposed to substances in utero.

“There may also be a genetic component to executive dysfunction, so if you have a parent or sibling who suffers from it, you may be more likely to develop symptoms,” says Dr. MacLean.

Executive dysfunction can also happen later in life from injury or conditions that cause deterioration of the prefrontal cortex in the brain, such as:

  • Alzheimer’s disease
  • Dementia
  • Epilepsy
  • Multiple sclerosis
  • Stroke
  • Traumatic brain injury

How To Improve Your Executive Function Skills

A wide range of tools can help strengthen the regions of the brain associated with executive dysfunction. A skilled therapist can help you come up with ways to work around your trouble spots.

“Cognitive behavioral therapy, where you learn to reframe your thoughts and actions, is very effective at addressing issues with time management, impulse control and emotional regulation,” Dr. MacLean says.

In addition to seeking outside support from a qualified health professional, there are several things you can do to better improve executive function, including:

  1. Set the stage for success. Design your environment to make it easier to stay on task. Put sticky notes on your computer as reminders, keep a daily to-do list or use time-management apps that allow you to schedule focus and break times.
  2. Meditate. Spending time thinking about nothing can help you clear your mind so you can focus on the task at hand when you’re working. Meditation also helps you learn how to stay in the present moment and take in your surroundings.
  3. Break down big tasks. Counter the sense of overwhelm by breaking down large tasks into small, manageable chunks. So instead of setting out to “clean the house,” break down the chore into specific tasks: sweep the floor, mop the floor, take out the trash, clean the toilets.
  4. Take breaks. Rather than force yourself to complete the job when you’re feeling overwhelmed, schedule breaks into your day. This helps you feel refreshed and more productive when you return to your desk. A good rule of thumb: For every 20 to 25 minutes of work, take a five- to ten-minute break to stretch your body, play with your dog or drink some water.
  5. Focus on sleep. One of the most important things you can do to maximize your executive function skills is to get sufficient sleep. High-quality shut-eye can enhance your focus and result in increased productivity and enhanced well-being.

If you suspect that you or someone you love is suffering from executive dysfunction, talk to your doctor or a mental health professional. They can provide you with treatment recommendations or refer you to another healthcare provider.

“The best treatment for executive dysfunction depends on the underlying cause,” says Dr. MacLean. “So working with a mental health professional who is skilled in identifying and treating executive dysfunction can make a big difference.”


Reviewed by Dr. Lisa MacLean, a psychiatrist specializing in adult ADHD treatment at Henry Ford Behavioral Services in Detroit. She is the director of physician wellness for Henry Ford Health, using her expertise to help doctors optimize wellness and find balance by teaching them healthy coping strategies so they can better serve their patients.

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