What Is Executive Function - And Why Is Executive Dysfunction So Bad for Mental Health?

Summary

Emma McAdam, a licensed marriage and family therapist, explains the significance of executive function skills in managing daily life challenges, such as ADHD, depression, and anxiety. She emphasizes that deficits in these skills can make people feel overwhelmed and ineffective, but specific strategies and interventions can improve productivity and mental health. McAdam introduces the POSITIVE acronym for key executive function skills and highlights the importance of tailored coaching, systems, and routines to enhance these skills. Ultimately, developing executive function skills can lead to better emotional regulation, relationships, and overall quality of life.

Takeaways

• 🌊 Executive function deficits feel like being stuck in the ocean, constantly battling waves.
• 🧠 Executive function involves mental skills coordinated by the brain's frontal lobe, managing thoughts, emotions, and actions.
• 📊 Deficits in executive function can manifest in ADHD, depression, PTSD, anxiety, impulse control issues, and procrastination.
• 📈 Improving executive function can provide specific, actionable solutions to daily challenges and mental health issues.
• 📚 Executive function skills include planning, organization, self-management, inhibition, time management, task initiation, visualization, and evaluation.
• 📋 Deficits in executive function can lead to shame, feeling broken, and mental health issues like anxiety and depression.
• 🔧 Executive function skills can be developed through specific strategies, interventions, and supports tailored to individual needs.
• 🧩 Identifying specific executive function deficits allows for targeted interventions and accommodations, improving productivity and mental health.
• 👥 Coaching, including executive function coaches, school counselors, tutors, therapists, and ADHD specialists, can help develop these skills.
• 🛠️ Small tweaks and systems, like using visual reminders and establishing routines, can significantly improve executive function and daily life management.

Q & A

What analogy does Emma McAdam use to describe life without executive function skills?

Emma McAdam compares it to swimming in the ocean with waves constantly crashing against you, making it difficult to get out and feeling like you're being crushed.

What are some common diagnoses related to executive function deficits mentioned in the script?

ADHD, depression, PTSD, and anxiety are mentioned as common diagnoses related to executive function deficits.

Why is it important to learn about executive function according to Emma McAdam?

Learning about executive function is important because it allows individuals to identify specific problems and develop skills to solve them, improving productivity, functioning, and mental health.

What does executive function help with, according to the script?

Executive function helps sort through information, delay gratification, manage thoughts and emotions, and decide what is most important, aiding in taking action towards goals.

What are some signs of executive function deficits as described in the script?

Signs of executive function deficits include difficulty managing time, organizing tasks, delaying gratification, and holding and processing thoughts, leading to issues like piles of unfolded laundry, overflowing email inboxes, and being late.

Who is Dr. Russell Barkley and what does he say about ADHD?

Dr. Russell Barkley is an expert mentioned in the script who says that ADHD is essentially a disorder of executive function with a high heritability estimate of upwards of 80%.

What is the acronym POSITIVE used for in the context of executive function skills?

The acronym POSITIVE stands for Planning, Organization, Self-management, Inhibition, Time management, Initiation of difficult tasks, Visualizing outcomes, and Evaluating priorities, representing different executive function skills.

How did learning about 'time blindness' help one of Emma McAdam's clients?

Learning about 'time blindness' helped the client understand their difficulty in keeping track of time, leading them to implement strategies like visual reminders, alerts, and using a visual calendar to become more productive.

What are some examples of executive function strategies mentioned in the script?

Examples include making lists, using visual trackers or apps like ClickUp, Pomodoro timers, specific routines, cues associated with incentives, rewards, and systems like body doubles.

What are the 'big three' for brain health that can improve executive function?

The 'big three' for brain health are sleep, exercise, and good nutrition, which can all contribute to improved executive function.

Outlines

00:00

🌊 Struggling with Waves of Executive Dysfunction

Emma McAdam, a licensed marriage and family therapist, compares life without executive function skills to swimming against crashing waves. She explains that many people experience difficulties with impulse control, procrastination, and reaching goals. Instead of jumping to diagnoses like ADHD or anxiety, Emma suggests understanding executive function skills, which can help identify specific problems and solutions. Executive function involves mental skills in the brain's frontal lobe that manage information, emotions, and actions toward goals. Deficits can make individuals seem lazy or disorganized, but they actually stem from issues like ADHD or other neurodiversities. Understanding and developing these skills can improve productivity and mental health.

05:02

🧠 The Importance of Executive Function Skills

Emma elaborates on executive function skills using Sean McCormick's POSITIVE acronym: Planning, Organization, Self-management, Inhibition, Time management, Initiation of tasks, Visualizing outcomes, and Evaluating priorities. She highlights a study by Dr. Adele Diamond showing that these skills improve quality of life, reduce divorce rates, and predict academic success. Without these skills, life feels like swimming against crashing waves. Developing them is like riding waves with a surfboard, making progress toward long-term goals. Emma emphasizes that the issue isn't laziness or lack of effort, but rather not knowing what skills are lacking and how to develop them.

10:05

🔍 Identifying and Developing Executive Function Skills

Emma discusses the value of psychological and academic testing to understand executive functioning strengths and deficits. These tests can be expensive but are valuable for getting necessary accommodations. She stresses the importance of getting clear on big-picture goals and identifying specific executive function challenges. Working with coaches or specialists can help develop tailored strategies. Emma shares practical examples like using visual reminders and timers for time management, or creating systems to avoid losing items. She concludes by highlighting the importance of sleep, exercise, and nutrition for brain health and executive function improvement.

Keywords

💡Executive Function

Executive function refers to a set of mental skills coordinated in the brain's frontal lobe that help individuals manage thoughts, emotions, and actions. These skills are crucial for organizing tasks, delaying gratification, and making decisions that align with long-term goals. The video highlights the importance of executive function in daily life, emphasizing that deficits can lead to challenges in productivity and emotional regulation.

💡ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is described as a disorder of executive function. It is highly heritable and affects individuals' ability to manage time, organize tasks, and delay impulses. The video mentions that ADHD is one of the most biologically predisposed mental health conditions, impacting executive function significantly.

💡Impulse Control

Impulse control is the ability to resist or delay an impulse, drive, or temptation to act. It is a critical aspect of executive function that helps individuals make decisions that are not solely based on immediate desires. The video discusses how difficulties with impulse control can lead to procrastination and challenges in achieving goals.

💡Procrastination

Procrastination is the act of delaying or postponing tasks. It is often linked to deficits in executive function, such as poor time management and organizational skills. The video suggests that addressing executive function skills can help reduce procrastination and improve productivity.

💡Time Management

Time management refers to the ability to use one's time effectively or productively. It is an essential executive function skill that involves planning, organizing, and prioritizing tasks. The video provides examples of strategies like using visual reminders and calendars to improve time management.

💡Emotional Regulation

Emotional regulation is the ability to manage and respond to emotional experiences in a healthy way. It is a key component of executive function, helping individuals handle stress and emotional responses. The video emphasizes the role of emotional regulation in improving mental health and relationships.

💡Organizational Skills

Organizational skills involve the ability to create and maintain systems to keep track of information or tasks. These skills are part of executive function and are crucial for managing daily responsibilities. The video mentions how deficits in organizational skills can make tasks like keeping up with emails or completing projects challenging.

💡Executive Function Coach

An executive function coach is a professional who helps individuals develop and strengthen their executive function skills. The video references Sean McCormick, an executive function coach, who provides strategies and support to improve planning, organization, and other executive function skills.

💡Neurodiversity

Neurodiversity is the concept that neurological differences, such as ADHD and learning disabilities, are natural variations of the human brain. The video discusses how these differences can affect executive function and emphasizes the need for tailored interventions and support to address specific executive function deficits.

💡POSITIVE Acronym

The POSITIVE acronym stands for Planning, Organization, Self-management, Inhibition, Time management, Initiation of difficult tasks, Visualizing outcomes, and Evaluating priorities. It is a framework mentioned in the video to help individuals remember and work on various executive function skills. Each component represents a critical skill necessary for effective executive functioning.

💡Accommodations

Accommodations are adjustments or modifications that help individuals manage their executive function deficits. These can include strategies, tools, or support systems tailored to an individual's specific needs. The video highlights the importance of identifying executive function deficits and implementing accommodations to improve productivity and mental health.

💡Systems and Routines

Systems and routines are structured methods for managing tasks and responsibilities. They help turn executive function strategies into automatic habits. The video gives examples, such as using a specific place to keep keys, to illustrate how systems can reduce forgetfulness and improve organization.

💡Brain Health

Brain health refers to maintaining and improving the overall functioning of the brain through practices like good sleep, nutrition, and exercise. The video mentions that enhancing brain health can support better executive functioning, highlighting the connection between physical well-being and cognitive skills.

Highlights

Emma McAdam, a licensed marriage and family therapist, discusses the importance of understanding executive function skills.

Executive function skills are crucial for managing thoughts, emotions, and actions towards achieving goals.

Deficits in executive function can manifest in conditions like ADHD, depression, PTSD, and anxiety.

People with executive function deficits may appear lazy, impulsive, or disorganized, but these are symptoms of underlying issues.

Improving executive function skills can significantly enhance productivity, mental health, and quality of life.

Executive function involves planning, organization, self-management, inhibition, time management, task initiation, visualizing outcomes, and evaluating priorities.

Sean McCormick's POSITIVE acronym helps to remember key executive function skills: Planning, Organization, Self-management, Inhibition, Time management, Initiation, Visualizing outcomes, Evaluating priorities.

Dr. Adele Diamond's research shows that strong executive function skills predict better life outcomes, including higher academic achievement and lower divorce rates.

Understanding and naming specific executive function deficits can lead to targeted interventions and strategies.

There are many practical strategies to improve executive function skills, such as using timers, visual reminders, and organizational tools.

Professional help from coaches, therapists, and specialists can be valuable in developing executive function skills.

Systems and routines, once established, can become automatic and significantly reduce daily stress.

The big three for brain health—sleep, exercise, and good nutrition—are essential for optimal executive function.

Improving executive function skills can enhance emotional regulation, relationships, and overall productivity.

Emma emphasizes the importance of small, consistent changes to develop better executive function skills.

Transcripts

It's almost like you're in the ocean, and you're  swimming, and waves just keep crashing, and you  

just keep getting stuck, and you can't get out,  right? You're just like swimming against these  

waves, and you just keep getting crushed.  That's how people are experiencing the  

day-to-day life without executive function skills.  Hey, everyone. I'm Emma McAdam. I'm a licensed marriage  

and family therapist. So here's the thing: you or  someone you know might have been diagnosed with  

ADHD, depression, PTSD, or anxiety because like  30% of the US has had a diagnosis like this.  

Or, even more likely, you might struggle with  impulse control or procrastination or getting  

stuff done. Or maybe you feel overwhelmed or  like you're not reaching your goals. And both  

the internet and professionals are quick to  give a big diagnosis like ADHD or anxiety  

or PTSD. But what if it might be more helpful  to think of it differently? What if we could  

describe the cause of your symptoms in a much  more specific, actionable way? Now I cannot say  

it loudly enough how important it is to learn  about executive function because when you do,  

you might be amazed to find out that you have a  specific name for a specific problem that has a  

specific set of skills that actually solve that  problem. So this is why we're going to talk about  

what the heck is executive function and six things  you can do to improve your executive functioning

skills. Executive function is a set of mental  skills coordinated in the brain's frontal  

lobe that sorts through information, it delays  gratification, it manages thoughts and emotions,  

and it decides what is most important. It helps  you take action toward your goals instead of just  

what you feel like doing. So yeah. It's pretty darn  important. But when you have specific deficits in  

executive function - and this can include um a full  diagnosis like ADHD, or it can be more discreet  

like learning disabilities or other neurodiversity - and maybe this hasn't been diagnosed or identified,  

um and maybe you don't have the skills to deal  with it, you might look lazy or selfish or stupid  

or impulsive or otherwise bad. You might have  a pile of unfolded laundry, or you might have  

dishes in the sink that you just keep avoiding, or  your email inbox is overflowing and you and you  

don't know where to start. Or you can't seem to get  places on time, no matter how how hard you try, or  

you can never pay that credit card off or finish  your homework. So it's is not that you don't care.  

You're not lazy or stupid. It's not that you're  not trying. You're probably exhausted from trying.  

It's that you struggle with executive functioning.  So a deficit in executive functioning underlies a  

bunch of mental health disorders and a bunch of  like adulting challenges, and this can lead to a  

lot of shame and to feeling like you're broken,  and that can lead to you feeling really anxious  

or depressed. But there is hope because you can  develop skills to address your specific executive  

function issues. So so first, I will acknowledge  that executive function is somewhat hardwired into  

our brains. So people are born with differences in  their inherent executive function. Uh Dr. Russell  

Barkley has said that ADHD is essentially a  disorder of executive function. And ADHD is one  

of the most biologically predisposed mental health  conditions, with a heritability estimate of upwards  

of 80%. But even without issues of hyperactivity  or attentiveness, some people have deficits in  

executive function that seem practically invisible.  Uh they might not be able to manage time, or one  

part of the brain might process information super  fast and the other part is average, so that leaves  

these like huge gaps in understanding that a  regular IQ test won't even identify. And this  

can make it hard to organize tasks or delay  gratification or hold and process thoughts in  

your mind. But even though executive function  is somewhat hardwired into our brain biology,  

you don't have to just accept that this is the  way things always have been or always will be.  

There really is a lot you can do to develop  executive functioning skills. So when we can  

identify specific executive function needs, we can  tailor specific executive function interventions,  

supports, and accommodations. And this is really  important to productivity and functioning and  

mental health. So basically what I'm saying is  that when you learn about this, life can be easier.  

You can get stuff done, and you can be happier. So  let's explore what executive function skills are,  

why they're so important, and what you can do to  strengthen them. And then, in the next video, we're  

going to talk about how deficits in executive  function can directly contribute to other mental  

health conditions like anxiety and depression. So  what are executive function skills? To learn more  

about this I talked to with Sean McCormick. He's  an executive function coach. So your executive  

function skills are the skills or tools that help  you reach your goals, and executive functions are  

a set of cognitive processes that you can develop  by working on those skills. So what he's saying is  

that executive function is your ability to plan,  organize, start, and finish tasks. It's like the air  

traffic controller for your brain. Your executive  function takes a big-picture view of all the  

things going on, decides which ones are most urgent,  which ones are most important, and how to solve any  

problems that come up. It's a super important  part of your ability to function, to regulate  

emotions, and to succeed. And then the processes  of your executive function can be managed by  

various skills. So Sean has an acronym for these  skills. Because there's so many different skills,  

I've come up with this acronym, POSITIVE, to help  people understand some of the skills you can work  

on. So POSITIVE stands for Planning, Organization,  Self-management, Inhibition, Time management is the  

T, the next I is Initiation of difficult tasks, V  is Visualizing outcomes or using your non-Verbal  

working memory, and then E is Evaluating priorities  so can you actually identify what the next most  

important thing is in your kind of domain of  things that feel like they're priorities. Okay.  

Why is executive function so important? There's a  major study done on executive function skills by  

this lady named Dr. Adele Diamond. And if you Google  her there's videos of her teaching the Dalai Lama  

about executive function skills. And she did this  study called "Executive Functions," and it's one of  

the most cited studies across all research  disciplines. And basically what she found in  

it were that executive function skills improve  your quality of life. They reduce the potential  

of divorce. They improve societal mental health  outcomes. And for students, they actually predict  

uh better long-term success in school, higher  rates of graduation. So executive function skills  

are highly critical for a high quality of life. So  that's the kind of fact. In the research, that's  

what it tells us. But then as an executive function  coach I've worked with so many students and adults  

who their lives were significantly impaired by a  lack of executive function skills. It's almost like  

if you're in the ocean, and you're swimming,  and waves just keep crashing, and you just keep  

getting stuck, and you can't get out, right? You're  just like swimming against these waves, and you  

just keep getting crushed. That's how people are  experiencing the day-to-day life without executive  

function skills. Developing executive function  skills is like getting that surfboard and being  

able to ride those waves and actually have a good  time, knowing that you can't ride every wave at the  

same moment but you can ride one, have a good day,  and then paddle out the next day and catch another  

good wave and make progress towards your long-term  goals. Now, most of us know that we struggle in one  

of these areas, but most people also just assume  that they are lazy or undisciplined or stupid or  

that they just need to try harder. And usually this  isn't a very helpful strategy. Um the problem isn't  

that you don't care or that you aren't trying;  it's that you don't know what you're lacking  

and what you need. So we give it a name, and then  we can tailor specific accommodations or support  

strategies to help fill that gap. Um so let me give  you an example. I was working with someone who was  

super smart and very talented and hardworking, but  he had a hard time finishing his projects. So he  

would work longer hours and do more research  and work harder and harder and still struggle  

to finish his projects. Uh finally I gave him an  assignment to write an article on time blindness,  

uh which relates to a specific executive function  deficit in your ability to keep track of time. So  

after he researched it he came back to me and said,  "Wait a minute. I have time blindness." He had never  

heard of that term, but for once he had a word for  it, and then he could learn a bunch more about it  

and learn a bunch of strategies to help him, like  setting visual reminders and alerts and timers, um  

using a visual calendar and an app specifically  designed for time blindness. And because he had a  

name for it, he started being more productive. So  with each of the areas of executive functioning,  

there are specific strategies and interventions  we can use to help ourselves. Um so for example,  

if we have a hard time prioritizing, that's an  executive function skill. We can use strategies  

like making lists, using visual trackers or apps  like ClickUp to manage tasks. Um if we have a  

hard time initiating tasks we can use things like  Pomodoro timers or uh specific routines and cues  

associated with like incentives and rewards or  things like body doubles, which is really common  

in the ADHD Community. Um here's another example:  if we get super overwhelmed by things that we need  

to do, we can use brain dumps, coaching, physical  organizers, planners, calendars, and mind mapping to  

break tasks down into small, manageable chunks. So  so it really is possible to improve your executive  

functioning. But before we jump into strategies  you can do on your own or with a coach, let's  

talk about testing for a second. So you can get  psychological and academic testing to learn more  

about your executive functioning. Um it's often  pretty expensive, unfortunately, and it's often also  

unfortunately not covered by Insurance a lot of  times. Um but if you're a student they'll sometimes  

do it for free. And these tests can be really  valuable in helping you get a better understanding  

of your strengths and deficits, but they can also  be used to help you get the accommodations at work  

or school that you need to be able to use these  skills to manage those deficits. So you can talk  

with an academic counselor or a psychologist  who specializes in these assessments to come  

to understand what your baseline is. And then  after you understand what your specific needs  

are, then you can develop skills um to help you  out. And there are a ton of small, simple executive  

functioning skills that can make a huge difference.  Um as Sean says, "Small tweaks can lead to big peaks."  

So let's talk about how. Number one: get super  clear on your big-picture goals. Like why do  

you care about this? You could have the best skills  in the world, but if you don't have a direction, you  

won't arrive at your destination. And then next we  want to help you explore specific areas where you  

struggle. And again, get as specific as possible. So  if your problem is, "I can't get my homework done,"  

replace it with um, "I don't know where to start  with my homework, so I avoid it by watching a  

bunch of TikToks." Um and you might think that your  problem is having Instagram on your phone, and and  

you might not be wrong, but the executive function  issue is an organizational skill deficit. Or you  

might say something like um, "After a brainstorm I  get overwhelmed and I don't know how to select the  

best idea for the paper." Or you might identify  a problem by saying, "Oh, I can draft the paper,  

but I hate editing it" or "After I finish it I  forget to turn it in um and I lose it" or "I miss  

the deadline." So you've got to make it concrete. So  you might need to write down your problem or talk  

it through with someone like a coach to help you  figure out what you're missing. And that takes us  

to getting coaching. So there are people trained in  helping people develop executive function skills.  

And these might be coaches uh like Sean or school  counselors, tutors, therapists, and ADHD specialists.  

And I would say just don't be ashamed to ask for  help. Uh the highest-performing athletes and CEOs  

use coaching to help them, so you can too. And then  once you've kind of identified your problem, you've  

had someone maybe give you a second opinion on  it or their outside perspective on it, the next  

thing you want to do is kind of explore executive  functioning skills for that specific area. So you  

probably don't know what you don't know, but you  can find out what you're missing. So take the time  

to make an executive function playlist on YouTube  and learn from others, or read a book or  

two. Uh there are a gazillion executive function  skills, and I I can't cover them all in this video,  

um so the third video in this series, I'm making a  big video with a huge list of executive function  

skills. And you could watch for that to learn more.  And then it's also just really important to build  

out systems and test those out and try them and  see how they worked. Um and and this includes only  

making one change at a time. Like I - like Atomic  Habits, people. Like I love it. If you haven't  

read it, read it. Um so for example, let's say um  every time I do my homework I'm going to do it  

at my desk. And when I finish my homework I have  a place to put that homework in, the red folder,  

and that folder goes in my backpack. And that  that that's a system, right? Now, this may sound  

too simple, but seriously, like systems work. Uh so  for me I used to lose my keys all the time, like  

multiple times a day. I thought this was normal.  Um I just got used to it. But when I got, when I  

got married, it drove my husband crazy. So we worked together to figure out a system where  

every time I walk in the door I just hang my keys  on a hook by the door. And this has worked really  

well. So I probably lose my keys now like once a  week instead of 10 times a day. So systems can be  

really important. And once you build out good ones,  the systems turn into routines, and they they can  

become almost automatic. They require less and  less energy over time. And then, um you know, if  

if we are looking at executive functioning, there's  the big three for brain health: sleep, exercise, and  

good nutrition. Anything that can help your brain  uh health can improve your executive functioning.  

Okay. So just to summarize: executive function is  your brain's ability to start and finish tasks,  

remember things, think flexibly, delay impulses, and  organize and prioritize things. Um some people have  

biological deficits in their executive function,  and most people also need to learn and develop  

executive functioning skills to really be able  to get stuff done and and to live the life that  

you value. So with coaching and practice you can  develop stronger executive function skills, and it  

can help you improve your emotional regulation,  your relationships, and your productivity. Okay.  

Hope you found that helpful. Um links to Sean's  channel and his coaching program are down in  

the description too, if you'd like to learn more  about that. Thanks for being here, and take care.

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