Yes, People With ADHD Often Struggle With Executive Dysfunction

People with ADHD may struggle with memory, cognitive flexibility, and impulse control. Here's how to manage executive dysfunction and other ADHD symptoms.

Learn more about our Clinical Review Process

Executive functioning skills are the cognitive skills that allow us to go about our business on a daily basis. “These processes include planning, organizing, and switching between tasks,” says Cecilia Masikini, MT-BC, Creative Arts Therapist with Charlie Health. We often take these skills for granted, but executive function challenges can make it hard to manage thoughts, emotions, and actions, affecting daily life. For example, people with executive dysfunction might be easily distracted when working on certain tasks or have a habit of forgetting appointments and important dates.

Anyone can experience executive dysfunction symptoms, but it’s more common among people with neurodivergent conditions like attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) or in people with a traumatic brain injury (TBI). Below, we review the leading symptoms, causes, and treatment options to help people with ADHD manage executive dysfunction and improve their overall quality of life. 

What is executive dysfunction ADHD?

ADHD is a neurodevelopmental condition involving persistent patterns of inattention, hyperactivity, and impulsivity. Symptoms vary by person and type of ADHD, but the condition typically causes challenges with focus and attention. Executive dysfunction isn’t an official symptom of ADHD, but research shows it’s common for people with ADHD to experience executive function challenges. In fact, some research shows that anywhere between 30% and 70% of adults with ADHD struggle with these skills. 

“When executive functioning is impaired, a person may struggle with things like procrastination, forgetfulness, impulsivity, time management, and motivation,” says Masikini. Here are some examples of how ADHD may impact executive functioning:

• Working memory: Also known as short-term memory, this helps people remember information like their home address or where they left their phone.
• Cognitive flexibility: Cognitive flexibility is the ability to adapt to new situations. Without it, you may struggle with switching tasks or adopting different perspectives. 
• Problem-solving: This helps people follow directions and solve complex problems. Without this skill, you may feel overwhelmed by information or make simple mistakes.
• Inhibition and self-control: This helps people regulate their thoughts, behaviors, and emotional responses. A lack of self-control may lead to impulsive decisions or unhealthy habits.

Executive function skills begin to develop during the first few years of life and continue maturing through adulthood. But for people with ADHD, it’s common to develop these skills at a slower pace. According to the 30% rule, having ADHD means you may develop skills such as planning, time management, and self-control 30-40% later than people without ADHD. 

What are executive dysfunction symptoms?

Executive dysfunction refers to a range of symptoms that affect people’s ability to complete tasks and interact with others. Interestingly, executive dysfunction shares many of the same symptoms as ADHD. Some of the overlapping signs and symptoms of ADHD and executive function challenges include: 

• Trouble paying attention 
• Difficulty with impulse control
• Trouble managing emotions
• Difficulty remembering things or retaining information 
• Trouble starting tasks or switching from one task to another
• Difficulty completing long-term projects 
• Trouble with time-management 
• Easily distracted and often forgetful

What causes executive dysfunction ADHD?

ADHD and executive dysfunction are both associated with brain structure and development. Research suggests that ADHD affects the brain’s prefrontal cortex, which is responsible for executive functioning. This area of the brain is often smaller or less developed among people with ADHD and other neurodivergent disorders.

“Individuals with ADHD have lower levels of neurotransmitters between the prefrontal cortex and the basal ganglia (dopamine and norepinephrine),” says Masikini. “These lower levels of neurotransmitters communicating make the prefrontal cortex ‘less active’ compared to a neurotypical individual, resulting in things such as poor judgment, lack of impulse control, and lack of attention to tasks,” she continues.

How to manage executive dysfunction

If you’re struggling with executive dysfunction or other symptoms of ADHD, consider meeting with a mental health professional. Depending on your situation, they may suggest a combination of talk therapy, medication management, and self-help strategies. 

Without the right resources and support, executive dysfunction and ADHD can impact your relationships, confidence, and performance at work or school. These symptoms can even contribute to burnout, ADHD paralysis, and other mental health concerns.

Fortunately, therapy approaches like cognitive behavioral therapy (CBT) can help people improve executive functioning skills related to issues like emotional regulation, impulse control, and stress management. 

With CBT, people learn how to identify negative thought patterns and replace them with more positive or empowering alternatives. CBT can also help people with ADHD manage co-occurring conditions such as anxiety and depression. Some people may also benefit from medication, but it’s best to speak with your provider about the best way to address your executive functioning challenges. 

In addition to talk therapy and medication, the following strategies and resources may help people with ADHD manage executive dysfunction or improve their executive functioning skills. 

If you’d like to improve your organizational skills, consider:

• Setting digital reminders for events, ranging from taking out the garbage to your sister’s graduation 
• Organizing your home or workspace to minimize distractions and clutter

If you’d like to improve your emotional regulation skills, consider

• Keeping a journal to document your emotions and how they impact your thoughts and behaviors 
• Practicing meditation and relaxation exercises to manage stress and help you focus on the present moment

If you’d like to improve your time-management skills, consider:

• Breaking projects into smaller, more manageable tasks that you’re more likely to accomplish in one sitting 
• Choosing five things that you’d like to complete each day; you may even want to start by tackling a task that you’ve been putting off or dreading

Improve executive function skills with Charlie Health 

Managing ADHD and executive dysfunction is possible with access to the right resources, strategies, and support systems. Charlie Health’s personalized virtual Intensive Outpatient Program (IOP) offers mental health treatment for people dealing with serious mental health challenges, including issues with attention, focus, and impulse control. Our team of expert clinicians incorporates evidence-based therapies into individual therapy, family therapy, and group sessions so that you can feel supported throughout your recovery process. Fill out the short form below to get started today.