What is Executive Function - How it Relates to ADHD

This is part one in a series of videos talking about managing ADHD symptoms with medication. Because ADHD can be thought of as a disorder of executive functioning so understanding this is an important lead in to making behavioral changes.

Executive function is a set of cognitive or thinking skills that are responsible for
• Planning, organizing and prioritizing
• initiating actions
• Self-inhibition
• Self-monitoring your behavior
• being able to shift your attention between tasks
• Working memory

The control for your executive functions occur in the frontal part of your brain that includes the frontal lobes and other structures such as the basal ganglia which are further down from the lobes. Executive function is also controlled by your pre-frontal cortex.

There are many conditions that could impair your executive functioning. Some of these are depression and a traumatic brain injury. A traumatic brain injury occurs when you have an injury to your head that disrupts your brain tissue. Alcohol temporarily impairs executive functioning. And if you have a stroke that occurs in the frontal part of your brain, you can have trouble with some of these functions.

The stimulant medications like Ritalin and Adderall used to treat ADHD work to increase dopamine in the pre-frontal cortex. But even with medication, many people are still left with difficulties managing some of these functions. Cognitive behavior therapy focuses on managing some of these executive skills.

Disclaimer: All of the information on this channel is for educational purposes and not intended to be specific/personal medical advice from me to you. Watching the videos or getting answers to comments/question, does not establish a doctor-patient relationship. If you have your own doctor, perhaps these videos can help prepare you for your discussion with your doctor.

[IAmCatElf]

THE BLOCK TO BEING ABLE TO DO ANYTHING!! THAT'S IT!! It literally feels like my entire being is resisting DOING anything!!

[b_ferg]

The beauty of having ADHD is that you don't need to remember if you're always late or unreliable. People all around you will constantly remind you of that.

[sandyposs]

As someone with severe ADHD, nothing makes me feel doomed to suck more than seeing all my limitations laid out so clearly. It feels like the odds are stacked against me from the start in everything I do and in every way I try to be a good adult. And the worst part is feeling like you're letting everybody down all the time, every time you lost track of time and start work late, every time you drop the ball and do none of the things on your to-do list, every time you should have done something but never got started. Because most of the time when people do that, it's seen as a moral failing or a failure of character - being too lazy or self-absorbed to care. But I DO care. I'm trying so hard. :'(

[natetheguitarteacher]

Executive dysfunction has basically ruined my career opportunities so far. Despite having the talent and the ambition required, I cannot get my brain to do the work necessary to finish projects. I also have depression, which exacerbates the issue further. When I was younger, even up until my mid 20s, I had the ability to use my procrastination as a tool (e.g. having that last-minute flash of inspiration that allowed me to finish projects or study for exams with very little time remaining until the deadline). These days, I find myself unable to do that, because the "fight or flight" response doesn't even kick in ... it's as if I'm numb.

[Sarappreciates]

No matter how it's explained, unmedicated ADHD all too often makes me feel like a damn child. I spent most of my life not knowing what was wrong with me, finally accepting that I wasn't meant to succeed at anything. When I do succeed I'm often left feeling exhausted rather than any sense of accomplishment. Not even a paycheck motivates me. Here's where it gets dangerous: having to show up for my routine oncology appointments. I swear, ADHD could easily be the death of me.

[KataisTrash]

Initiating actions is my biggest issue with ADHD. That description of just having a "mental block" is exactly what I ran into for years and years, where I could only do things under very high pressure. And without that pressure - I'm wasting so much energy just trying to get over that block; instead of actually doing what I'm supposed to do. Its just frustrating.

[normairisflores]

When I was diagnosed with ADHD I realized that all the “qualities” I have are actually how I controlled the disease. I keep lists, over prepare for projects of any kind, always have a plan b, always are very punctual because I make it a mission. In between all these qualities, I procrastinate, retrace every step to see if I forgot something, and if I don’t leave my keys or my bank cards in the same place, I will spend a while looking for them because I have no recollection. I am also not good with names or dates, which is embarrassing when I meet someone I actually already met.

[sgillman]

I really wish the name of this could be changed to something like executive disorder, because people seem to think it just means "you can't pay attention", making them think it's not even real

[Xenro]

"Yesterday is forgotten and every day is just a new day". My lord, does this resonate with me. I keep telling people "hey, my memory is pretty bad... I can remember obscure stuff about hyperfixations from 10 years ago, but I cannot tell you what happened yesterday, or even 20 mins ago."
I'm on the autism spectrum and both my GP and psychiatrists reckon I'm also afflicted with ADHD, so yay :(
Why does everything have to be so damn hard D:

[JohnGeorge-pwxo]

I was severely traumatized years ago as a teenage, got diagnosed with ADHD. Spent my whole life fighting ADHD. I suffered severe depression and mental disorder. Not until my wife recommended me to psilocybin mushrooms treatment. Psilocybin treatment saved my life honestly. 8 years totally clean. Never thought I would be saying this about mushrooms.

[jackiemasek]

You managed to describe ADHD extremely well in under 7 minutes that everybody can understand easily. That’s something all the books I’ve read on the subject hasn’t done. Bravo! I also love your calm, rational, yet easy going attitude. I look forward to Part 2!

[lasphynge]

I have ADHD and my short term memory is so bad that before I was diagnosed, I thought I might have early onset Alzheimer's or something similar. It's a really frightening thing to have your brain escape your control and fail you, to be painfully aware of it happening, but still be completely powerless about it. My ADHD is well compensated and scaffolded for the most part, but short term memory is by far the most crippling thing for me. It's not just about having a calendar and reminders in my phone, it's about holding information long enough to perform a simple mental task like basic math or even remembering my point all the way through pronouncing a sentence. When I write, everything stays under my eyes permanently, so I can articulate my thoughts and still seem like a decently intelligent person, but I feel less and less able to speak coherently because I keep forgetting what I was saying or answering to... when that happens, I can only hope the poor person trying to follow me will kindly repeat it for me... for the umpteenth time... and not everyone knows I have ADHD. Some repeat for me, some don't, some mock me, some roll their eyes, some assume I don't actually try or care and resent me... It's subtle, but it's like a thousand small humiliations throughout my day. And I'm powerless.
I was initially hoping to get a medical appointment this spring and ask to try ADHD medication, but with the current pandemic situation... I kinda want to leave the doctors to those who need them more urgently, so to speak. I consider myself lucky that remote work makes for more written communication and no more stress about getting ready and commuting to work in time in the morning, I manage much much better these days... but whenever things start to settle, and/or when I eventually have to go back to the office, I'd really like to get some help.

[janets]

This is slightly off topic, but you’ll never guess where I’m watching your video today. I’m in a locked psych unit. They took my clothes but they have let us have our cell phones because of the whole no visitors/covid thing. Things fell off the rails and they have to jiggle my meds around a bit. Thank god for wifi! I’m so glad I didn’t miss an episode. A friendly face in this scaaaary place.

[SSoulDiamond]

I love how the adhd videos are so short. If they were longer I'd lose so much of the information.

[lizericsonn]

My executive function was so broken I spent six hours needing to get up and get water and couldn't make myself get up and get some. That was the point I got help. Diagnosed with severe ADHD and the meds changed my life. I can suddenly just think of something and then just get up and do it, just like that. I am 45 and in my whole life I have never been able to just think and do, everything I ever did needed mental motivating.

[succeedingwithmentalhealth]

I want her to have 1 million subscribers ❤️

[austinmifsud]

I have never had so many 'aha moments' back to back than while watching your videos of ADHD. I never knew that my procrastination and poor planning or time sense were part of a poorly functioning frontal cortex. Things make more sense now. Thank you so much for making this information easily accessible for us.

[ragnakak]

I wish I had received help for this so long ago. I'm 38 and just got tested this year. My whole youth is gone with nothing to show for it.

[johndredge]

I feel so seen while watching this. Thank you, Dr. Marks.

[myaebanks]

I was just diagnosed with adhd combination add at the age of 25. Now that I’m medicated, it has helped me monitor my behavior and how long it takes me to do stuff. I keep track of all of this and plan my week ahead of time. Sometimes I don’t follow through with certain tasks because I spent too much time on one. I also realized that it’s hard for me to complete 3 different tasks a day. So I limited it to 2 and have a day where I just don’t do anything. I get up on time and don’t go back to sleep. I take shorter naps and I’ve been turning in my homework in time! Even though it takes me a whole day to to an assignment that most people can get done in 3 or 4 hours. And this just reminded me to ask for more time on assignment lol.