What are the biggest challenges with ADHD? How do these challenges relate to executive functions?
Struggling with executive functions—skills that help with complex cognitive tasks—can make many aspects of daily life more challenging for people with ADHD. Phil Boissiere names five challenges, each relating to a specific executive function.
Let’s look at these five ADHD challenges and how they can disrupt your day-to-day life.
Challenge #1: Maintaining Emotional Equilibrium
One of the biggest ADHD challenges is that affected people often struggle to regulate their emotions. This means that if you have ADHD, you might find it harder than the average person to recognize the feelings you’re experiencing and moderate their strength.
According to Boissiere, difficulty regulating emotions can cause problems in numerous ways—for example, strong emotions can lead you to act irrationally and impulsively. Having poor emotion regulation can also make you feel like you’re not in control of your feelings or actions.
For example, say you’re at a party with friends, and you start to get overwhelmed and frustrated trying to focus on the people you’re talking to because of all the conversations happening around you. Then, one of your friends makes a joking comment about your inability to stay focused on a single topic. Rather than taking the comment lightly or ignoring it, you react impulsively, raising your voice and getting defensive. Your heated reaction sparks an argument, and soon the party atmosphere becomes uncomfortable.
ADHD-specific struggles with emotion regulation connect back to the prefrontal cortex. The PFC is responsible for mediating the intensity of emotions, while the emotions themselves come from a part of the brain called the limbic system. Since the PFC doesn’t typically work as effectively when you have ADHD, the emotions coming from your limbic system run unchecked.
Challenge #2: Making Plans and Prioritizing
According to Boissiere, another hallmark challenge of ADHD is difficulty keeping your life organized and making plans. When you’re unable to properly plan out the tasks you must complete—work projects, household chores, and so on—they feel more overwhelming, provoking anxiety. Feeling anxious makes it more likely that you’ll procrastinate on the task, which can lead to missed deadlines, work backlogs, and a continuous cycle of overwhelm.
For example, say you have friends visiting next weekend. You need to clean your house before they arrive. You also know you’re going to have a busy week at work, and you struggle to plan time into your schedule to complete your household tasks. Every evening, you’re tired after work, so you tell yourself that you’ll do the chores the next day. By the time Friday arrives, you’re overcome with anxiety when you realize that you’ve done none of the chores and your house is messier than it was earlier in the week. Because you procrastinated, you have to spend almost all night after work cleaning, so you’re exhausted by the time your friends arrive.
Boissiere explains that ADHD can also make it difficult to decide which tasks to do when, meaning that people who have it often spend their focus and time on the wrong things. When you’re not allocating your time well, you may feel like you’re constantly running behind, making it even more difficult to decide which tasks are most important. Instead, you address tasks as they come to you, regardless of how urgent they are. Thus, your most important tasks can get left behind in favor of those right in front of you.
Challenge #3: Forming Memories Through Focused Attention
Boissiere conveys that ADHD affects memory formation as well. ADHD makes it difficult for people to focus their attention consistently on the right things, and memories can only be formed when you’re paying attention. Memory begins with awareness of your subject, and then the information moves from working memory to short-term memory and finally to long-term memory.
Boissiere explains that working memory, an executive function, involves recalling information about the task you’re currently doing, without which you’re unable to finish the task. For example, if you’re cooking, you use working memory to recall which steps you’ve already completed and which ingredients you’ve already put in, so you stay in the right place in the recipe.
Boissiere adds that distraction and switching between tasks weaken working memory. People with ADHD often become distracted easily and thus struggle with working memory, making it more difficult to complete tasks. For instance, you might get distracted by something on the TV while cooking and forget that your food is on the stove until you smell it burning. Then, the dinner you made is ruined, your house smells like smoke, and you have to spend extra money on takeout.
Challenge #4: Pausing Before Acting
Boissiere names poor impulse control as another common ADHD challenge. Impulse control involves stopping, considering your options, and choosing the best action in a given situation. Executive functions are necessary for this process to work, which is why people with compromised executive functioning (as in people with ADHD) struggle to manage their impulses. This can become problematic, as impulsive behaviors aren’t the best responses in most circumstances.
Impulsive behavior typically looks like this: Something happens that provokes an emotional response. You react immediately without considering the possible consequences of your actions. Then, you must face those consequences, no matter how unpleasant they are.
For example, say you get a notification that your favorite clothing brand is releasing a limited-edition jacket. Without considering the cost, you immediately order the jacket using your credit card. A couple of days later, you see the charge on your credit card statement and feel overwhelmed by how much money you’ve spent. Now your budget for everything else this month needs to be overhauled, and you have several hundred dollars more debt than you did before.
Challenge #5: Being Cognitively Flexible
Finally, Boissiere names low cognitive flexibility as a common challenge for people with ADHD. Cognitive flexibility is what enables you to move between different tasks, jump from old to new ideas, and engage with multiple concepts at the same time.
Shifting your attention from one complex task to another requires a lot of cognitive flexibility. People with ADHD commonly struggle with this, especially if they’re emotionally invested in the original task.
To illustrate the challenge of low cognitive flexibility, let’s return to the scenario in the previous example: When your partner comes in, you’re working on a project for your job that’s due the same day. Doing well on this project could get your supervisor’s attention and set you up to take on more responsibility, which is what you’ve been working toward all year. You train all of your focus and attention on the task of finishing this project and your hopes for it. When your partner interrupts, they introduce a new task, whether they’re asking you to do something or they just want to talk. Your brain struggles to shift between your project and your partner’s task, and this struggle manifests as irritation.
Low cognitive flexibility can also make everyday problem-solving difficult. If you have ADHD, you may struggle to think of multiple solutions for a problem because your brain gets stuck on one idea.
