More Than Laziness: Executive Dysfunction

"Get up,” I muttered to myself. “Just do it.” I was lying curled up on my bed. I wanted to get up and turn off a lamp on the other side of the room so I could go to sleep, but I was stuck. I’d been telling myself to get out of bed for 30 minutes to no avail. I tried breaking it down into something smaller that I might actually be able to start. “At least roll onto your back. Do something, anything,” I pleaded with my brain. It took me several more minutes, but I rolled over. Sitting upright took another 10 minutes. I had to coax myself through every movement until I was out of bed and finally turned off the lamp, at which point it had been an hour since I’d decided I wanted to go to sleep. I truly wanted to just get out of bed and turn off the lamp, and I knew it wasn’t a very complex task, but my brain wouldn’t allow me to get started. I wasn’t being lazy. My depression and anxiety were causing problems with my executive functioning. 

Executive function refers to a variety of skills, including the ability to start, plan, prioritize, organize, and complete tasks, as well as working memory, flexible thinking, self-awareness, and emotional and impulse control. Having a deficit in these areas is known as executive dysfunction. It’s not a diagnosable condition in and of itself, but a variety of mental illnesses can cause it. These include but are not limited to ADHD, depression, anxiety, and PTSD. Someone with executive dysfunction may have difficulty starting tasks, like I sometimes do, or they may struggle with breaking a task into steps, knowing what tasks to do first, or staying focused on just one task long enough to complete it.

When somebody has a problem with executive dysfunction, it’s not a matter of laziness. Laziness is saying, “I don’t feel this task is important, so I have no intention of working on it.” Procrastination is saying, “I know this task is important and I intend to work on it eventually, but I don’t want to start right now,” and it’s usually due to uncertainty or anxiety of some sort. Executive dysfunction is saying, “I know this task is important, I want to do it and have every intention of starting, but I can’t.” 

The strategies that help manage executive dysfunction will vary from person to person and will depend heavily on the person and their specific struggles. Someone who struggles solely with initiating tasks might find it helpful to break tasks down into tiny chunks to make it feel more manageable, but for somebody who struggles with how to plan out the process of completing a task, that might not be possible. They might instead find it helpful to use an example of the already completed task so they can reverse engineer the process of doing it. 

One thing that can be helpful to anyone struggling with executive dysfunction is finding others with executive dysfunction. Others who understand your experience may be better able to provide empathetic support. Having a sense of community can help improve mood and sense of self-worth. Most importantly, try not to beat yourself up over your struggles. It’s not your fault, and there’s nothing wrong with or broken about you.