By: Stacy Pellettieri, LCSW-R
Clinical Director and Founder
What most people know ADHD to be is an impairment in one’s ability to focus and to remain seated. Simply put, when we think of ADHD we think of the child that exhibits an exuberant amount of energy and can’t pay attention. Although this is accurate, it really is just scratching the surface.
What most people don’t know is that ADHD is an impairment in executive functioning. If you have a child, spouse, family member, friend, or coworker with ADHD and you aren’t sure what this means then it’s time to learn! Understanding ADHD and ALL of its symptoms will not only help you to support your loved one, but will enable you to cope with how difficult it can be to remain patient and calm.
So what exactly are executive functions? Executive functions are mental or cognitive abilities to create and follow through on goals. We’re talking about emotional regulation, time management, self awareness, motivational levels, problem solving, self control (or impulsivity) and memory. The frontal lobe of the brain monitors and controls these major functions. The ADHD brain does exhibit an impairment in some or sometimes all of these functions.
- Emotional Regulation: Learning to use self awareness, self control, and memory to take control of how we allow our thoughts to make us feel.
- Time Management: The ability to plan the timeliness of your actions and to plan ahead to complete tasks.
- Self Awareness: Self direction; an ability to pay attention to and be in control of one’s actions
- Motivational Level: The ability to push one’s self to engage in and complete a task
- Problem Solving: The ability to take the information in our mind and find different ways to use this information to complete a task or overcome an obstacle.
- Self Control or Self Restraint: The ability to inhibit one’s impulses
- Memory: How we hold things in our mind, coupled with our ability to picture things and talk to ourselves (inner monologue).
Let’s examine for a moment what this actually means in terms of daily functioning for an average teen. Consider the case where there is some impairment in all of the above mentioned functions. What would this look like? This individual is a teenager in high school and he has a research project to do about what college he would like to go to. The thought of college makes him anxious. Where will he get in? Is he ready to go away? Will it be too hard? How will it feel to start something new? The amygdala, the part of the brain that regulates how thoughts make us feel, is very easily triggered in this ADHD brain, thus, this particular individual is easily upset by this. These thoughts make him anxious. He has a hard time regulating his emotions and as a defense, avoids the project for the time being so that he doesn’t have to endure the intensity of emotion he is feeling from these thoughts. In the back of his mind he knows that this project is due at some point, however, he struggles with management and organizational skills (another executive function), therefore, he is unable to come up with a system to remind him about the project. Furthermore, he also has an impairment in time management. What does this mean? It means he is not able to plan ahead as to how much time he will need to do said project and plan accordingly. This means he is likely to do the project at the very last minute without the ample time needed to get it done efficiently. Oh and that’s not all. This student also has an impairment in the function of memory. So, in addition to lacking the emotional stability to endure the subject matter, the organization and time management skills to set reminders and plan ahead for the time that will be needed to get it done, he also will likely forget about the whole thing! Now picture this…it’s the day before the project is due. The teacher reminds the class that this project is due tomorrow. Now our student is freaking out! He has baseball practice after school until 6:00. By the time he gets home and showers and sits down to do the project it’s after 7:00. What does he do? Without the proper problem solving skills, time management skills, emotional management skills, and organizational skills he is challenged by this task and struggles to muster up the motivation he needs to even get started. Can we blame him? Imagine what motivation you would have with all this going on! And don’t forget the most commonly known symptoms, attention, focus, and hyperactivity. Now we have a student with an impairment in focus and the ability to sit still having to endure hours worth of homework in one night? Noway! He knows what a struggle that is going to be. The torment of having to sit there and focus and organize himself to get the work done triggers the amygdala (the center for emotional regulation) and he just shuts down. It must be so hard for him to find motivation. This is all so much work. Plus, our student lacks the self awareness (another executive function) to understand all of these things about himself. He is just overwhelmed.
For the typical student, getting from point A to point B is a straight path. For the ADHD student, as you can see, there are so many curves and obstacles in his or her path. The journey is both emotionally and physically exhausting. As a parent, you might often find yourself feeling frustrated and possibly angry. As the caretaker or loved one of someone with ADHD, understanding the true nature of these symptoms helps to regulate your own emotional responses. The frustration or anger you may experience could very well stem from the beliefs you have about the individual’s behavior. If you believe they can control their actions or that it is a choice that they make it is very easy to become reactive and even to take it personally. Due to the lack of motivation and ability to remember or organize, the individual with ADHD is often falsely seen as lazy or as if they just simply don’t care. This is not the case. Understanding the neurological process taking place, which cannot be controlled, helps us to understand the behavior rather than to judge it. Punishing this behavior is not going to fix it. The individual struggling needs the self awareness and the tools necessary to work within his or strengths to become successful and reach life goals.