Executive Dysfunction: Are Executive Dysfunction And Depression Related?

Executive functioning refers to mental processes such as working memory, cognitive flexibility, and self-regulation, which enable us to perform fundamental tasks in our day-to-day lives. Experiencing executive dysfunction symptoms may be a cause for concern and may impact a person’s ability to complete tasks. Executive dysfunctions can be linked to many different conditions or illnesses, including mental health conditions like depression. Read on to learn how to recognize signs of executive dysfunction and understand how it may be related to your mental health.

What Are Executive Functions?

Executive functions are skills that are involved in a wide variety of daily tasks, such as time management and completing tasks. They can be split into two types: those used for organization and those used for regulation. Organizational functions include attention, planning, verbal working memory, problem solving, and flexible thinking. Regulatory functions involve monitoring internal and external stimuli, exercising self-control, emotion regulation, moral reasoning, and decision-making.

These executive functions develop from around two years of age and are usually fully formed by 30. Each plays a crucial role in everyday life, which is why deficits in executive functioning can be challenging or even debilitating, depending on the severity of the issue.

What Is Executive Dysfunction?

Experiencing executive dysfunction means having difficulty with any of the abilities listed above. It may manifest as:

• Trouble shifting attention from one task to the next
• Getting distracted easily or trouble focusing
• Working memory deficits
• Frequently daydreaming during conversations, work, or school
• Difficulty with self-motivation
• Difficulty organizing or planning ahead
• Focusing too much on one thing
• Frequently misplacing school materials or items
• Experiencing problems with impulse control (snacking when trying to stick to a diet, blurting out thoughts you didn’t mean to, having inappropriate emotional reactions or struggling to regulate emotions)

Causes Of Executive Dysfunction

According to the British Medical Bulletin, executive dysfunction can have or be linked to a variety of different causes, including:

• Traumatic brain injuries
• Toxins (such as carbon monoxide poisoning)
• Vitamin deficiencies
• Alzheimer’s or dementia
• Epilepsy
• Substance use disorders
• Bipolar disorder
• Schizophrenia
• Obsessive-compulsive disorder (OCD)
• Anxiety disorders
• Depression

In general, it’s related to damage to or deterioration of some parts of the brain. It can also range widely in severity and duration or frequency based on the main cause. 

To assess the individual’s executive functioning abilities, clinicians may use a variety of tools, such as the Behavior Rating Inventory of Executive Functioning (BRIEF) and Comprehensive Executive Function Inventory (CEFI). The BRIEF is administered as an interview or self-report questionnaire that provides information about behavior regulation, emotional control, and problem-solving skills, while the CEFI is a performance-based assessment that measures executive functioning in areas such as cognitive flexibility and self-regulation. The Executive Functioning Scale (EFS) is another tool used to measure executive function and provides both qualitative and quantitative data about an individual’s skills. Whichever tool is chosen, it can provide valuable insights into the individual’s executive functioning abilities and help clinicians develop a treatment plan. Additionally, these assessments can be repeated over time to chart progress or determine if any changes need to be made to the plan.

How Executive Dysfunction Relates To Depression

Isolating the exact cause of executive dysfunction can be challenging in some cases. There are many possible contributing factors and some can be congenital or undiagnosed, making the main source harder to isolate. However, research does show that those who have depression or people with ADHD are likely to experience some level of executive dysfunction as a symptom, which might be linked to the prefrontal cortex.

What Is Depression?

Depression is more than feeling sad. It’s a mental illness that can be chronic and persistent, and it can negatively affect the way you think, feel, and behave. There are several different types of depression and many different ways it can affect a person. To be diagnosed with depression, an individual must exhibit a combination of several of these symptoms for at least two weeks:

• Loss of interest in previously enjoyed activities
• Significant fluctuations in appetite or weight
• Significant fluctuations in sleep
• Problems with planning or completing goal-directed activities
• Lack of energy
• Feelings of worthlessness, hopelessness, or guilt
• Trouble thinking or making decisions

As you can see, some of the symptoms of depression overlap with executive dysfunction symptoms. However, that doesn’t mean that someone experiencing executive dysfunction definitely has depression. There can be other factors at play, as outlined in a previous section. That’s why a mental health professional would need to take an overview of your situation and learn more about what you’re feeling to decide if depression may be the root cause. 

Treating Executive Dysfunction And Depression

If you've noticed the symptoms of executive dysfunction manifesting in your life and you've noticed some symptoms of depression as well, there may be a link. Speaking with a medical professional or a therapist can be a helpful first step in getting to the bottom of it and exploring potential treatment options if the cause is mental-health related.

Therapy is one of the best treatment methods for depression and some other causes of executive function difficulties, with cognitive-behavioral therapy (CBT) being especially effective. CBT is based on the concept that our thoughts and our behaviors are very closely linked, so it aims to help individuals learn to recognize and shift any unhelpful or flawed patterns of thinking. Over time, this type of therapy may contribute to a decrease in symptoms of depression—including executive dysfunction and emotional regulation—and improve an individual's self awareness and daily functioning.

Seeking Treatment For Symptoms Of Depression

Connecting with a mental health professional is typically the recommended first step for those who are experiencing symptoms of depression and executive function skills issues. When seeking therapy for mental health concerns like this, the most important thing is to find a provider and a format that you feel most comfortable with. For those who prefer to receive mental health support or treatment from the comfort of their own home, online therapy is one available option. 

Studies have shown online cognitive behavioral therapy (CBT) to actually be slightly more effective in treating certain mental illnesses than the face-to-face modality, though both are recognized as valid treatments. One literature review of 17 studies on the topic, likely including experimental psychology research, suggests that online CBT is more effective than traditional, in-person therapy for reducing symptoms of depression, specifically. It also notes that virtual CBT can be less expensive than in-person therapy.

If you’re interested in trying online therapy, consider a platform like BetterHelp. After filling out a brief questionnaire, you can get matched with a licensed mental health professional who suits your needs and preferences. If you prefer face-to-face therapy, you can search for providers who are located near you and specialize in the areas in which you need support, such as interference control. Regardless of the format you choose, a therapist can help you manage symptoms of mental health issues like depression, including executive dysfunction.

Below, you’ll find reviews of BetterHelp counselors who have helped people in similar situations.

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