How Executive Dysfunction And Depression Are Related
If you have depression or know someone who does, you might be curious about what depression is and what it means for the person experiencing it. You might also be wondering what type of symptoms come with depression and what they could mean for you or your loved one’s future. When learning about depression, you’ll want to pay attention to the relationship between it and executive dysfunction. After all, your executive functions can be extremely important to your everyday life. If you’re not paying attention to how they can be affected by depression or other mental health disorders, you could run into some challenges.
What Are Executive Functions?
First, let’s take a look at what executive functions are. These are the skills you use when trying to pay attention, multitask, or remember information. Executive functions can be split into two types: organization and regulation. Executive functions that fall under organization include attention, sequencing, planning, working memory, problem-solving, rule acquisition, cognitive flexibility, abstract thinking, and selecting relevant sensory information. Meanwhile, executive functions under the regulation umbrella refer to initiating action, monitoring internal and external stimuli, self-control, emotional regulation, initiating and inhibiting context-specific behavior, moral reasoning, and decision-making.
In short, your executive functions are responsible for allowing you to plan, organize, strategize, and manage your time better. For most people, these skills start to develop somewhere around two years of age, and by the time you reach 30 years of age, your executive functions are typically fully developed. As you can likely guess, each of these skills plays a role in your everyday life. Therefore, problems with executive functioning can be challenging or even debilitating, depending on the severity of the issue.
What Is Executive Dysfunction?
When you have executive dysfunction, it means that you have difficulty with any number of the functions discussed in the previous section. You may have trouble with only one or two different aspects of executive function, or you may have all of them. For those with these types of difficulties, this executive dysfunction is sometimes referred to as executive function disorder. However, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), this isn’t considered an official mental health disorder. Still, there are ways that executive dysfunction can be treated. Many methods are available to you that can help you either gain these skills or improve them.
What About Executive Dysfunction And Depression?
One reason that you may have executive dysfunction is depression. That’s because depression affects several areas of the brain. One of the potentially affected areas is the part of the brain that controls these skills and responsibilities. If you have damage to this area of the brain, either through injury or a congenital disability, or if the area is affected by depression, you could have difficulty developing these skills in the first place. Or, you may have trouble getting your executive functions to the level that they should be. That’s why it’s important to find out more about why and how the executive dysfunction began.
If you have had executive dysfunction for a long period, you may have an injury or some other reason explaining why you’ve never been able to accomplish these types of tasks. On the other hand, if the dysfunction is relatively recent and you’ve been diagnosed with depression, the two may be linked. In that case, working through your depression may allow you to regain some or all of your executive functions and get back to the life that you want to live with all of the skills you are meant to have.
Do I Have Executive Dysfunction?
If you live with executive dysfunction, you may experience any combination of the symptoms in the bulleted list below or experience something else entirely. Because every person is different, you can experience executive dysfunction will be different as well. Talk to your doctor and a mental health professional if you find yourself experiencing difficulty with any combination of these or other experiences not listed so that you may be able to start working toward improvements as soon as possible.
- Trouble managing your time effectively
- Difficulty keeping your things organized
- Continued loss of items
- Lack of ability to deal with frustration
- Difficulty following directions
- Difficulty recalling information
- Lack of ability to monitor emotions and behavior
- Misplacing items constantly
- Difficulty in planning and starting work or other projects
- Inability to multitask
- Difficulty with verbal fluency
- Difficulty processing, storing, and retrieving information.
- Mood swings that are hard to control
- A lack of concern for people and animals
- A loss of interest in activities that you once enjoyed
- Engagement in socially inappropriate behavior
- Inability to learn from consequences from your past actions
- Difficulty comprehending abstract concepts
If you feel like the list above (or aspects of the list above) describes you, or like you’re constantly falling behind on things that you used to be able to do, then it’s possible that you’re being affected by this disorder. Combine that with some of the symptoms of depression that we will discuss in the following sections, and you may see drastic improvement if you seek help from a mental health professional.
What Is Depression?
Depression is more than feeling sad. It’s a mental health disorder that is chronic and persistent, and depression can negatively affect the way you think, feel, and behave. There are several different types of depression and many different ways it can affect you in your life. We’ll talk about some of the symptoms here, which you may be experiencing in any combination. To be diagnosed with depression, an individual must exhibit a combination of several of these symptoms that persists for at least two weeks. A mental health professional will be able to make an official diagnosis and let you know if depression is the most likely cause of the symptoms you’re experiencing.
- Loss of interest in previously enjoyed activities
- Increase or decrease in appetite or weight
- Increase or decrease in sleep
- Lack of energy
- Purposeless activities
- Slowed speech
- Feelings of worthlessness, hopelessness, or guilt
- Trouble thinking or making decisions
- Thoughts of death and suicide
As you can see based on the two bulleted lists in this article, some of the symptoms of depression overlap with those of executive dysfunction. This is one of the reasons that the two are so closely linked in many ways. Because of depression and the lack of interest and motivation that often goes along with it, it’s entirely possible that you could start to experience a type of brain fog that makes it difficult to think.
If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached at 1-800-273-8255 and is available 24/7.
To make a diagnosis, a therapist or mental health professional will also look at several different aspects of your life and health conditions to ensure no other reason for the symptoms you are experiencing. Brain tumors, vitamin deficiencies, and even thyroid problems can result in some of these symptoms. These will be evaluated as possibilities before treatment for depression will be started in any form. In the next section, we’ll talk about the combination of therapies and treatments commonly used to treat both of these disorders.
Treating Executive Dysfunction And Depression
If you’re looking for treatment, one of the best things that you can do is seek out a mental health professional. Therapy is one of the best treatment methods for these disorders, especially cognitive-behavioral therapy or CBT, which focuses on your behaviors and how your thinking can control them. When paired with medications (and even on its own), this type of therapy has seen tremendous results. CBT can greatly improve the chances of getting back to the type of life you want to live again. Always talk to your doctor before beginning any medication.
With this combination of therapy and medication, you may start to recognize improvements in your life and how you perform different functions. If you are only interested in therapy and prefer not to take medication, that option is available. Keep in mind that your physician or primary care physician, working in conjunction with your mental health professional, may prescribe you different medications to help treat these disorders. If you decide to take medication, continue to see your therapist and put in the work for the best possible outcome. After all, medication without therapy is generally less effective than medication paired with therapy.
Before signing up for medication, though, please consult with your doctor or primary care physician first.
Finding Your Help
If you’re looking for professional help, the first thing you should be looking at is the therapists who can treat the disorders that you’re currently experiencing. You won’t have a formal diagnosis until you talk with a professional, but if you know the type of symptoms you’re experiencing, you can get an idea of what you’re dealing with and who you will want to talk to. You can start narrowing it down even further to who has the experience level and the training you feel most comfortable with.
Evidence has shown that online therapy has been proven to be slightly better than face-to-face therapy regarding cognitive-behavioral therapy (CBT). In a literature review of 17 studies on the effectiveness of online CBT or eCBT when contrasted with traditional therapy, it was found that eCBT was better at reducing the symptoms of depression. It was also noted that eCBT could be less expensive than face-to-face therapy. Online therapy for CBT can also be used effectively for other mental health conditions. People with PTSD, eating disorders, and anxiety have found relief through this type of treatment.
How BetterHelp Can Support You
BetterHelp is one way you can get the online help that you’re looking for without having to worry about going to a physical office for your therapy. You’ll be able to reach out to a mental health professional who has expertise and experience working with people who have depression. You’ll be able to communicate with them from a place where you feel completely comfortable, your own home.
No matter where you are or what you’re doing, all you’re going to need for online counseling is a mobile device of some kind and an internet connection. You’ll be able to connect to your therapy session from absolutely anywhere. That’s definitely going to make it easier and more convenient for you to get in a session, so you can work on managing those symptoms of depression and get back to doing the things you enjoy. Read below for some reviews of BetterHelp counselors from people experiencing similar issues.
Counselor Reviews
“Negin is incredible! She has created a safe space for me to be vulnerable and share my struggles with anxiety, depression, and life in general. She is very authentic and will be honest and kind with you about the hard stuff. So thankful to have been matched with her!”
“She is a wonderful human being, both understanding and insightful. Her expertise is reflected by how she approaches situations presented to her, and she offers concise help in tackling the root of my issues. I highly recommend her to anyone who is struggling with anxiety, depression, or any other issues that you may be facing.”
Frequently Asked Questions (FAQs)
What are the signs of poor executive functioning?
Executive function is controlled by a vast group of mental skills that allow people to interact with others, arrange thoughts, and complete tasks. When a person has poor executive functioning skills, they may have issues problem solving, managing schedules, selective attention spans, or challenges processing information. Executive Function Disorder is not an independent diagnosis. Its signs and symptoms are usually associated with a secondary illness or an instance of traumatic brain injury. Medical News Today explains the link between executive dysfunctions and neurological issues and the various mental health and behavioral challenges that are routinely associated with it. Medically reviewed studies explain the intersectionality of these conditions, which makes it difficult to isolate the signs and symptoms of ill-developed executive functioning. Any suggested signs are typically associated with related disorders like depression, Obsessive-Compulsive Disorder (OCD), or Attention Deficit Hyperactive Disorder (ADHD), which only a mental health professional can diagnose.
Usual signs of poor executive function include struggling with time management, difficulty remembering details, faulted decision making, and inability to multitask. Executive dysfunction may lead to problems with performance at school or work, an unstable mood, low self-esteem, or loss of motivation to perform routine tasks. Since the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not recognize executive function disorder as a clinical mental illness, there are no set guidelines to measure the deficit. Challenges may present for reasons as vast as Alzheimer’s or a traumatic brain injury after a fall, brain surgery, or head injury. To ensure that the signs of poor executive functioning you or someone you know may be experiencing are not evidence of a more serious condition, speak with a doctor for further testing and evaluation.
Is executive dysfunction a symptom of anxiety?
Anxiety is associated with a wide variety of symptoms, some of which may align with the recognized signs of executive dysfunction, but medically reviewed research does not link the two conditions. Anxiety is extremely diverse, and each person experiences it differently. The National Institute of Mental Health defines anxiety as the “persistent or excessive worry about everyday situations or issues.” While worry is a natural human reaction, anxiety disorders significantly differ in what is considered a typical response. Recent articles compare the effects of executive function, anxiety, and self-regulation. While these terms present similar definitions and share relevant consequences like altered decision making, no evidence directly associates executive dysfunction as a symptom of anxiety.
When extreme triggers are presented, people with anxiety can struggle with shifting attention from one issue to another, which makes it difficult to process executive functions such as planning and information retention. Anxiety can be distracting, prohibiting people with the disorder from paying attention to suggested treatment strategies, which can exacerbate the effects of an anxiety attack. While the effects of anxiety may appear to be cross-sectional with the signs of executive dysfunction, medically reviewed studies still regard them as two separate concerns.
What are the seven executive functions?
Medically reviewed studies have identified seven main executive functions that assist the mind with information processing and healthy decision-making skills. These fundamental skills involve adaptable thinking, planning, self-control, self-monitoring, organization, scheduling, and working memory.
Developed adaptable thinking skills help develop alternatives to everyday problems or obstacles (i.e., finding a new route to work if your usual route is under construction) with little overwhelm or confusion. People who struggle with shifting attention may have issues with managing these skills.
Healthy planning allows you to create and follow objectives for performing daily tasks (i.e., writing a grocery list and using it to go shopping).
Self-monitoring is a vital executive function skill required to safely maintain independent living, employment, or advance through school in your younger years. After evaluating your performance or decisions, people should be able to determine if they’re happy with the projected outcome. Symptoms of executive dysfunction like shifting attention make it difficult to focus long enough to perform adequate self-monitoring.
Self-control also reflects in a person’s decision-making skills. This executive function may pose considerable challenges for a depressed group, especially those who remain undiagnosed or improperly treated. It can also present challenges in children and adults with other learning or emotional disorders like ADHD and anxiety.
The ability to retain and store learned information in short-term memory impacts a person’s ability to mature and thrive. It is difficult for people to gain knowledge and skills without this executive function. Learning challenges like dyslexia may also impact memory.
Frequently shifting attention while completing a task is a sign of executive dysfunction. Inability to focus and pay attention makes it challenging to manage time, adhere to schedules, or interact with society. It also affects a person’s reaction time, leading to an increased risk of accidents or unintentional harm.
Organization references a person’s ability to arrange thoughts or materials in a cohesive, practical manner. Challenges with this skill can impact a person’s memory, storytelling, and ability to keep up with their possessions.
If any of the seven executive functions are underdeveloped or impaired, an individual may experience considerable challenges while living, working, or forming healthy relationships.
Is executive dysfunction a symptom of depression?
According to the National Library of Medicine, executive dysfunction is commonly seen in people with major depressive disorder. When surveying the symptoms of a clinically depressed group, researchers regularly noticed issues that alluded to signs of executive dysfunction. Medically reviewed studies explain how the extent of a person’s executive dysfunction varies among each depressed group, depending on the type of depression, the severity of the disorder, and how soon treatment is issued.
Neuropsychological testing proves that a depressed group experiencing declining brain function due to advanced age has much larger rates of executive dysfunction. While depressive symptoms are not considered a sole cause of executive dysfunction by any rating scale, they present a significant difference in the onset of signs associated with the deficit. Things like shifting attention, planning, organization, and decision-making challenges are frequently reported by people with depression. Since people without depressive symptoms are still susceptible to experiencing some degree of executive dysfunction, medically reviewed information cannot list depression as a cause for executive dysfunction. Studies continue to explore the connection between depression and the complication of executive skills, especially when the depression is challenged by variables including individual triggers, treatment methods (or lack thereof), environmental factors (i.e., stress, poverty, etc.), and physical health.
What is the difference between ADHD and executive function disorder?
Attention Deficit Hyperactivity Disorder (ADHD) is a developmental impairment that directly affects certain executive functioning skills. Symptoms of ADHD, such as hyperactivity, lacking impulse control, shifting attention, acting without considering consequence, forgetfulness, and difficulty organizing, can all be synonymous signs of executive dysfunction. Still, there is a significant difference between the two diagnoses.
The main difference between ADHD and executive function disorder is that ADHD has a list of medically reviewed diagnostic criteria recognized by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). According to the DSM-5, ADHD is the “persistent pattern of inattention and hyperactivity-impulsivity that interferes with functioning or development.” To be diagnosed with ADHD, the person’s symptoms must have been present before 12. They would have had to exhibit those symptoms in at least two settings (i.e., at home and school), and there must be clear evidence those symptoms interfere with their school, work, or social function.
Executive Function Disorder (EFD) is not recognized in the DSM-5, so there are no definitive criteria used to offer diagnosis or treatment. Despite the term, EFD is not a mental disorder; it is a deficit in managing daily tasks effectively. Without official regulation, professionals retain open access to the definition, signs, symptoms, and suggested treatment for EFD. While there is an abundance of medically reviewed research and material on both ADHD and EFD, varied findings prevent EFD from being classified as a disorder.
People are born with ADHD, but EFD develops and declines over time. People can exhibit signs of executive dysfunction after experiencing a brain injury, trauma, or lacking social maturity. A person who was previously proficient in all the main executive function skills may later present signs of executive dysfunction like loss of focus, shifting attention, and memory loss due to brain damage, whether from an accident, aging, or a fall. Despite exhibiting symptoms congruent with certain mental disorders, those symptoms result from damage to the frontal lobes, not a mental illness. People with executive function issues could have ADHD or a host of other underlying illnesses or complications. The relative nature of both conditions does not make them congruent disorders.
Can an executive function be improved in adults?
Medically reviewed data shared by Harvard University states favorable findings that suggest adults can build their core capabilities and strengthen executive function in the process. The best way to ensure healthy executive function later in life is to build the necessary skills during childhood. A brain is a dynamic tool capable of adapting and expanding according to the instructions and stimuli used to train it. While it’s possible to help adults fortify executive function skills like organizing, prioritizing, and decision making, the ability to influence the brain’s cognitive function is most successful when specific regions of the brain are still developing.
As the largest lobes and the last to fully mature, research proves that the frontal lobes are not fully developed until a person reaches their mid-30s. Critical to controlling the mind’s influence on the movement, decision making, and reaction time, the frontal lobes are an influential factor in an adult’s daily function. If you’ve ever suffered a brain injury, you may experience issues with your speech, mood, impulse control, concentration, memory, reasoning ability, planning skills, and decision making. Traumatic brain injury can make it difficult to improve your executive function, but constant therapy may help you see improvements over time.
If you do not suffer from brain trauma, the extended development of the prefrontal cortex makes executive function improvement possible for adults. Medically reviewed research programs advocate for executive function therapy and intervention methods such as the card sorting test, which helps counter the effects of shifting attention spans, reaction time, and decision-making. The International Journal of Psychology & Psychological Therapy shares research that successfully aided in improving executive function skills and reducing the symptoms of ADHD in preschool-aged children. Non-invasive techniques designed to treat the underlying cause for executive dysfunction have also shown favorable results in the treatment of adults.
First, evaluate any environmental adjustments you can make to make shifting attention to healthy outlets easier to commit to. This means limiting clutter in your personal and work environments to make organization and planning easier for tasks. Utilizing automation tools and digital planners or schedulers may also help develop coordination and organizational skills.
Learn strategies that allow you to recognize some of the emotional and mental signs you exhibit when your executive functioning skills don’t perform as expected. Conditioned responses like anger, frustration, or guilt can be redirected into positive thoughts and feelings that are more conducive to your expected outcomes. Try concentrating on forming micro-goals, a smaller subset of daily to-do lists. Create strategies to remind yourself of the consequences of task avoidance and be realistic about the challenges that contrast the short-term gain of procrastination.
Overall, adults will need to devote time and effort to understanding the cause of their executive dysfunction, the symptoms it manifests in their lives, and the frequency or severity of these occurrences. Performing these tests and properly evaluating the outcome is a major task that is best performed under a professional’s guidance and support.
What is an executive function test?
Studies on executive function have aided in developing medically reviewed tests designed to gauge a person’s decision-making skills, organization, planning, reaction time, and regulation, among many other executive functions. Executive function tests have grown in popularity in recent years. More adults are becoming aware of signs and habits that have impacted their lives in ways that did not necessarily align with depressive symptoms. While the effects of executive dysfunction can be frustrating and upsetting, people who face these challenges don’t always qualify as members of a clinically depressed group. Debilitating symptoms make it difficult to function in depression, but the effects may not align with current measures used to evaluate executive function.
Some executive function tests use scales with scores assessed by parents, teachers, therapists, or even individuals whose skills are in question. Self-reporting can be a non-invasive way of monitoring your executive functioning development, as long as the responses are honest and complete. Results are then compared to the function of other people within the same targeted age group. Some argue that the results of these style tests can be biased, which is why other forms of testing exist.
Most professionals prefer to isolate individual skills sets before determining a person’s executive function ability. Some tests focus on a person’s shifting attention, while others isolate areas like impulse control. The Wisconsin Card Sorting Test (WCST) is a neuropsychological examination used to measure high-level cognitive processes. It measures behavior patterns that may allude to a person’s inclination to engage in faulty decision-making. The card sorting test challenges the mind’s flexibility and adaptability while forming new strategies and solutions. Other tests, such as memory examinations, evaluate the mind’s neurological response to stimuli. All of these tests are most accurate when performed with the help of a licensed psychologist.
