One of the things I’m learning to navigate post-diagnosis with autism and ADHD is executive dysfunction, which explains so many of the things I’ve struggled with in my life!
What is executive (dys)function?
Executive function describes how your brain decides what to do, plans and organizes the steps to do it, develops a timeline for doing it, adjusts as needed during the process, and completes it. It applies to everything you do, whether accomplishing a complicated project or just taking a shower. It’s sort of the administrative team in your brain. Executive dysfunction, not surprisingly, is when that part of your brain has a hard time doing its job compared to the average neurotypical person (neurotypical just means someone who is neurologically typical, like your average person who doesn’t have ADHD, or autism, etc.). Many people who have ADHD or autism, including me, struggle with this. As you might imagine, seemingly simple things like getting ready in the morning can be much harder if you have executive dysfunction.
Why is it so hard?
One of the biggest things I’ve learned about myself through both my ADHD and autism diagnoses is that I need a routine! I do my best when I have a routine to help structure my day. That’s why I sometimes function so much better at work than I do at home. At work I have set times for starting, stopping, and meals. Everything has a place, there’s a clear structure, and I have a clear idea (usually) of what I need to do and how best to do it. It gets cluttered sometimes, but I have a system in place to deal with that and I don’t stress too much about it. I’m able to delegate the things I need help with most of the time. It’s still exhausting sometimes, but I can accomplish a lot and feel good about it.
At home on my days off, I don’t have set start and stop times for much of anything. Even if I set a morning alarm, it’s hard to actually get up at that time because I don’t have to. It takes a long time to get up and get ready for my day because I keep forgetting what I need to do or how to do it. I get distracted a lot, or I just have a hard time initiating anything. Meds and coffee help, but it’s hard to get those done in a timely manner because of the lack of routine. I’ll find myself still sitting on the couch at 11 AM in my pajamas, still no meds in my system. It makes me feel stuck and tired and bad about myself. I want to get moving, get on with my day, and do a few of the things I want to get done so I can take care of myself and feel capable of accomplishing things. It affects my mood, my self-esteem, and the things that don’t get done affect my quality of life.
When I have a routine to follow, I don’t have to use a lot of brain power to decide what to do, figure out how to do it, and keep track of all of the steps. I can just follow the steps in the order I always follow them, almost like muscle memory (usually, though I still get stuck sometimes). When your brain struggles to organize and plan things like that, a routine can save an enormous amount of mental energy! That translates to physical energy too, since my brain is burning plenty of calories as it works.
In a way, it seems sort of obvious now how much difference a routine can make. It’s one of those things people talk about plenty, but the fundamental importance of it didn’t really sink in for me until after I started to learn about how my brain works. A routine isn’t something I can just do without deliberately planning it, but somehow I thought everyone just did it automatically. I also didn’t realize to what extent I have to think about how to get things done. Something simple like taking a shower, I figured everyone just does it without having to think about how to do it every time. I didn’t realize I was struggling with keeping track of the steps and planning out the action, I just knew I tended to get stuck and overwhelmed sometimes, or I’d get partway through a task and keep having to stop and remember what I was supposed to do next. I took long showers, not because I wanted to soak in all the hot water until it was gone, but because it took me that long to remember all the things I needed to do and do them. I had this difficulty with all sorts of things, but I didn’t know what to call it. I sort of thought I was just lazy and scatterbrained, even though I really wanted to do all kinds of things and I can be really organized with certain things (like my job).
To take the shower example, if I plan out what my shower routine is in detail beforehand and follow it pretty much the exact same way every time, I can take a much shorter shower. It becomes a natural sequence of actions and I don’t struggle to remember anymore. The task for me isn’t “take a shower”. It’s
Take a shower:
- go in bathroom
- check for towel
- shut and lock door
- start hot water
- turn on shower
- get in
- get hair wet
- shampoo hair & rinse out
- condition hair & rinse out
- use body wash & rinse off
- wash face
- turn off shower
- dry off
- put on bathrobe
I actually have to go a bit more detailed than that at first, but you get roughly how I need to break down the task. I have a specific list of things I need to do every time in a specific order, and in the case of the shower I line up the different bottles of shampoo and whatnot in the order I use them every morning beforehand as visual cues to guide me. If I don’t have a set routine for doing it, I have to actively work to remember each one of these steps individually as I go and try to put them in the right order.
If I’m not doing something that allows me to hyperfocus, I’m constantly forgetting things or suddenly thinking of things at the wrong moment. My brain feels pulled in a dozen directions at once and I have to work to keep track of what train of thought I was trying to follow. Medication helps with that somewhat, but it doesn’t fix it completely, so the rest I’m making up by trying out some of the strategies that supposedly help with this stuff. I maybe would’ve learned some of it in school if I’d been diagnosed back then and had access to services or coaching, but a diagnosis is no guarantee that you get what you need, so maybe not. I’m also metaphorically spackling over the whole mess with a big bucket of cutting-myself-some-slack! I have a couple disabilities and not much of a guidebook for how to adapt to them, so I think it’s a good idea to accept that I’m not going to get it all done or get it all right (we could all stand to be kinder to ourselves anyway, disabled or not).
I have some ideas to try around figuring out this whole routine thing, and I’ll save that for the next post!