WHAT IS EXECUTIVE FUNCTIONING AND HOW COULD DEPRESSION AFFECT IT?
Executive functioning is a term that many of us won’t have heard before. It encompasses a range of things that affect our everyday lives; depression or no depression. Understanding what executive functioning is, and how it interacts with depression, can help us to have a greater understanding of the difficulties we face.
WHAT IS EXECUTIVE FUNCTIONING?
The formal definition of executive function is: ‘The cognitive process that encompasses an individual’s ability to organise thoughts and activities, prioritise tasks, manage time efficiently, and make decisions.’
Executive function can affect things like working memory, flexible thinking, self-control, attention, organisation, and planning, starting tasks and staying focussed, managing our emotions, keeping track of what we’re doing, managing our time, and multitasking.
HOW DOES DEPRESSION INTERACT WITH EXECUTIVE FUNCTIONING?
Depression can affect all aspects of our executive functioning. It can clog up our memory, negatively impact our processing speed, and stifle our ability to think and plan. It can fill our limbs with lead and our brain with cotton wool. Starting any task can feel as though it requires the effort of climbing a mountain coated with treacle.
Our hope can become buried, and we’re often left focusing on getting through the days 60 seconds at a time. Planning further into the future feels almost impossible.
Working memory, or short-term memory, is our ability to remember information for a short time. Often, we then need to apply it to what we’re doing.
For example, if we’re planning a trip to the seaside, we might need to get the bus to the station and then the train to the beach. To do this, we would need to hold the train times in our head along with the length of time that the bus journey takes to work out which bus we need to catch at what time.
When living with depression, it can be hard to hold anything in mind. This can be immensely frustrating. It often means that we do things like making a cold cuppa because we’ve forgotten to boil the kettle. We might also struggle to work down a list because we forget what we’re doing, what comes next, and where we’ve put the list that we wrote to prompt us.
This means that as well as having poor short-term memory, it can be difficult to keep track of what we’re doing.
FLEXIBLE THINKING AND SWITCHING FOCUS
Flexible thinking is sometimes called ‘cognitive flexibility’. It’s about our ability to think about things in more than one way.
For example, we might have been planning to go out for tea. But when it comes to tea time we’re absolutely shattered and it’s throwing it down with rain. So instead, we decide to stick our PJs on and order a takeaway. A situation like this requires an element of flexible thinking.
Without that flexibility, we might push on, force ourselves out into the rain, go to a busy restaurant, despite not enjoying it, because it was ‘what we had planned’.
Depression negatively affects our cognitive flexibility. It can make it hard to shift our thinking. We can become increasingly rigid in what we do and how we do it. This can make it particularly difficult to cope if something unexpected crops up, someone interferes with our routine, or something goes wrong.
Self-control allows us to stick to what we’re focusing on without getting distracted. Avoiding impulsive behaviour, regulating emotions, and ‘bouncing back’ from difficult situations are all part of self-control.
It can help us to step back, assess situations, and respond in a measured way, as opposed to reacting there and then and regretting it later.
Those of us with strong self-control are often able to see the ‘bigger picture’. We then make decisions accordingly, rather than having a narrow focus on the ‘now’.
One way that depression can interfere with self-control is when avoiding impulsive behaviours. For some of us, self-damaging behaviours almost call out to us and it can be hard to avoid doing them.
ORGANISATION AND PLANNING
Part of executive functioning is our ability to organise and plan things.
When we want to do something, we first have to set a goal, make a plan, and organise what we need to take. For example, go to the park, in half an hour, take a coat. This is quite a basic goal, but the more complicated our goal is, and the more people it involves, the greater the levels of organisation and planning required.
Prioritising can also come into it. When planning, we need to prioritise the tasks that are the most important. This can be quite a tricky skill, particularly when our brain feels foggy.
Other aspects of executive functioning can also influence our ability to organise and plan. For example, our working memory allows us to keep tasks in mind, cognitive flexibility means that we can prioritise and shift tasks, and focus allows us to get stuff done.
Depression can affect every single one of these aspects of our functioning and bring with it a horrible sense of overwhelm. We don’t always want to face the day, nevermind think about which tasks on our to-do list we should prioritise.
STARTING TASKS, STAYING FOCUSSED AND ATTENTION
Part of our executive function is getting going on a task, and keeping our attention focused on it until it’s done. When focussed, we’re able to ignore things around us rather than getting repeatedly distracted.
Depression can zap our energy and motivation, making it incredibly difficult to start tasks. Once we do get going, it interferes with our concentration and ability to think, making it difficult to stay focused. Our attention can further be diverted by difficult and often intrusive thoughts that come into our head.
HOW EXECUTIVE FUNCTIONING IS INVOLVED IN MANAGING EMOTIONS
When our emotions are intense and overwhelming, they can affect our ability to think clearly. Our emotions overtake our executive functioning and start running the show. We react to things, and make decisions, according to how we feel rather than by logically thinking things through.
The more-intense our emotions are, the more brain-space is taken up. So, it follows, that the more intense our depression is, the more we’re likely to make decisions based on feeling over fact.
Perceiving and managing time is part of executive functioning. When planning our day, it helps us to allocate an appropriate amount of time for the stuff we have to do.
Depression can make each task take longer than we’re used to because we’re more likely to struggle with concentration and focus. It can also alter our perception of time, so some people with depression feel as though time passes more slowly.
WAYS TO MANAGE POOR EXECUTIVE FUNCTIONING
Clearly, executive functioning plays a vital role in our ability to manage our lives. Unfortunately, it’s also clear that depression can have a big impact on it.
We can learn different tools and tricks to help us manage at times when our executive functioning is poor. Different things work for different people at different times. It might be that we have to try a few different things before we find something that works for us.
Additionally, something might work well for a while, but then our situation changes and we need to try something else.
VISUAL REMINDERS AND AIDS
When organising ourselves, we can use things like planners, apps, diaries, and calendars. We could try making a plan for each week, day, or even half-day. Some people like very structured plans whereas others prefer to keep them a little vaguer.
Signs, noticeboards and sticky notes can be lifesavers. We could have a system where we pin important things to a noticeboard by the door so we see them as we leave the house. A sign above our kettle could remind us of the things that we need to make sure we do every morning.
For example, eating breakfast, feeding any pets, and taking our medication. Sticking a post-it on our laptop with the times of any appointments that day can be the visual prompt we need.
Getting things out of our head and onto a piece of paper can free-up some brain-space, allowing us to think more clearly and flexibly.
If someone asks us to do something, it’s often helpful to ask them to write it down or record a voice note. This gives us something to fall back on if we forget what we’re doing half-way through.
OTHER TOOLS TO HELP US WHEN OUR EXECUTIVE FUNCTIONING IS POOR
Many of us use alarms to wake up on a morning, but we could use alarms during the day, too. If we struggle with time management, or with remembering appointments, alarms or reminders can prompt us.
Breaking our tasks into small chunks, means we don’t have to worry about focusing for such a long time. Our goals start to feel more achievable, and our levels of overwhelm are likely to reduce.
This often makes it easier to get going. It’s particularly effective if we do something totally different for a few minutes between each chunk, such as walking around the block or going to find the dog for a cuddle.
Cluttering our space can clutter-up our mind. Adding in a quick five-minute ‘sweep’ at the start or end of each day can help us to keep our space clear. Alternatively, we might be someone who prefers to batch tasks. Spending 30 minutes once a week blitzing a space that’s bothering us might be preferable.
When organising, it’s helpful to have places to put things. If we find that we have increasing amounts of ‘clutter’, then it might be helpful to have a clear-out and invest in some more storage.
Minimising distractions is usually a good idea when we’re trying to concentrate. This could involve blocking particular apps for certain time-periods, turning off notifications, keeping our phone out of site, having a clear workspace, and using headphones in noisy or busy spaces.
Having little rewards for ourselves can give us a motivation boost. For example, once we’ve sorted ten items from the toppling stack of paper on our desk, we could sit down with a cuppa and a biscuit for a bit.
ASKING OTHERS TO HELP US
We might find it useful to be accountable to someone else when setting goals. For example, we could say to a colleague ‘let’s both get our heads down for the next half an hour and then check-in to see where we’re up to’. Sometimes having that external accountability can be just what we need to kick-start our motivation.
Asking a friend or family member to help us problem-solve can allow us to manage the lack of flexible thinking that often comes with depression.
They might be able to see things from an alternative perspective and offer different ideas. Talking to someone else can also help us to stay on track, logically work through things, come up with an achievable plan, and be accountable.
HAVE A GO
Have a go at different ways of doing things. Some people love pictures, others prefer text. Some are a fan of the mind-map approach and others who like a structured list. There are those who learn by doing, others by seeing, some by hearing and others by reading.
When working, some people have the radio on, others enjoy music, and some find anything other than complete silence distracting.
We’re all different, so different strategies work for different people. With that in mind, it’s important to remember that if something doesn’t work for us then it doesn’t mean we’re hopeless, it just means we need to try something else.
Above all else, bear in mind that we live with depression. Depression is an illness, and however hard we try, it can affect our ability to do certain things. When our depression is very present, we’re unlikely to be at the top of our game, and that’s okay. All we can do is our best, and our best is good enough.