How Executive Functioning Relates to ADHD and Other Disorders
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- Опубликовано: 16 июн 2024
- 00:00 Introduction
00:43 How does ADHD relate to executive functioning (EF)
03:25 How ADHD symptom domains fit into my theory of EF
05:04 How EF relates to ADHD
06:06 How EF relates to ASD (autism spectrum disorder)
07:32 How EF relates to Depression and Anxiety
09:17 How EF relates to Bipolar Disorder (BPD)
10:49 How EF relates to other brain disorders
12:55 Conclusion
This video provides a quick overview of the relationships between executive functioning (EF) and ADHD as well as with several other mental disorders that may involve EF to some degree. It then discusses how other brain disorders can create EF deficits without necessarily leading to ADHD, which is a pervasive disorder across the major components of EF.
Excellent! I'm a brazilian psychiatrist and ADHD patient, and this content is one of the best I've ever seen! Thanks, Dr. Barkley, you are a reference to us!
Good morning Dr. Barkley! You make life bearable for people like me who live with ADHD. Thank you very much for continuing to share a wealth of knowledge. I aspire to become an ADHD coach so that I can be the person I needed but didn't have back when I was struggling immensely. Happy New Year; may 2024 bring you good health and joy, and many more of your videos to us subscribers 🎄
Dr. Barkley is God's gift to us ADHDlers.
Given the overlap between some of the EF deficits associated with anxiety and ADHD, and the higher rates of anxiety in females, I think a video(s) examining the research on females with ADHD would be very interesting! For instance, is there evidence that females tend to show a different symptom presentation vs males (e.g. more inattentive symptoms, hyperactivity is expressed
more verbally versus moving around), show different responses to medication, or due to higher levels of anxiety tend to show more compensation/masking strategies (e.g., obsession with list-making or orderliness to compensate for poor WM) akin to what some HF females with ASD do in social situations? This may seem to go against the more equal sex ratios in ADHD in adults (ie you would expect more masking to result in fewer diagnoses in adult women) but I would be interested to hear Dr. Barkley’s take on it…
Dyspraxia and dyslexia, working memory , processing speed out of sync with strengths, similar to ADHD, 40% - 50% of people with dyslexia and / or dyspraxia have ADHD, and vicer versa .
Exercise helps with dyspraxia !
Hi Dr. Barkley! I have the tiniest gripe with "BPD" for Bipolar Disorder. To my understanding BPD was Borderline Personality Disorder.
Thank you for all that you do for the ADHD community
True - and it would be interesting to see the actual BPD venn diagram overlap. CNS stimulants has had better results for lessening significant suicidal behavior in those with BPD than antidepressants and mood stabilizers, while benzodiazipines make things worse - all presumably because of executive function and impulse control issues. Swedish population study in the JAMA network this year.
Bipolar Disorder is BD! At in the context of everything I’ve come across
@@publius9350 borderline personality disorder is above all things, a personality disorder. i believe what he was going for here was more cognitive related disorders in which markedly from shifting perspective bpd is definitely hugely affected by but again, is from the framework of individual human perspective as opposed to self regulatory mechanisms, neuroticism that stems from genetic mental executive dysfunction, how oneself regulates as such, root causes as opposed to symptoms (bpd being a symptom of many factors and ones perception and not a genetic cause for these possible perceptions that supercede all domains) etc, not to mention nature and nurture are essentially the same because of epigenetics but im not a doctor so that could just be the wrong approach from a perspective of cognition
@@perfectpersona4334 - yes, it is a personality disorder, but generally receives neurochemical medication therapy and has overlap and differential diagnosis issues like all of the other conditions within the chart as well.
Hi Dr. Barkey, thank you so much for your ongoing series. It has improved my understanding and the management of my ADHD in a truly significant way. One question I have is what is your opinion about the whole 'dopamine detox' idea relating to social media and entertainment consumption? Is there any science behind it relating to the claim that it will restore dopamine levels to a normal baseline resulting in increased focus because you’re not craving the dopamine highs that social media and entertainment provide? And what general advice do you have for people with ADHD (medicated or non-medicated) as it relates to social media and entertainment consumption? Thank you again for taking the time out of your much-earned retirement to help those of us with ADHD live meaningful and fulfilling lives.
Dr K (healthygamer) has an awesome video on this that Id recommend. He says its much more complicated that most people say and that a true ressetting of dopaminurgiv pathways would take a minimum 2 weeks.
from personal experience, I tried 2 weeks without tv, youtube, social media, etc, and it was rough but i did find myself much more productive during those 2 weeks. sadly i didnt find any lasting results and fell quickly back into scrolling. For those 2 weeks I felt a bit better and was definitely getting a lot more done that i wanted, but it was challenging as I had to plan a bunch of time filling activities beforehand to replace scrolling time.
I gained a great deal from your power point demonstration that allowed me to understand why the various aspects of giftedness and the need for positive disintegration to thrive instead of just survive is essential. Falling into traps that executive function allows us to master instead is a challenge, and it is interesting to see your perspective, yet you still indulge in drinking and eating so as to leave your body aging faster than you could, allowing yourself to indulge without reservation or guilt. For some, the prospects of perpetual improvement and growth is an daily construction of habits that are healthier, though a single moment could end our life, we might live on and thrive until a hundred if we control our reaction to endless temptations to decay faster, be unhealthy. Fascinating show and example to learn from and I thank you for sharing. At 68, this is the best time of my life, and learning so much daily is like feasting on candy for the mind, body, and Spirit.
I am really thankful for this much more in depth explanation of ADHD, because most common symptoms never fully applied to me and it is very hard to explain to others what exactly I am struggling with. Especially because most symptoms are about how the ADHD person disrupts/fails to perform in social settings or in presence of people (makes sense but shouldn't be only perspective symptoms are identified from), and disregards how lot of these executive function deficits "quietly" ruin one's life.
Thank you for taking the time to post these. Liked and Sub’d!
This is great. Thanks, Russell😊
Thank you for all you do for our community!
Thank you for the continuous insightful content!
I hope your golf game went well after that crazy night!
Thanks Dr Barkley, I appreciate you and all the work you’re doing! I hope you and your family have a great holiday!
Happy Thursday Dr. Barkley! Thank you for another amazing, in depth conversation about ADHD. You're my most trusted source of information.
The Venn diagram is such a great visualisation!
short sharp and on point ! thanks
i have been diagnosed with anxiety and adhd (and prev depression as well). i find that my anxiety has caused me to avoid doing things and makes it hard to get started. does that count as EF? is that a common issue for non-adhd axienty-havers? If procrastination of anxiety causing activities can be considered EF problems then id say theres a lot of overlap. Or if this is not common for anxiety-havers then is this just a synergy of multiple problems? Would love to hear thoughs and further discussion here! Thanks for the video!
The most impressive thing in this video is giving a better presentation hungover than I have ever given
Another great video!
Thank you for all your work. I can’t tell you how much this has helped me to better understand myself. I was diagnosed with dyslexia in grade 2. I am now 45 and have suffered all these years, but now I have a better grasp of what the problem really is. I am looking to get tested for both ADHD and Autism as I believe I was misdiagnosed.
This is such great content. Thank you for sharing all of this info about ADHD. It helps me understand my own shortcomings better and have more compassion for myself the more I learn. Thank you 🙏❤
Perfect!!! Thank you so much!!
Happy holidays Russell!
Thank you very much. I especially liked the portion where you talked about the EF and hyperactive & inattentive presentation. And I LOVED your acknowledgement of the mislabelling of the later.
It was also great to see why many conditions overlap. Cause they actually do! I love visual presentations like this. Very cool!
YES Dr. B., the illustrations, ven diagrams etc. are GREAT for my understanding.
I’m grateful that our society is beginning to appreciate the variety of learning styles and abilities. Imagine a world where people can contribute their best abilities without shame about their limitations. It’s happening thanks to teachers like Dr. Barkley.
❤
This is a good video since I've been looking into the connection between these disorders. Although, I feel like OCD/Tourettes were the only other major EFD missing from the link. There was a paper I read that showed that 5 major disorders(ADHD, ASD, Bipolar, OCD/Tics, and Depression) have a link with each other genetically. OCD is also in the same hemisphere/area of the Executive as ADHD is. Which makes it more interesting given that people think both are opposite disorders, but you can have them both.
Russell Barkley, I'm an Educational Psychologist of over 20 years working in both private and public sectors, and a parent of 3 ADHD'ers and I have to say, You are the GodFather, of ADHD Dr. Barkley! Thank you for all your dedication to this field.
❤
Thanks, Russ
I really appreciate your presentation of all these things, Dr. Barkley. I’m curious: with so many potential causes for executive function disorders, how do you go about doing a differential diagnosis of executive function issues?
I’ve been alternately diagnosed with depression, anxiety, PTSD, and ADHD at different times in my life. The only one I’m personally certain of is the PTSD, because I can point to the traumatic incidents that triggered it and the resulting symptoms. But I ended up with an ADHD diagnosis when my executive function worsened as I got older. If I had ADHD as a child, it was definitely a subclinical presentation (there were symptoms-trouble with time management and organization, frequent complaints by teachers about me daydreaming in class-but they largely didn’t disrupt my life). I’ve had my doubts about whether the diagnosis is correct. That said, I’m certain my grandmother would get an ADHD diagnosis if she ever sought therapy, and my mother has clear symptoms as well. And I respond well to stimulant medication (it virtually eliminated my anxiety and significantly relieved certain aspects of my depression that hadn’t responded to SSRIs). But I keep seeking more information and insight, because I remain unpersuaded that ADHD is the correct diagnosis.
THANK you for related info including brain injury and strokes ❤on top of adhd & being on the spectrum
Thanks a bunch Russ
Merry holiday's!
pls do a video on cognitive disengagement syndrome and possible treatment options
I’m autistic and have ADHD too. Being conscious of left/right hemisphere balance keeps me on track. I never feel disabled (level 1 autism) until I take the time to meditate on building up empathy and awareness of others. I didn’t realize how close to psychopathy I can get when I’m in my left hemisphere dominant tunnel vision. I’m sure I’m there a few days a month during my cycle. I seem to only have a small window of opportunity to feel like a neurotypical female and engage the right hemisphere effectively. I take down mental notes of how I’m going to work on relationships and be kinder to others in that small window of time. The rest of the time my brain is too rigid to even think that I might be the problem.
I really appreciate your response.
Check out the video about hormones and ADHD on this channel. That might be a piece in your puzzle as well.
Thank you, this is really interesting. I do have a tiny nit pick: You leave open what the venn diagram is describing: # of Affected People? Cognitive Abilities? Deficiencies? What quantity does the size of an area represent? Couldn’t stop wondering … but maybe this is a nerds-only problem ;-)
Thank you, Dr. Barkley. I think this presentation really helps with visualizing the overlap of these various disorders.
I expected there to be a much bigger overlap between ADHD and anxiety. (I might be biased because I've been diagnosed with both, but a lot of other people whom I've chatted with in online ADHD forums also said that they have anxiety.)
Also, I am curious how you would show the overlap with Cognitive Disengagement Syndrome. I've watched some of your presentations on CDS [SCT], and I feel like I have more CDS traits than ADHD Inattentive presentation... though I consider it likely that I have both. (Maybe CDS, the emotional traits of ADHD, and Adult ADHD diagnostic criteria will be included in the DSM 6. I certainly hope that they are.)
How does one train ones executive functions? It is wonderful to know that these categories exist, even if they are only recently developed, but have we got a handle on any of them? Can you be treated for executive dysfunction beyond stimulants?
Great questions, I'd also like to know.
This is something I wonder so often
As some of my longer lectures on EF explain as well as the video on digital medicine, the EF components are not especially sensitive to direct training that generalizes to natural settings. But there is a lot of information on how to cope ,with and compensate for these deficits in various books on EF in ADHD such as books on CBT for adult ADHD that target these domains. My book Taking. Barge of ADHD discusses many such strategies and provides a list of readings and references on the to
Ic. Be well.
I’m trying to help my adult son with ADD develop a career path. It’s a tough time for any kind of career development but harder with ADD.
No Dyslexia!!! I'd like to see a video going more into depth on neuro-divergent comparison. Adhd, Dyslexia and Autism.
Also, I have been finding alot of overlapping on adhd/autism and Monotropism. I'd like some clarification on that subject too.
So how do you differentiate depression and anxiety from inattentive subtype adhd in particular? Especially with the use of atomoxetine in this group
Well.. this was an interesting start.. now, where is the rest? 🤔 😉 This needs even more details I think. It's not clear where one thing differs from the next one here. It really needs more details. 🙂
Hi Dr. Barkely, sorry to bother you by asking this question again. My son was diagnosed with ADHD at the age of 6 and has been taking Concerta for seven months. However, he struggles with emotional regulation at school, often screaming and crying. As a result, the doctor suggested taking Aripiprazole (1.25mg/day) to help stabilize mood. Considering the numerous adverse effects of aripiprazole, we're contemplating whether using aripiprazole is a wise choice or if there are other methods with better risk-benefit ratios available. Deeply appreciated if we can receive your advice. Happy holiday!
I have BPD II and ADHD. I am 62, so I was not diagnosed as a child. But I do recall symptoms of ADHD as early as 9 and BPD as early as 13.
Are there studies that separate out BPD II and BPD I in relation to ADHD?
😂 much love to you, doc.
Hi, I guess the next question is at what point do EF difficulties due to brain disorder (for example cerebral palsy or dyspraxia) become a separate diagnosis of ADHD. Is it due to severity?
If they meet the criteria for ADHD, but had trauma at birth/in the womb indicating a clinical presentation of /causing one of these developmental brain disorders, could a diagnosis of ADHD be warranted?
Diagnosed after 60. Typical problems etc. how to understand the meds are working and pair that up with EF. Yeah, how to be your own coach to be your own coach
What if you’ve got them all? ADHD, ASD, anxiety, and depression?
Thank you so much for the visuals and bite sized information!
Maybe a fun/helpful video idea could be to walk through the day of an average person going through the daily routines:
Waking up
Going to work
Eating
Sleeping
Socialising
Chores etc.
Areas of life that everyone must go through daily and could be nice to showcase some challenges people with ADHD might encounter.
I’m medicated and a Psych major and I found that people are interested in learning about the symptoms of ADHD but don’t understand how it’s a constant thing.
“Watch this and you’ll understand” kind of video. I think it would do well coming from an expert in the field and could be a nice mental health awareness tool.
Something to share during the holidays haha ;)
My psychiatrist said to me something yesterday that suggests that she believes ADHD medication just works for focus. I'm been frustrated with my executive function problems and she keeps telling me that I just need to put in the work and have motivation. She procribed me Welbutrin and just increased the dose so I hope that helps me
yeah i find my stimulats helps with focus and decreases my feelings of being overwjelmed, which can in turn help with EF but isnt directly helpful. Would live to know if other meds effect things diferently.
Wellbutrin helps adhders live in a neuro-typical world. Makes you indifferent. Stimulants do way more than focus for adhd. Try to find a better shrink, one that specializes in neuro-divergence.
And that Wellbutrin is very hard to get off of, very bad withdrawl.
How about schizophrenia, psychosis, and schizoaffective disorder? And PTSD?
Dear Dr Barkley, I’m interested to know more thoughts about Irlens Syndrome and the correlation between ADHD. Please reply if you have a spare moment or maybe someone else could direct me to another video that Dr Barkley talks about this?
I have heard of any connection but you can use Google scholar to search the journals and for those topics. Sometimes I miss some research.
Great idea thanks 👍🏼
Interesting
Good morning Dr Barkley. Would you explain that gifted persons with ADHD may have high scores of IQ because some EF are compensated to say so by high cognitive skills, I.e some of the EF are less or not impacted by ADHD ( in the outer part of the EF circle to say so)?
This may be a rude question, it is absolutely not intended to be so. Do you find that your aging brain has given you new insights into the executive function problems of ADHD (and other executive function affecting conditions) and has it prompted any new ideas?
You say most people with depression don't have executive deficits, but isn't a hallmark symptom of depression lack of motivation? Is there a difference between lack of motivation as a depression symptom and self motivation as an executive function?
+ dyspraxia
I’m wondering where CPTSD falls into this EF diagram🤔 surely it’s mistaken for ADHD a lot
Unrelated, but a memory trick for remembering a six digit number is:
-Visually remember the first three
-Remember the second three as words you speak in your mind.
💚🙏🎄
Isn't here any creative designer with ADHD who could help Dr. Barkley with his color schemes?
Yeah, my executives are so dysfunctional...
I am not familiar with Cognitive Disengagement Syndrome. Did you just make this up? I'll have to look it up.
Cognitive Dissonance rules the day for most who ignore Boolean Logic or other means of analog thinking to get through their days, often rarely interacting face-to-face with people in a real communicative way. Sadly for most, detachment from reality is an executive function problem based on digital minds that do not store massive files of facts but link them to a separate memory chip, a "smart phone" that stores the facts of a person under 30 who was brought up with phones that replaced most of the short to long term memory buffers in it brains. The ability to retrieve information internally on which to base decisions, construct abstract ideas, and then take action to manifest them hinges on a memory that is external, social platforms that offer identity, fashion, friends, and resources that create an artificial reality. What binds the young digital mind to reality is facts stored inside the head, not on a phone for referencing to in order to determine truth or false in a simple test, requiring internal memory. Digital minds do not have analog access to long term accurate memory storage. They work on annotated versions stored long term, and Smart Phones to answer detailed questions, calculate math, seek wisdom, exercise, directions that have made most illiterate when it comes to map reading, cursive writing, and foreign languages other than English. The lack of stimulation for the freshly created neural stem cells and their eventual decaly for lack of stimulation leads to cognitive disassociation that is impossible for the analog minded to understand in many ways, what appears to lack logic based on a foundation of facts, history, or laws of nature now understood better than ever before, if people only sought to understand, be autodidactic, and thus ever growing, but awareness is harder than distraction.
It’s a comparatively resent name for a condition that’s similar to but distinct from ADHD. It’s previously been called Sluggish Cognitive Tempo (SCT).
It is less well known than ADHD.
That said I think Doctor Barkley has contributed to the research on it, but it’s not something that he made up and definitely not on the fly in this video.
I think there might be some video on it on this channel.
I don’t recall of the top of my head what differences there are in diagnostic criteria, but I hope I at least gave you a term to google if you’re interested.
I see. CDS is Dr. Barkley's term for the badly named Slow Cognitive Tempo.
@@dkdisme Something like that. But I think the name change has been made more official than that at some meeting or conference or however that works.
Also, even though I’m quite confident that dr Barkley was in favor of the change I don’t remember whether he came up with it or just supported it. But you can probably find that information easily if you’re interested. 😊