What is Executive Dysfunction?

Ever ask the question--"Why is adulting SO hard?"

Ever set a goal for yourself--again, and again, only to give up each and every time?

Ever forget to defrost something for dinner? or how about forgetting appointments?

Ever avoid a simple task like picking up milk, or going to the pharmacy, just because it's not a part of your daily routine already?

Ever start unloading the dishwasher only to find that you need more dish detergent so you go to the supply closet and realize the mop bucket is missing so you go to find it, only to find it was left dirty so you start to clean it out which leaves the tub dirty so you begin cleaning the tub only to end up needing to get the supplies from under the bathroom sink and then you realize that you haven't organized under the bathroom sink since, I don't know, Spotify launched, so you start organizing it only to realize after pulling everything out and burying yourself unde the contents of years of bathroom junk that you never finished unloading the dishwasher and you have somewhere to be in 20 minutes?

You can thank executive dysfunction for these things.

Formally, executive functioning is the ability to plan, make decisions, set and achieve goals, manage time, complete tasks, respond to demands, and adapt to changes. Informally, executive functioning is the thing that helps us human. 

Parts of the Brain Involved

We call it neorodivergent because these issues are impacted by differences in our neurological make-up. Neurology has to do with the brain and the nervous system. Scientists have found a number of differences in the brains of neurodivergents, and executive dysfunction impacts the brains of many of them, especially those with ADHD and/or Autism. 

Each of the next sections takes a look at the parts of the brain involved in executive dysfunction. In each section you'll be able to learn What the part does, How Neurodivergence is Impacted by it, and will be given a real life struggle for each. Keep in mind that neurodiversity is broad and impacts everyone differently and the examples provided are just to help make connections and not to exclude anyone or to misinform. Neurodivergence is NOT one-size-fits-all.

Prefrontal Cortex

What it does

The prefrontal cortex (PFC) is the brain’s command center, responsible for executive functions like planning, decision-making, impulse control, emotional regulation, and focus. It’s where logic, reasoning, and problem-solving happen. 

The part it plays in Neurodivergence 

• Overactive Prefrontal Cortex: An overactive PFC can lead to excessive control and analysis, resulting in:

  • Overthinking and Perfectionism

  • Difficulty Switching Gears or Letting Go of Tasks

  • Hyperfocus on Small Details While Missing the Big Picture

  • Heightened Anxiety from Constant Evaluation of Outcomes

  • For example, someone may get stuck running through every possible scenario before making even a minor decision, which can be exhausting and paralyzing.

• Underactive Prefrontal Cortex: When underactive, the PFC struggles to manage executive functions, leading to:

  • Poor Impulse Control and Difficulty Regulating Emotions

  • Trouble Planning, Prioritizing, and Completing Tasks

  • Easily Distracted and Difficulty Maintaining Focus

  • Difficulty with Goal Setting and Following Through

  • This often shows up in conditions like ADHD, where the PFC doesn’t provide enough top-down regulation to filter out distractions or organize thoughts effectively.

Mixed Activity and Conflicting Effects

The PFC can be overactive and underactive in different areas, causing contradictions. Someone might hyperfocus on an interest but struggle to complete daily tasks, or be highly analytical in certain situations but impulsive in others. This imbalance highlights how complex and multifaceted executive dysfunction can be. 

Real life struggles: Forgetting to get half the things on your list at the grocery store. 

Basal Ganglia

What it does

This area of the brain serves as a traffic control center if you will. It takes in information, processes it, and tells the brain what information is worth sending forward to the prefrontal cortex to make decisions related to movement and habit forming. 

The part it plays in Neurodivergence 

• Overactive Basal Ganglia:
  When overactive, the basal ganglia treats all information as equally important, leading to:

  • Impulsivity and Emotional Reactivity

  • Repetitive Behaviors and Fixations

  • Rigidity and Difficulty Shifting Focus

  • Heightened Threat Response: Treats minor issues (like eggs on the wrong shelf) as urgent.

• Underactive Basal Ganglia:
  When underactive, it struggles to prioritize information, causing:

  • Difficulty Concentrating and Task Completion

  • Poor Impulse Control and Planning

  • Motor Control Challenges

Mixed Activity and Conflicting Effects

Parts of the basal ganglia can be overactive and underactive simultaneously, leading to paradoxical behaviors:

• Someone may prefer rigid structure yet struggle to maintain routines.

• They might fixate on an organizational system but still have trouble keeping things clean.

The brain is complex, and the basal ganglia’s role in neurodivergence highlights just how nuanced and varied these experiences can be.

Real Life Struggle: Difficulty switching between tasks before getting to a good stopping point. This might look like intense irritibility when interrupted by something unexpected like the phone ringing or a drink spilling.

Thalamus

What it is

The thalamus is the brain’s sensory processing hub. It doesn’t perceive sensations but receives and filters sensory input—like sight, sound, and touch—and decides what information to send to other brain regions for processing.

The part it plays in Neurodivergence 

• Overactive Thalamus: An overactive thalamus floods the brain with too much sensory information, which can be overwhelming. This is common in:

  • Autism: Sensory overload from busy environments.

  • ADHD: Difficulty focusing due to excessive external stimuli.

  • Sensory Processing Disorder (SPD): Intolerance to certain textures, sounds, or lights.

  • Anxiety and PTSD: Heightened threat perception, even in safe situations.

• Underactive Thalamus: An underactive thalamus processes too little sensory information, leading to:

  • Reduced Sensory Awareness: Difficulty noticing pain, temperature changes, or environmental cues, which can lead to injury (e.g., missing signs of sunburn).

  • ADHD: Lack of engagement and zoning out due to insufficient sensory input.

  • SPD: Engaging in risky play or missing cues about being too hot or cold due to incomplete sensory feedback.

In both cases, the thalamus plays a key role in how neurodivergent individuals experience and respond to their environment.

Mixed Activity and Conflicting Effects

The thalamus can be overactive and underactive at the same time, creating a confusing mix of sensory experiences. Someone might become overwhelmed by loud environments while simultaneously missing important sensory cues, like hunger or pain. They may struggle to filter out background noise but fail to notice when they’re getting too cold or hot. This imbalance highlights how unpredictable and inconsistent sensory processing can be, making it difficult for neurodivergent individuals to navigate their surroundings comfortably. 

Real Life Struggle: Feeling really overwhelmed and overstimulated busy places like a Costco or at your kids' extra-curricular events.

Amygdala

What it is

The amygdala is the brain’s emotional alarm system, responsible for detecting threats and triggering emotional responses like fear, anger, and anxiety. It processes emotional significance and decides whether a situation requires a fight, flight, or freeze response.

The part it plays in Neurodivergence 

• Overactive Amygdala: When overactive, the amygdala treats minor situations as threats, leading to:

  • Heightened Anxiety and Hypervigilance

  • Emotional Reactivity and Overwhelm

  • Difficulty Regulating Emotional Responses

  • For example, a small change in plans may feel like a major crisis, triggering a disproportionate stress response.

• Underactive Amygdala: When underactive, it struggles to detect threats or gauge emotional significance, resulting in:

  • Blunted Emotional Responses

  • Difficulty Recognizing Danger or Social Cues

  • Reduced Sense of Urgency in Stressful Situations

Mixed Activity and Conflicting Effects

In some cases, the amygdala can be both overactive and underactive, creating mixed signals. Someone might be hyper-aware of perceived threats but slow to react appropriately, or they may shut down emotionally in situations that require action.

Real Life Example: Running in a parking lot without regard to safety.

Insula

What it is

The insula is the brain’s internal monitor, processing information about the body’s internal state, including hunger, pain, temperature, and emotional awareness. It helps us interpret and regulate these bodily sensations. 

The part it plays in Neurodivergence 

• Overactive Insula: An overactive insula can make someone hyper-aware of bodily sensations, leading to:

  • Heightened Sensory Sensitivity (feeling overwhelmed by internal cues)

  • Intense Emotional Reactions to Physical Discomfort

  • Overinterpretation of Minor Bodily Changes (e.g., anxiety over a slight heart rate change)

• Underactive Insula: When underactive, the insula doesn’t pick up enough sensory information, which can result in:

  • Difficulty Recognizing Hunger, Thirst, or Fatigue

  • Reduced Awareness of Pain or Discomfort

  • Emotional Numbness or Disconnection

Mixed Activity and Conflicting Effects

Like other regions, the insula can be overactive and underactive at the same time. Someone might overreact to minor physical changes while simultaneously missing important signals like dehydration or exhaustion. 

Real Life Struggle: Forgetting to eat for long periods because you just never felt hungry. Not realizing you need to use the restroom until the last second.

Default Mode Network (DMN)

What it is

The Default Mode Network (DMN) is the brain’s “daydream mode,” activated when we’re not focused on a specific task. It’s involved in self-reflection, imagination, and mind-wandering—basically where our thoughts go when we’re on autopilot. 

The part it plays in Neurodivergence 

• Overactive DMN: An overactive DMN can lead to excessive mind-wandering and intrusive thoughts, resulting in:

  • Difficulty Staying Present and Focused

  • Ruminating or Overthinking

  • Increased Anxiety from Dwelling on Past or Future Events

  • This can look like getting stuck in a loop of overanalyzing conversations or daydreaming to the point of missing what’s happening around you.

• Underactive DMN: When underactive, the DMN struggles to engage in introspection, leading to:

  • Difficulty with Self-Awareness and Reflection

  • Lack of Imagination or Creativity

  • Trouble Understanding Social Dynamics

Mixed Activity and Conflicting Effects

The DMN can be overactive and underactive, causing a person to bounce between excessive introspection and feeling disconnected from their thoughts, making it difficult to balance focus and reflection. 

Real Life Struggle: Being told your head is in the clouds or you're never present.

Cerebellum

What it is

The cerebellum is often known for motor control and balance, but it also plays a big role in timing, coordination, and predicting the outcomes of actions. It helps fine-tune both physical movements and cognitive processes.

The part it plays in Neurodivergence 

• Overactive Cerebellum: An overactive cerebellum can create excessive control and rigidity, leading to:

  • Perfectionism and Difficulty Adapting to Change

  • Overcorrection of Movements or Actions

  • Heightened Awareness of Errors, Causing Anxiety

• Underactive Cerebellum: When underactive, the cerebellum struggles to regulate movement and timing, which may cause:

  • Clumsiness and Poor Motor Coordination

  • Difficulty with Timing and Sequencing Tasks

  • Slower Processing of Consequences and Adjustments

Mixed Activity and Conflicting Effects

A cerebellum that’s overactive in some areas and underactive in others may lead to situations where someone is hyper-aware of small errors but still struggles with motor control, or where they’re overly focused on timing but miss the bigger picture. 

Real Life Struggle: Having poor balance or bumping into things a lot.

Key Takeaway

Executive dysfunction involves both overactivation and underactivation across multiple brain regions, but the key takeaway is that no two neurodivergent experiences are alike. These variations can affect everything from focus and impulse control to emotional regulation and sensory processing. Because these brain structures interact in such complex ways, the result is a unique blend of strengths and challenges for each individual—what works for one person may not work for another. Recognizing this diversity is essential for providing the right support and understanding.

When they say neurodiversity is a spectrum, they really mean it. Remember--This was only looking at executive dysfuntion, which is only a sliver of the neurodivergent experience. Neurodivergents also experience different styles of communication and relationships, identity and interests, emotions and emotion regulation, sensory processing, memory and learning styles, and more. 

My hope for you is that if you are or you love someone who is neurodivergent, you educate yourself as much as possible about how it impacts a person so that the right supports can be put in place.