Executive Dysfunction Disorders are the Opposite of Laziness
Like likely the slight majority of people, I suffer what what is called an executive function disorder. This condition is not a specific diagnosis, but rather a grouping of labels for disorders that have similar effects. Just like the “Executive Branch” of the United States government is meant to be the branch that does stuff (other than threaten to start nuclear war), executive function means your ability to actually do stuff. Imagine a little US government in your head, if you will; you have the legislature, which is theoretically the part of your brain that decides you want to write the Great American Novel, or maybe work to make enough money to live. There’s a judiciary which (in most neurotypical people) reality-checks these thought proceses to make sure what you want makes sense, and finally, there’s your brain’s executive branch, which actually gets the stuff done that the legislature and judiciary of your brain agree upon.
There are many forms of executive function disorders. I have one of the most severe, a form called Non Verbal Learning Disorder, which is a condition that combines what used to be called Asperger’s Sydrome with ADHD. Because I was homeschooled, I was left undiagnosed until this year, and it’s nearly impossible for adults to get pharmaceutical treatment for ADHD-related issues due to fears about drug-seeking. I lucked out — for the moment — and found a doctor who trusts me and was able to get access to Vyvanse, a novel extended release amphetamine stimulant similar to Adderal but that lasts longer but less intensely. The thing is, it’s not a magic bullet.
When you hear “executive function disorder,” you may be thinking about someone who just can’t get their head out of their ass long enough to do anything. Or rather, they won’t get their head out of their ass, because they choose to be an insufferable, lazy git.
Thing is, that’s pretty much the opposite of what the vast majority of the wide spectrum of those of us with executive function disorders experience — and those disorders almost certainly include people you know in your life, because it can be anything from autism to depression, anxiety, or obsessive-compulsive disorder. These conditions combined are present in the majority of the population.
The thing is that when you have an EF disorder, your brain doesn’t spend no time thinking about That Thing You Need to Do. It spends a lot of time thinking about it. I want to write the great novel about transgender teen time travelers fighting terminators TERFs, and I have literally dozens of story arcs plotted in my head. In many cases, I’ve shared these details to Twitter but not been able to get it down on paper.
The issue is that your brain literally “cannot even.” This is probably where the memetic phrase originates. When you have trouble with executive function, you, in the famous worlds of Kylo Ren, “know what you have to do, but don’t know if you have the strength to do it.” While I’m not advocating stabbing your space dad, it’s pretty clear to me that in Star Wars VII Kylo Ren has an executive function disorder, one that manifests in indiscriminate destruction and pointless scheming and posturing rather than getting things done like his hero, Darth Vader. In that sense, him killing Han Solo, horrible as it is, is a moment of breaking free of the EF disorder — like, in my case, taking Vyvanse, only with more stabbing of dads (don’t worry day, I’d never stab you, especially not over a bottomless pit of space radiation)
In more mundane, less space-stabby terms, we experience executive dysfunction when we can’t do what we know we want or need. This could be something we really want, too — a simple need like getting out of bed to eat in the morning. Or preparing properly for work. All too often, executive function disorders keep very capable athletes, scholars, game developers, and astronauts figuratively and literally grouned until the day comes when they give up on their dreams.
I am bad with deadlines. I recently found out that I missed an important court filing deadline in a civil case; this came on top of the effects of letting the organization of my university classroom teaching become at times jumbled and confusing. At no point did I look up and say, “I am too good to do this dumb thing.” In most cases, I really wanted it. Because this works exactly the same way for things like “writing the trans time travel novel” or “working on that Star Trek pastiche in RPG Maker” or even things like “going out with friends” or “chatting with my wonderful boyfriend.” The thing is, our brains are spending all of the energy it takes to to do the thing we’re not doing on not doing it — on finding reasons why we can’t, why it’s too hard, too risky. But we know it’s easier to just do it, and we don’t need condescending lectures to that effect. The truth is that this is in many cases, like mine, a biochemical problem requiring drug treatment. Freud would probably have said this was a case of an overactive superego — he’s not taken seriously in psychology anymore, but it’s a worthwhile case to consider.
But these are truly disabling conditions. I want to do the work — hell, I enjoy the work — that I do. My brain just generates sucessive reasons why I can’t, and this can be momentarily treated with amphematamine therapy (momentary as in, it doesn’t cure the condition, you have to keep taking the medication).
Many of my friends, whether because of situations like mine where they were undiagnosed as children, international medical record situations, or past substance abuse — often because they were denied medication that could be supervised by a doctor out of these other concerns — have not been able to obtain amphematine treatment, or even treatment with the “lesser” stimulant modafanil. I myself am facing questions from my doctor because, in an episode of being off of my ADHD medications, I sent her a somewhat incoherent email because, first of all, my phone keyboard is shit, but second, because proofreading, revising and following through are all things I want to do, may even like to do, but I just couldn’t do them. And because of that my lifelong illness is at risk of intesifying if I can’t convince my doctor that I’m just terrified out of my fucking mind at the prospect of adulting.
I’ll close with this: I love Star Wars: Rogue One. On a day when my executive function is working I could watch it twice and then write two essays about it.But right now, as I’m feeling like shit and terrified of losing my medication? I can’t even pull up the video player.
Executive function disorder is living hell on Earth. I won’t even apologize for e-begging — I have a job for now, but please help me survive and afford the bare necessities; I have PayPal at paypal.me/eleanorlockhart .
If I could get up and accomplish my dreams, I would. For years they’ve been locked behind massive pharmaceutical gates that have proved impossible to breach. Many others are even worse off. Don’t call us lazy.