5 Tips for Navigating Chronic Illness With Executive Function Challenges

I taught for years in alternative schools and found that too often the students found themselves in my programs because their needs were simply not being met in school.  For many, it was because they didn’t quite know what their needs even were.  Some were on the cusp of a medical diagnosis, were working through mental health challenges, or were housing-insecure and just couldn’t focus on school with everything going on.  Most of these students, for one reason or another, struggled with executive functioning.

Executive Function (EF) skills are not often taught explicitly in school the way we teach reading, math, or the scientific method.  EF skills are things like self-regulation, memory, organization, and time management.  They are crucial for school success, but even more so for adult life.  Some of us pick up these skills innately or learn them through watching adults in our lives who use them successfully.  But for many, underdeveloped EF skills are a significant barrier in life. 

I have obviously seen these barriers in my work as a teacher, but it has also played a tremendous role in my work with the chronic illness community.  This aspect of neurodiversity is complicated, but there are a number of common reasons someone might not have great EF skills.  ADHD and ASD tend to come with EF challenges.  High levels of stress can also affect this part of the brain; I’m sure we’ve all noticed when times get tough that our memory, focus, and ability to think through complicated situations go out the window.  Overwhelm, lack of sleep, and pain can also have these effects.  It is then unsurprising that those of us dealing with chronic illness would struggle with executive functioning.

The catch-22 is that EF skills are crucial to managing chronic illness.  Taking medications on time, keeping track of doctor visits, sticking to a medically-necessary diet, remembering to do PT, creating a self care plan… these seemingly small speed bumps on our road to wellness can easily derail us if we don’t have strong EF skills.

Whether you have diagnosed neurodivergence or are just foggy and overwhelmed, here are a few tips to help build EF skills:

1. identify the barriers

As always, the first step is naming the problem.  Take a minute to reflect – where are you struggling?  Are you not able to control your emotions or impulses?  Does starting a task feel impossible and sustaining focus is a joke?  Do you lose track of time and miss important meetings or just lose track of your keys and medications?  Whichever EF skills you struggle with, write them down and take a minute to reflect – which ones are impacting your life the most?  Which ones feel like “low-hanging fruit” that you could see positive change most quickly?  Identify one to start working on.  No need to further overwhelm yourself by trying to fix everything at once!  

2. learn more

Yes, this one might be tricky if you’re already struggling to balance your life.  But if you do have time and energy (and brain space) to look into executive function at all, you may find it enlightening!  Not only does it feel validating to read about something you’ve always found challenging and learn that you are far from alone, but many EF skills have simple tips and tricks that can bust you out of your funk.  For example, if you have trouble starting things, try setting a timer for five minutes and simply see how much you can get done in that time.  This lowers your expectation of what you hope to accomplish and often this results in reducing your overwhelm enough to actually get going.

Because EF challenges are so common, there are a wealth of learning opportunities.  Check out online hubs, helpful books, or sign up for a group or coach to get you going.  Fight back any embarrassment or stigma you may feel and remember that what you’re struggling with is extremely common!

More tips for making positive habits here.

3. use tools

Just as there are plenty of learning opportunities for EF skills, there are also ample tools available.  Sticky notes and planners can help with memory and planning.  Timers, reminders, and alarms can help you get started, manage your time, and sustain focus or motivation.  The right backpacks, furniture, and other organizers can help you keep track of your items.  Something as simple as music can be a gamechanger – listen to pump-up tunes when doing boring tasks and find a focus playlist you like for getting work done.  Whatever EF challenges you face, there’s probably an app for that – here are some favorites for organization, self-regulation, time-management, memory We often feel the need to do these things on our own, but it can make a world of difference to let a tool carry the weight of making a change for you. 

Check out our Brain Fog Fix planner here!

4. care for your brain

Creating new habits rewires your brain for positive change.  This work is worth it for the payoff, but anything you can do to grease the wheels will lighten the load!  Getting more (and better) sleep, meditating, eating nourishing foods, and adding in some movement or exercise each day can go a long way.  Taking steps to lower stress and increase mental health are also important.  This could look like taking time for self care, having a friend or counselor to talk through stressful parts of your life, or getting out into nature.

For some of us, EF challenges are solely caused by brain fatigue or emotional stress.  In those cases, caring for your brain and mental health may be the only step needed to get back on track!

Check out more tips for your brain here.

5. accountability and self-love

Making change on your own is tough!  It can help to have someone in your corner acting as a source of accountability.  Consider sharing your goals with a trusted friend or loved one. They can remind you along the way and point out your successes.  Be sure to communicate clearly and openly – they are there for accountability, not nagging!  If it starts to feel that way, talk it out and see if a different type of support would be more helpful.

More on asking for support here.

Unfortunately, we live in a world that adds shame and stigma to EF challenges.  Showing up late or having a messy house can make us feel like bad people, somehow worthy of being judged.  Remember that this is just a social construct!  There is nothing morally wrong with not having been taught these skills.  It is not your fault or anything you should feel ashamed of!  So try to give yourself grace in the moments when you do struggle.  Having this self-love is crucial to success and to maintaining a positive relationship with your accountability supporters.  If you feel yourself starting to feel shame or embarrassment, talk it through with someone.  The best way to dispel shame is by giving it voice to someone trusted.

More on how to find self-love here.

We hope you find these tips helpful!  If you are looking for a community of other foggy and fumbling folks who’ve been there and can cheer you on, check out our Friends in the Fight facebook group!

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