Action — Our Second Executive Function
Welcome back to the ADHD: Bitesize Guide to our Six Executive Functions!
Last time we took a look at Emotion, the first of our executive functions.
We examined how our emotions are affected by ADHD, and how those impairments can affect our lives. We also looked at ways we can improve our ability to regulate and respond to emotions. If you missed it, you can read it here!
This time we're looking at Action—the second of our six executive functions.
Action includes monitoring ourselves, regulating our actions and behaviour, and controlling our impulses. In short, Action concerns our ability to appropriately regulate our behaviour to accommodate different situations.
Those of us with ADHD often have trouble regulating our actions and behaviour, and tend to have poor impulse control.
The result can manifest itself in the following ways:
Getting really impatient when stuck in traffic, even to the point of road rage.
Frequently interrupting people when they're talking.
Answering people before they've finished asking a question.
Having trouble waiting—such as in queues, taking turns, or on hold on the phone.
Suddenly doing or saying something random, even inappropriate.
Making sudden (often poor) decisions or taking risks.
Being reckless with money—gambling, impulse-buying, or overspending.
Blurting out hurtful remarks or throwing things when upset.
Being unable to resist going too far—not knowing when to stop.
Switching jobs often, never feeling satisfied or fulfilled in them.
Do any of those sound familiar to you?
The Trouble With our Actions
Not every person with ADHD exhibits behaviour to a degree that's problematic. When problems do manifest, however, they can range from the moderately frustrating to the downright dangerous.
Compared to neurotypical people, those of us with ADHD are:
At a 1.5 times greater risk of substance abuse.
More likely to be involved in a traffic accident, be convicted of traffic offences, and engage in risky driving behaviours.
More likely to clash with our parents about more issues when growing up.
More likely to have poor interpersonal relationships due to "anger issues".
More likely to quit our jobs, or be fired.
At a higher risk of pregnancy / getting someone pregnant, or contracting a sexually transmitted disease, due to risky sexual behaviour.
In fact, we may live up to 13 years less than neurotypical people, due to impulsive behaviour and substance abuse, amongst other factors.
I'm not including these rather frightening statistics to scare you, but rather to highlight the importance and seriousness of getting appropriate help and support for the very real condition of ADHD.
Why Do We Have Trouble Regulating Actions?
One of the main reasons we struggle to regulate our actions is our unique brain chemistry. ADHD brains have far lower levels of several hormones and neurotransmitters than neurotypical brains, and our subconscious seeking of them can explain our behaviour.
Dopamine is our brain's "feel-good" hormone, and those of us with ADHD have a natural lack of it. As a result, it's very easy for us to find pleasurable pursuits that reward our brains with a little dopamine hit than it is for us to do that not-very-pleasurable-thing-we-should-do-instead.
For example, it's probably sensible to stop playing video games so we can do our chores. We may even want to do the chores. But the chores won't give us a hit of dopamine like the video games do. So we keep playing, and the chores don't get done.
Then there's impulse control. This too is linked to the need for dopamine in the ADHD brain. Impulse control can be defined as knowing when to stop or say "no", and whether a behaviour is appropriate or not for the current situation.
We tend to be really bad at impulse control.
A lack of impulse control in children is common whether or not they have ADHD. It's a skill that's learned as the relevant areas of the brain develop and grow. As children age into teens, and later into adults, these differences in impulse control between people with ADHD and without become greater.
Once again, the lack of dopamine in the ADHD brain can lead to us literally craving the "hit" created by a pleasurable-but-not-very-sensible decision we make, such as buying something we can't afford, or eating that third slice of cake.
When the ADHD brain doesn’t have enough stimulation, it looks for ways to increase its activity. Stimulating our understimulated brains can come from unexpected—even unpleasant—sources, such as confrontation.
Being angry or negative has an immediate stimulating effect on the brain. When you get upset, your body produces increased amounts of adrenaline, raising the heart rate and brain activity, and rewarding our underactive frontal lobes with a little "rush".
Although undoubtedly some people enjoy arguing and creating drama, the vast majority of us with ADHD do not. We feel terrible when these arguments and negativity continually happen in our lives, but worse still, we often have no idea that we're causing it.
We don't engage in these behaviours willingly. Rather, these behaviours are driven by the needs of the ADHD brain to boost the hormones and neurotransmitters it naturally lacks.
What Can We Do About It?
There are many areas that are impacted by the impairments in our Action executive function. Thankfully, there are things you can try to help improve each of them.
Make a plan. Take a moment to identify the problems you tend to have, and brainstorm as many solutions you can think of. No matter how crazy the ideas sound, write them down anyway—you can always discount them later. Use the best ideas to create an action plan to help curb the problem.
Count to five. It sounds simple—and it is—but it can also be very effective. Stopping for a moment when you feel an impulsive urge to do or say something can give you the space you need to think more rationally about the decision.
Create an alternative. If you tend to impulsively reach for the chocolate bars too much, for example, find an alternative snack that's healthy and tasty. That way, when you get the urge to snack, you can do so healthily and harmlessly.
Allow an outlet. It's fine to indulge impulsive behaviour if it's done within healthy boundaries. Perhaps you give yourself a small "impulse-spending budget" each month—£25 to spend on whatever you want.
Mindfulness. Focus on your thoughts, emotions and urges when you're impulsive. This won't be easy to start with. But with time and practice, mindfulness can help you observe your impulses rather than be driven by them.
Make it harder. If you tend to spend impulsively when you go out, for example, leave your credit cards at home and just take a fixed small amount of cash. If it's harder to act impulsively in the moment, that creates a bit of space to allow you to make better decisions.
Humour is the best defence. Learning to laugh at your mistakes is a great way to take the sting out of saying or doing something awkward. Let's face it—frequently what we say and do is utterly ridiculous! Take responsibility for the actions and words that spill out by laughing at how inane they seemed, and others will start to chuckle about it, too.
Apologise if you offend. If what you said or did isn't just silly and it's caused actual offence, apologise immediately and genuinely, without excuse or explanation—even a real explanation can sound like a non-apology. A simple, "I'm so sorry, that was out of line. Please forgive me," is best.
"Give me a minute to think about it". This is a great phrase to use if you are asked your opinion on something. If a topic is particularly inflammatory—politics or religion, for example—it's usually best to avoid jumping in with the first thought that comes to mind. This phrase allows us a few moments to think about who we are with, and what effect our words will have.
Don't speak if you're emotional. If you're angry, upset, over-enthusiastic, or any other powerful emotion, consider saying nothing at all for a while until the emotion has subsided. Strong emotions can override our better judgment and make a verbal faux-pas more likely. If you're concerned you'll forget what you wanted to say, write it down and revisit it when you're calm.
If you HAVE to speak, use code. If you're angry or upset to the point where you absolutely HAVE to say something, have a stock phrase—a code—that conveys how upset you are without saying something you might regret. Something like, "I'm REALLY upset! I want to deal with this later!" Then take yourself off somewhere to cool down.
The harmful results that can often occur as a result of our impaired Action executive function can be mitigated or avoided altogether with support. Options include professional therapy, prescription medication, ADHD-focused life coaching, and self-help strategies.
Join us next time when we take a look at Activation—our Third Executive Function. Learn why we often have trouble with prioritising, planning and organising, the ways that affects us, and powerful solutions to help. See you there!