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How to Cope with Executive Dysfunction After Brain Injury

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Executive dysfunction after brain injury can impact everything from how you make plans to how you socialize with others. This enormous effect on quality of life makes it essential to get proper diagnosis, treatment, and management as soon as possible.

To help determine if you are experiencing executive dysfunction after brain injury, this article will explain the most common symptoms. You’ll also learn some effective ways to cope with the difficulties that accompany executive dysfunction.

What Is Executive Dysfunction After Brain Injury?

Executive dysfunction refers to a range of cognitive, emotional, and behavioral difficulties that typically occur after damage to the frontal lobe. As the name suggests, it impairs a set of higher cognitive skills called executive functions that help individuals interact purposefully and appropriately with the world around them. These skills are what allow you to learn new things and manage daily life, for example.

Some executive functions include:

  • Planning and organizing
  • Making decisions based on good judgment
  • Self-awareness
  • Understanding social cues
  • Multi-tasking
  • Initiating proper behavior and inhibiting improper actions
  • Concentrating and following a conversation

Most of us never think of these actions as “skills” since they come naturally to us. But in reality, they require complex cognitive activity.

Signs of Executive Dysfunction After Brain Injury

Executive dysfunction can affect every aspect of a person’s life, from their organization skills to their interpersonal relationships.

The following are a few signs of executive dysfunction that can occur after brain injury:

1. Lack of Motivation and Initiation

depressed-looking girl leaning over railing which could signify executive dysfunction after tbi

Lack of motivation and initiation (also known as adynamia) usually occurs after damage to the frontal lobe. Symptoms of adynamia can include low activity, difficulty getting tasks started or finishing a task to completion, and social isolation.

In severe cases, the person can struggle to perform basic self-care tasks such as showering and taking medication.

While adynamia can look a lot like depression, it is not a psychological illness. Rather, the person’s lack of motivation stems from several cognitive deficits, such as poor attention and problem-solving skills and memory problems. Helping the patient improve these skills can therefore often improve their motivation.

2. Loss of Organization and Planning Skills

Executive dysfunction also causes a person to have trouble planning out the steps needed to accomplish a goal. As a result, they usually get overwhelmed and give up.

Some signs that you may be struggling with poor organizational skills include:

  • Difficulty starting or finishing a task
  • Putting off work or assignments until the very last minute
  • Easily distracted
  • Poor time management
  • Difficulty working on more than one thing at a time

Poor organization can also be a symptom of cognitive fatigue after brain injury. Cognitive fatigue simply means your brain does not have the energy it needs to function efficiently.

3. Inflexible Thoughts and Actions

couple arguing with each other

Difficulties changing plans or changing opinions are another effect of executive dysfunction after brain injury. Depending on how severe the brain injury was, this mental rigidity can manifest as aggressive behavior or even violent outbursts.

It’s important for family members to remember that this stubbornness is not the person’s fault, but an effect of their brain injury. Fortunately, a neuropsychologist can help the patient find effective coping methods for this effect.

It will take a lot of work, but it is possible for TBI patients to learn how to handle unexpected circumstances again.

In addition, reducing stress, getting enough sleep and exercise, and eating healthy can all help reduce the severity of rigid behavior. As one brain injury survivor explains:

“When I take care of my body, the physical factors that contribute to rigidity don’t have a chance to get a foothold.”

4. Impulsivity and Social Difficulties

young man with sunglasses on and tongue sticking out

Finally, executive dysfunction after brain injury affects a person’s self-awareness and can lead to disinhibition.

Areas of the brain involved in regulating behavior include the gyrus rectus and the insula, both located in the frontal lobe. Damage to both of these areas is associated with greater disinhibition.

Signs of disinhibition after brain injury can range from laughing at inappropriate times to uncontrollable bursts of rage. Some people will struggle with aggressive behavior, while others might seem overly friendly.

Other common symptoms of disinhibition include:

  • Tactless or inappropriate remarks
  • Impulsive decisions
  • Divulging personal information to strangers
  • Agreeing to a task they cannot complete

While disinhibition after brain injury can cause serious problems, with the help of counseling, it is possible for a person to regain control of their most harmful behavior.

Coping With Executive Dysfunction After Brain Injury

Executive dysfunction can make daily tasks more difficult. Fortunately, there are methods you can use to cope with these difficulties. Some recommendations from psychologists who specialize in brain trauma include:

  • Find external motivation. Since executive function causes problems with finding internal motivation, it can help to use external forms of motivation to compensate. For example, ask a loved one or friend to take you to your therapy appointments even when you don’t feel like it. Sometimes having someone else come to your house and pick you up can give you that extra dose of motivation that your brain can’t quite supply on its own.
  • Break down activities. Sit down with someone else and try to come up with a step-by-step plan for whatever goal you might have. To stay on track, write it down and cross off every step you complete. You can also keep checklists around the house. For example, keep a list in the kitchen so you can remember the right sequence to prepare a meal.
  • Create signals. For impulsive behavior, work with your loved ones to create a special “stop and think” signal that they can flash at you when you are doing something inappropriate or dangerous. This can help you retrain yourself to not make so many mistakes.

These are just a few examples of some techniques you can use to manage executive dysfunction. For more personalized coping methods, talk to a neuropsychologist.

Executive Dysfunction and TBI

Executive function is something we all take for granted. As a result, we can easily forget that these skills require a healthy brain to perform them and make unfair judgments on those who struggle with them.

That’s why it’s so important to educate others about executive dysfunction, and to help those suffering its effects find ways to cope. With the help of doctors and therapists, many people can find effective ways to manage their difficulties.

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Get Inspired with This TBI Recovery Story

Independance, motivation and hope!

“My son Sharat suffered a severe traumatic brain injury 23 years ago leaving him with Aphasia and right sided weakness from his vision,hearing to his limbs. The lockdown in June was a great challenge for him as his caregivers stopped coming, no gym workouts and no outings for a coffee.

Being his mother and primary carer I feared that this was a hotbed for depression. I scoured the net and chanced upon FlintRehab. As there was a trial period it was safe for us to risk getting it across to Auckland.

His OT checked it out and felt that it was ideal. I can honestly second this.

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He has to use both sides of his brain. The caregivers are OT students who returned enjoy working on it with him.

In three months there motivation built up in him with a drive to use his right hand. There is definitely a slight improvement in his right hand.

This encourages him as well as the caregivers to try harder.His overall mood is upbeat. He enjoys it, so much so, that it doesn’t matter if his caregiver is away.

FitMi is a blessing.”

Sharat’s review of FitMi home therapy, 10/10/2020

5 stars

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