Finding Motivation Through the Brain Fog: Managing Low Executive Function Days

Over the past couple of years, I’ve had the opportunity to work with many folks experiencing executive dysfunction. Executive dysfunction can accompany various psychological conditions or injuries; and the reality is, many of us will face some degree of executive dysfunction in our lives (1). Executive functions include our ability to self-regulate, plan and prioritize, and manage working memory, among others. Working memory is simply our brain’s ability to hold different information at one time. Think of executive functions as the managers in the front of your brain that work together to get things done.

Many of the clients I support live with attention deficit hyperactivity disorder (ADHD) and corresponding executive function challenges. But don’t let the name deceive you. ADHD is more about challenges with self-regulation than attention and focus (2) . People with ADHD also experience seasonal affective disorder (SAD) at a higher rate than the general population; even more so for women (3). Depressive symptoms can also contribute to executive dysfunction, making this time of year especially challenging for many. 

Periods of executive dysfunction can negatively affect motivation and self-regulation, which can impact our ability to work, take care of things at home, and even impair relationships. And because January is known as the most depressing month of the year, I have gathered some strategies I often use with my clients to cope with periods of low executive function and take care of ourselves the best we can. 

1. Ease perfectionism — your efforts are enough, especially on hard days. Perfectionism and shame work in a loop; fortunately, this loop can be disrupted by practicing self-compassion and awareness. Perfectionistic tendencies and shame can wreak havoc on motivation and often stops us in our tracks before we even start! Learn more about perfectionism and shame here, and self-compassion here. 
2. Feed your brain and body efficiently. Our appetite and ability to feed ourselves often suffer on difficult days. Don’t make these days any more difficult than they need to be! Coming up with efficient go-to systems for hard days can include low effort foods that are easy to prepare (bonus points if it’s prep-free!) and don’t require a lot of energy to consume. Consider working with a dietician who works specifically with executive dysfunction to create a system that works for you if you need more support in this area. 
3. Set realistic expectations for yourself using the “one thing” system: if you could do one thing to help you feel better now, what would that be? That one thing is enough for the day if that is all you have the capacity for. What I find works well for many of my clients is making a list. I know, it sounds simple. But gathering the energy to organize your thoughts alone is a daunting task and often keeps us in a state of task paralysis until we are able to make small movements.
   1. Start using a blank page and write your tasks and/or worries in no particular order.
   2. Once you have run out of ideas, take a break and come back to it when you discover more things you may have forgotten.
   3. Later, begin to prioritize what is on your list
   4. Start with a low effort, rewarding task. This is something you define. For me, it’s starting a load of laundry. 
   5. Once the motivation ball is rolling, task paralysis starts to dissipate and you can begin higher priority tasks. 
   6. Pro-tip: don’t overdo it. Task hyperfocus is real and can deplete our energy quickly. If you aren’t taking breaks, your brain is not recuperating. Use timers if time-blindness is a challenge for you.

The “one-thing” system is individual to you and may not be a list or prioritization. This is where self-awareness comes into play — get to know what works for you and keep track of these systems to keep them working. 

4. Social support and body-doubling: we tend to withdraw from others when we feel low and unmotivated. Try your best to reach out to a trusted support person who understands how difficult days affect you. Humans are social beings, and sometimes we can gain energy simply by working alongside someone who is engaged in a task. This is also known as body doubling and can be a useful system for low motivation.
5. Refuel your dopamine: this is the fun part. Neurochemicals dopamine and norepinephrine play a major role in self-regulation, reward and motivation. It is difficult to find motivation if we can’t experience reward. Thankfully, we can find dopamine in our environment by following a Dopamenu. This system was coined by Jessica McCabe and Eric Tivers and breaks down helpful (and sometimes unhelpful) choices to increase pleasure and reward. The key here is to get to know (here we are at self-awareness again) what activities work best for you and keep track of these things. For help getting started, check out this template.

You may notice that some of these strategies focus on adopting systems rather than changing thoughts. Using systems to change our environment are often very effective if you struggle with executive dysfunction. This list is not exhaustive but should help to get the proverbial ball rolling on days where the ball weighs a tonne. And although the size of the ball may be out of our control, the systems and supports we have behind it can help it feel less heavy. 

SAD can seriously impact our lives. If you or someone you know is experiencing symptoms of SAD, please get in touch with your health care provider and mental health clinician. You don’t have to do this alone. 

References

1. https://www.additudemag.com/what-is-executive-function-disorder/
2. Barkley, R. The 30 Essential Ideas Every Parent Needs to Know. https://www.youtube.com/watch?v=SCAGc-rkIfo
3. https://www.psy-ed.com/wpblog/adhd-and-sad/

Men’s Mental Health and the “Silent Crisis”

Men often struggle with mental health concerns in silence because of public, individual and developmental perception of what it means to be a “man”, the ability to be strong and the stigma (and perceived weakness) around mental health concerns.

Counselling vs Coaching: Making the Choice That Works for You

You have made the decision to tackle some issues and learn to approach things differently, but as you start to do the research, you come up with a question: “do I need counselling or coaching?” Let’s take a look at the differences between these two supports to help demystify the titles, skills and approaches.

What is coaching?
Coaching is an approach that is designed to help you see clearly where you are today, and then find ways to move forward toward your goals. A good coach will not tell you what to do, but instead will ask thought-provoking questions that will require you to reflect, and ultimately gain clarity on the choices you need to make first to set, then achieve your goals. A coach is a sounding board to help you discover what it is you want to do and how you are going to get there.

What is counselling?
The term counselling is often used interchangeably with the terms therapy and psychotherapy. A qualified counsellor is someone with a Master’s Degree or higher in the field of therapy. A counsellor is trained to assess functioning and development as they apply various therapeutic techniques to create a safe and supportive space for you to explore who you are and what you want in life. A good therapist will help you identify problems, aid in developing skills to manage a mental health concern or diagnosis, provide you support and guidance, identify strengths and ultimately help you improve coping and move forward, rather than allowing past issues to keep you stuck.

Coaches and counsellors are similar because both:
● want to help you find create a life you feel good about
● encourage self-discovery
● can help you identify and work toward life goals
● create an environment of trust, non judgement, and support to help you
identify what is holding you back
● focus around using good listening skills and asking you effective questions
● help you with identifying core beliefs that may limit you, and then focus on challenging this perspective
● help foster resiliency
● want you to find your own answers that will work for you
● help you move forward in your career, relationships, and home life
● have the goal of helping you reach your potential

But here is how they differ:

I am going to be honest here. Due to the lack of strict guidelines and regulations governing the field of coaching, individuals should do their due diligence to learn about their potential coach’s education, experience, ongoing training and specialties. It is also important to know whether the coach has the wisdom and professionalism to pass on working with a client because they are not mentally or emotionally well, and as such, are in need of counselling before coaching can begin. A similar warning can apply to therapists too. Just because one has the education, it does not mean that they are qualified to treat all issues, nor do they have the experience you need to feel supported. Asking questions of your provider and assessing fit is key.

What about a counsellor who is ALSO a coach?
Some counsellors integrate coaching approaches into their work. This ‘therapeutic coaching’ includes helping you identify obstacles, set goals, change perspectives, and identify and modify core beliefs. As a therapist who is educated, experienced and who practices both counselling and coaching, I aim to assess my client’s needs and use the approach that best fits with what they want to achieve and how they want to get there. I am up front with my clients in identifying my opinion on which approach will work best for them. I have worked with people who have come to me for coaching, but ultimately realized that some counselling is required before the coaching can begin, or conversely, counselling clients who have achieved therapeutic goals and who are ready for coaching to help them move to the next level.

The Take-Aways
Whether you choose counselling or coaching depends on your personal preference, but a qualified professional will be able to guide you in the right direction. In general, if you want to focus on what you are dealing with right now, don’t want to probe too deeply into emotional issues, you need help taking actionable steps, and you are in need of guidance as you travel through life stages and changes, coaching may be for you.

If you are ready to think about identifying and breaking patterns of thinking and acting that have been impacting your life for some time, you want to feel heard and understood, you would like to improve your self-esteem and understand yourself, and want to figure out what you want in life and move towards it, counselling might be a good choice.

Remember that the professional you choose needs to appeal to you and be someone you can see yourself connecting with. Aside from training, approaches and skills, both counselling and coaching are far more effective if the communication between you and the professional works for you. It is essential that the environment is open and non-judgemental, and that you feel heard and understood during your work together. Each coach and counsellor will bring with them their own personality and unique way of working with clients. It is essential that the professional you choose is skilled and knowledgeable of the issues facing you and is able to identify when they may not be the right person for the job.

Be a savvy consumer of services. This is your life! Do your research, ask questions, and arrange a meet and greet with your counsellor or coach so you can ensure that you have found a professional who is “your person”, who will guide you as you do the heavy lifting required to fulfill your potential.

“Am I Depressed?”

“I don’t know what’s wrong with me”

Through the last two years, we as therapists have noticed an increase in folks who have sought out therapy for the first time in their lives, because “they don’t know what’s wrong”.  This has been a refrain for all of us at various times during the pandemic.  It is upsetting, frustrating, overwhelming…(all the feels) to not feel like ourselves, and to have no idea how to pull out of it because everything that usually helps does not seem to be working.  

When we are feeling unwell and our coping skills are depleted, our minds can spin out of control with “what ifs” around possible chronic mental health issues, diagnoses, dependence on medications and the need for professional intervention.  It is a scary reality to think we are stuck and unsure if these feelings will ever relent.  

As I sat down to write this blog, I decided to google “Am I depressed or…?” to see what popped up.  Here is a small sampling:  Am I depressed or sad, lazy, tired, bored, burned out, bipolar?  WOW! What a laundry list of inquiries, ranging from questioning and attempting to label emotions to querying mental health and diagnosis.  We as therapists are pleased that people are becoming more aware of their emotions and mental health, and how they both impact their day to day habits and quality of life. We also worry that the feelings of hopelessness and the overwhelming volume of information on mental health that is all over the internet can actually exacerbate symptoms, rather than providing comfort or relief. 

There are literally thousands of tools, therapy interventions and medical treatments used to assess, diagnose and treat depression that need to be utilized by a trained professional. There are also many valid informational and educational pieces on depression out there that you can use to first sort through the symptoms you are experiencing,  gain an understanding of the severity of them, learn how to assess and incorporate day to day habits that may help ease symptoms, and finally help you to make informed decisions about seeking professional support. 

Here is one, from the Centre for Addiction and Mental Health (CAMH), that provide useful information on depression, diagnosis, coping and treatment. Remember that this is not to be used as a substitute for professional advice and support, but it is from an accredited, professional organization that aims to educate so that you can self-assess before making decisions about reaching out for support. 

I think I am depressed…now what? 

One of the most studied and supported treatments for depression comes from psychiatrist Aaron Beck, called Cognitive Behavioural Therapy (CBT).  To put it very simply, one of the pillars of CBT is the Cognitive Triangle.  This triangle helps us examine the intertwined relationship between our thoughts, feelings and behaviours.  When you are doing CBT with a trained professional, you are learning how to identify negative and intrusive thoughts that impact how you feel about yourself, your situation and your relationships, which in turn impact the choices you make about how you behave or respond. Again, professional support to help with this triangle is just one of the keys to managing depression, but doing a self-assessment check-in on your own can be a powerful way to understand whether or not to seek professional support to confirm a diagnosis, or treatment to help manage these thoughts and make some changes for the better.

Check Your Thoughts

Many of us resort to googling information on any issue we are faced with, whether it be a leaky faucet or our mental health. We do this because it feels safer to “DIY” our problem, so that we don’t have to say it out loud (because that makes it more real), and so we can hopefully find a solution that we hope will be an easy fix. The other reason we often start with Google is because we are feeling some shame around the issue and the act of even asking for help.  Many of us hold longstanding and firmly planted beliefs around the concept of admitting to a problem (think perfectionism) and asking for help (think “weakness”, “incompetence”, and feeling “less than”).  

Challenge yourself to really identify your thoughts around what you are experiencing, and how these thoughts may be roadblocking your ability to manage your moods, relationships and overall functioning.  It is so easy to believe everything that pops into our heads.  The truth is, a lot of what we think about ourselves is hyper-critical, and is driven by fear and shame.  Newsflash: we don’t have to listen to these messages! 

Check Your Feelings

As therapists, we hear clients using “negative self-talk”, whether it be out loud, or in their heads to put themselves down, name call, and shame themselves for experiencing what are actually normal and healthy feelings. Throughout the pandemic, many of us have resorted to “numbing behaviours” such as scrolling through our phones or Netflix bingeing because we have just not had the will or the energy to identify feelings, much less actually feel them! If this sounds like you, try to get into the habit of asking yourself “what am I actually feeling right now?”  Identifying the feeling and actually naming it will help you manage it, rather than pushing it further within by seeking quick fix and feeling-numbing behaviours that actually take us into a perpetual shame spiral of negative self-talk. 

Check Your Behaviours

Here comes your mother’s, fitness instructor’s, therapist’s, doctor’s voice: get plenty of sleep, drink lots of water, eat your vegetables, go for a walk, and practice mindfulness. “YUP, got it,”  you are saying (me too).  The issue for most of us is not that we need this knowledge, it is ensuring that we actually practice these behaviours. 

Let’s go back to the thoughts part of this cognitive triangle.  When we are feeling depressed, our minds generally block out these simple, yet challenging habits which we know in our heads will help us feel better.  Depression can almost act like a magnet that keeps us attached to our bed, sofa, phone or computer screen, thereby blocking out the will to incorporate habits that will naturally increase the happiness chemicals in our brains and will contribute to us feeling even a little better. Again, the shame-spiral of knowing that you already know what to do to feel better but not being able to push yourself to actually do it is activated, thus leaving you feeling further down and depressed. 

Just having a basic understanding of this cognitive triangle can be helpful to become more self-aware of our feelings, moods and behaviours.  The smallest bit of self-awareness and the tiniest of changes is progress.  Drinking one glass of water instead of none, reaching out to a friend to walk and talk, or getting into bed 15 minutes earlier than usual is all part of living the change. 

So if you are reading this and still asking yourself whether or not you need help to cope with this post-pandemic reality, the answer is YES! We all do. The past two years have been a harrowing and traumatic experience for every single one of us.  For some, emotional and mental health issues that existed before the pandemic have increased in intensity and severity.  For others, the current set of circumstances has led to new and uncomfortable emotions that have taken a toll on quality of life. 

Seeking the support of a qualified, experienced therapist will help you sort through your own cognitive triangle and make choices around the next steps to take to alleviate the symptoms on one end of the spectrum, to seeking out more intensive and long-term interventions on the other. Regardless, reaching out for professional help will ensure you are getting outside of your head and that you are not walking the path to feeling better all alone. 

Day Ten – Pressing The Re-Set Button on Your Family Life During Social Isolation

Nobody Is Perfect.  End. Of. Story.  

So while you’re at it, abandon perfectionism.  Be kind to yourself and your family. The house will be messy, people will have to be convinced to bathe, you will eat junk, those long-standing house jobs will not get completed as quickly as you envisioned, if not at all.  That’s alright. Go back to the values. I can safely guess that NOBODY came up with “Do All The Things” as their top family value.  

Start with today.  Look at these tips and take one hour at a time.  Take it slow. Be forgiving. You can have do-overs.  Each day is it’s own. Motivation will go up and down, moods will set in, energy levels will fluctuate.  Find what works and do more of it when you can. Do less of what doesn’t. Know that what works one day will not work on another.  

Alternate between doing what works and pushing the comfort zone to try new things, ways of coping and communicating… and then give a high five, regardless of the outcome.  

Remember: your family WILL come out of this stronger, more connected and victorious.  Surviving will mean thriving.  

Day Nine – Pressing the Re-Set Button on Your Family Life During Social Isolation

Recognize that this is hard. These days may seem long.  Making all the lists in the world does not help the work get done, the structure implemented and the values applied.  Some days will just suck.  

Moods, loneliness even when amongst the family, loss or reduction of connections with peers, sports, teachers, co-workers will take its toll.  Recognize this and take a break. Pyjama days, Netflix marathons or extra screen time will be necessary. And that is ok. Fatigue will set in. Neither parents nor kids are required to be perfect. Just stop doing for a while.  

These days are a gift (even though some days that feels like a stretch). Never before have we collectively had such a large chunk of time where we are ALL at home, without the normal day-to-day pressures being applied.  It takes a while to get out of the achievement headspace (I MUST do something, I NEED to do this, I HAVE to get this done). Relax. Forgive yourself. We have NEVER BEEN THROUGH A PANDEMIC BEFORE! This is a choose your own adventure kind of thing! 

Keep an eye out for emotions and talk about them.  It will not be uncommon for many people (adults and kids alike) to feel sad, lonely, depressed and hopeless.  This will happen, even in a house full of people who love us. Encourage connections with friends, co-workers and extended family.  Ride the waves of emotions, and remember, that professional help is still out there, offered virtually.

Pressing the Re-Set Button on Your Family Life During Social Isolation

Day One

So here we are, settling into Covid Family Life.  This is a time marked with uncertainty as to where this is going, and for how long.  Most of us have experienced the roller coaster of emotions associated with this experience.  From shock, to sadness, depression, anxiety and back through again. Hopefully, you are moving into accepting this situation for what it is today, and are now thinking about how you are wanting to travel through it as a family.  

Ironically, as difficult as this time is to endure, many people have enjoyed the slowed pace and the ability to really enjoy each other, and think about putting some family habits and systems in place that we have lagged on a little.  You can do this too! But you need to follow the first guiding rules: 

• NOBODY, NO FAMILY, NO PARENT is perfect
• Be forgiving of yourself and each and every member of the family as they adjust to these times and struggle to manage emotions
• Be patient.  Change takes time.

Over the next couple of weeks, we are going to provide some tips for helping and even improving your family dynamic during our social (read physical) distancing.  We are hoping that this will be a virtual family therapy of sorts. You don’t have to be dysfunctional, riddled with conflict or in crisis to need family therapy! In fact, it is our belief that every family could benefit from using these tips to open conversation and foster connection. 

Share some of the biggest challenges you have experienced as a family since the Covid situation began.