The first time I heard the term “executive functions” was when I went with Dan to meet his new psychiatrist. The doctor explained that people with obsessive-compulsive disorder typically experience deficits in their executive functioning.
What are executive functions? A search on the Internet yields plenty of information, though much of it is quite technical. One of the easier to understand explanations, which describes executive functions as the air traffic controller of the human brain, can be found here. Some skills associated with executive functions include planning, organizing, managing time, and remembering details. Those with executive dysfunction might find it difficult to focus, concentrate, make decisions, follow through on creative ideas, and shift attention to new information.
Dan struggled with all of the above. I’ve previously written about his trouble focusing and concentrating, which led to his misdiagnosis of ADHD. Decision making was also a big issue for him, as was time management. I always thought of these issues as by-products of his OCD, and that once his OCD was under control, all these other concerns would just melt away.
There’s no question that once Dan’s OCD was quelled, there were noticeable improvements in all areas of his executive functioning. So many of these issues had been interwoven with his OCD. Still, given Dan’s major recovery from severe OCD, the gains he made in areas of executive functioning didn’t quite correlate. They lagged behind. I concluded that this is just who he is and how his brain works.
I have since come across various studies such as these that confirm my belief. In one study, the executive functions of those with symptomatic OCD were compared to those who were in remission. In a second study, the executive functions of those who were symptomatic in the first study were reassessed after they reached remitted status. Results from both studies indicate that the “identified executive function deficits in individuals were stable over time and remained unchanged despite symptom remittance.” So even if someone’s OCD improves, their executive function deficits (if any) remain.
To me, these results serve as a good reminder that we are never dealing with “just OCD.” Really, when evaluating any illness, mental or physical, it is so important to consider the whole person: who they are, what makes them tick. I realize now the improvements I saw in Dan’s “executive functions” were most likely deficits directly caused by his OCD. Thankfully, he has learned to compensate for any shortcomings he might have pertaining to his executive functions, just as most of us do. We all have strengths and weaknesses; our brains are not all “wired” the same. And thank goodness for that!