Executive Function Rules Emotional Regulation

When I was diagnosed with autism four years ago, my psychologist told me that my tentative bipolar diagnosis from when I was 19 was probably wrong – she said that I probably had “mood lability associated with autism”.  I had no idea what this meant, nor why she was saying this as though it were a known quantity.  I’d never heard of mood swings being an autistic trait.  But as I’ve learned more about how my brain works, I’ve learned that executive function is one of my biggest challenges and – surprise – executive function rules emotional regulation.

A Refresher on Executive Function

Executive function is a set of cognitive skills used by the brain’s frontal lobes to handle planning, organizing and prioritizing, initiating activity, inhibition, responding to change, and lots more besides.  This is the cognitive function that’s most affected by ADHD, making it hard to organize information, plan and finish tasks, and control our impulses long enough to focus.  It covers eight specific areas, one of which is emotional control.

Some clinicians separate executive function skills into “Cool” skills – our skill levels when we’re relaxed and at our best – and “Hot” skills – our skill levels when we’re under stress.  Obviously, nobody is at their best when they’re stressed, so some deterioration in executive function is expected.

It bears restating here that autistic people of all ages are always under stress from living in this world that isn’t made for us, so our executive functioning is never at its best.

How Does This Apply to Emotional Regulation?

Basically, executive function controls emotional regulation through a combination of inhibition and healthy response to change.  Together, these allow a person to make transitions easily and think through their emotions before acting on them. 

Conversely, executive dysfunction affects a person’s ability to identify and communicate their emotions.  It allows someone to be overwhelmed by an emotion, perhaps to the exclusion of other feelings, or to rapidly shift back and forth between feelings.  Executive dysfunction can also affect someone’s ability to modulate their emotional responses.  Just like some autistic people have trouble regulating the volume of their voice, this means that emotions may be out of proportion to the situation.  People may be overly upset at something small or seem to react coldly to larger issues.

If you’re under constant stress, whether you’re NT and going through a lot of problems or autistic and dealing with regular sensory and social overload, your executive functioning will suffer.

If, like most autistic people, you have some form of executive dysfunction or ADHD as a fun bonus to go with the sensory sensitivities and processing issues, you’re starting the race a hundred feet back with weights on your legs.

If it’s both, emotions are always going to be a challenge for you – and if there’s trauma into the mix, say, from bullying or abuse, that just adds another layer to the cake.

So What Can Be Done?

What can you do to improve your emotional regulation and executive function? 

Short answer: Therapy.

Long answer: The right therapy for you and your specific issues.  This is much harder.

CBT (Cognitive Behavioral Therapy) is where many therapists start.  It’s good for working through thoughts and feelings and beliefs, but it’s more about thinking through emotions than processing or modulating them.  It may or may not work with an autistic brain – it’s never worked for me and I’ve heard from other autistic people that it’s ineffective for them as well.  There’s no harm in starting with CBT, as long as your therapist is open to trying something else if it doesn’t help.

DBT (Dialectical Behavioral Therapy) can be good for adults and can be especially helpful if there’s more to deal with like trauma or abuse.  DBT focuses more on taking responsibility for your emotions and their effect on yourself and others.  It also offers strategies for avoiding emotional overwhelm and processing emotions that feel “too big”.  If CBT doesn’t get good results, this is a good next step.

Medication can be a helpful option as well.  I know, it sounds a bit Twilight Zone to think of taking meds to control your emotions, but they can be useful.  ADHD meds improve all areas of executive functioning, which means they can help with emotional regulation from that side.  Anti-anxiety medication can cut down on excessive worry, test anxiety, or social anxiety, and in many cases that alone can help people maintain a more even keel.      

You have options.  Talk to your doctor and therapist to find the best course for you.

It’s a Challenge, Not an Excuse

Just because you have executive function issues does not give you the right to let your emotions explode all over the people around you.  You don’t get to say “I can’t control my emotions because I have ADHD/executive dysfunction, so you can’t be mad at me for anything I say or do”.  That’s childish, toxic, and abusive to those around you.  Remember Wheaton’s Law.

Knowing that emotional regulation is a part of executive function can offer more possibilities for managing your emotions – and I’m all for finding as many ways to attack a problem as possible!  Since stress makes executive functioning worse, try to avoid sensory stress as much as possible and counteract it with good sensory input.  Make self-care a priority to manage anxiety.  Work on learning to identify and name your feelings with a Wheel of Emotions or other exercises so that you can talk about what you feel rather than letting it overwhelm you.  Try to anticipate obstacles so that they aren’t surprises – yes this is challenging for those of us with executive dysfunction, but isn’t it easier to deal with problems that you’ve already thought about?

Learning that my emotional regulation was connected to my executive dysfunction was a revelation for me.  The same process that makes my brain forgetful and distractible is the reason I can go from one emotion to the next in 0.07 seconds and come back down just as quickly once I get that initial burst out?  Who would have thought?  It’s at once a relief and a responsibility – I’m not at fault, and I’m not sick, and there are ways I can manage it.

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Have you found that your emotional regulation improved when your executive dysfunction was treated?  I was only on ADHD meds for three months, so I never really got to see.  Do you have any tips or exercises you’ve learned to help manage your emotions?  How about any hacks for the EF-challenged brain?  Have you ever known someone who let their feelings run roughshod over everyone around them and then expected people to just accept it?   

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