Health
How to Tackle Your To-Do List if You Struggle With Executive Functioning
The pomodoro technique. Power poses. Planners. Denise Daskal has tried them all, searching for the right strategy to improve her executive functioning, or the mental skills used to manage time and pursue goals.
Ms. Daskal has spent hours hunting through TikTok, reading books and taking classes to become better organized and more focused both at work and in her personal life. But the long list of strategies, while somewhat helpful, has felt exhausting, she said.
“My mind breaks a bit when I get overwhelmed and I have too much coming at me all at once,” said Ms. Daskal, 63, who lives in Dearborn, Mich., and was diagnosed with attention deficit hyperactivity disorder a few years ago.
Conditions like A.D.H.D., autism, obsessive compulsive disorder and depression can impede executive functioning; so can the period of life when women transition in and out of menopause. Life circumstances such as parenting young children, getting a bad night’s sleep or even missing a meal can scramble a person’s ability to focus and complete tasks, too.
Here’s how to understand executive functioning, and figure out which coping strategies might work for you.
What is executive functioning?
Executive functions are life management skills that help people “convert intentions into actions,” said Ari Tuckman, a psychologist in West Chester, Pa., and author of the “The ADHD Productivity Manual.”
In other words, if you plan to do something, executive functions help you do it at the right time and place because it will benefit you, either now or in the future, he added. These skills are essential for planning, solving problems, managing time, making decisions and initiating tasks, as well as controlling your emotions and attention.
Amy Dorn, 44, a mother of three in Evergreen, Colo., who has A.D.H.D., has trouble staying calm when her brain becomes overstimulated by too many things happening at once. It doesn’t take long before she becomes frazzled. Sometimes, she said, she’ll even “scream at the top of my lungs.”
There are no quick fixes, but the self-awareness that her brain is different helps her calm down faster, take a deep breath and say she’s sorry.
“The kids call me the apologizer,” she said.
Her tendency to go from 0 to 100 may never go away, she added, so her family has found ways to prevent overstimulation from happening in the first place. Her husband changed his working hours, arriving home earlier to ensure that she has an extra hand shuttling the kids to activities. And they have limited their children to one sport per season.
Moving beyond tips and tricks
There’s no shortage of techniques to help with executive functioning, like the pomodoro method that Ms. Daskal tried, the gist of which is a 25-minute burst of focused attention followed by a short break.
But before trying one of these strategies, experts say, it may help to start with a brief self-analysis.
Identify which aspects of executive functioning are most problematic for you.
Tamara Rosier, the founder of the ADHD Center of West Michigan and the author of “You, Me, and Our ADHD Family,” said that difficulty starting a task was the most common executive functioning issue for her clients. The to-do list can feel overwhelming, which may lead to frustration, anxiety and avoidance.
When Ms. Daskal planned to finally clean out her garage, for example, she was so paralyzed by the prospect that she went out and adopted a dog instead.
Potty training a puppy seemed simpler than confronting the thousands of little decisions required to organize her space, she explained.
Next, look for solutions that address your problem.
For task initiation, ask yourself, “What’s making this hard to start?”
It might be perfectionism, fear or unclear steps, Dr. Rosier said. Once you have a better idea of what’s slowing you down, try to address it. If you’re unsure of what steps to take because your are overwhelmed with emotion, make a list of what is overwhelming. Then ask yourself, “Am I overcomplicating this task?” Challenge yourself to think of the simplest way to do it, Dr. Rosier said.
Another strategy, she added, is to use “body doubling,” which is working alongside someone else — virtually or in person — to create momentum. For example, the Attention Deficit Disorder Association offers an online “productivity powerhour” where people can gather to work toward a goal. You can also pair your task with something pleasant like music or a podcast to make it feel more enjoyable.
Try solving the problem outside your mind.
“Externalizing” your thought process — by discussing your problem with a friend, writing it down or physically manipulating the things you’re working on — can be more helpful than trying to hold everything in your mind, Dr. Tuckman said.
Ms. Dorn, for example, often forgets things that seem boring or mundane. She now wears a recording device on her wrist and says her to-do list out loud, then plays it back later in the day.
Set expectations for yourself and others.
Personal strategies are less effective if your environment isn’t friendly to people with executive functioning deficits, such as a job that requires you to complete a complex task on the computer while continuing to receive instant messages that may or may not require a response, breaking focus on the main task.
Ms. Daskal decided to pivot from owning a salon and spa, which involved managing a facility and a staff, to focus on her dream of starting a new nail polish brand. This time around, she said, she’s mindful of how many responsibilities she’s taking on and which ones need to be outsourced. That helps her make time for sleep and exercise.
“I limit both what I attempt to do in a day as well as the time I attempt to do them,” she said. Her mantra: “One step at a time, one thing at a time.”
Setting expectations with the people you interact with is also important, Dr. Tuckman said. Say you’re always late to meet friends. You can work on arriving earlier while also being honest, saying, “Don’t leave until I text you,” Dr. Tuckman suggested.
Don’t judge yourself too harshly.
If you’ve had trouble with executive functioning, it can be easy to blame yourself — especially if other people are continually suggesting that you fall short.
Remind yourself that you aren’t flawed or irresponsible, Dr. Tuckman said. Rather, you have difficulty following through on what you intend to do and juggling all of the other demands of life in order to make it happen, he added.
This mind-set can be “tremendously validating,” he said, especially when someone has tried so hard — sometimes even harder than others — yet doesn’t have as much to show for it.
“If you are someone who struggles with executive functions, critical people with very specific expectations may not be the people who should have a starring role in your life,” Dr. Tuckman said. “It’s not just you are a bad fit for them — they are a bad fit for you.”
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Cannabis has been linked to some significant medical benefits, but recent research calls those into question.
A major new analysis published in JAMA examined more than 2,500 scientific papers from the last 15 years, including other reviews, clinical trials and guidelines focused on medical marijuana.
“While many people turn to cannabis seeking relief, our review highlights significant gaps between public perception and scientific evidence regarding its effectiveness for most medical conditions,” Dr. Michael Hsu of University of California – Los Angeles (UCLA) Health Sciences, author of the study, said in a press release.
Many medical claims about cannabis are not supported by strong scientific evidence, according to a comprehensive review published in JAMA. (iStock)
The researchers — led by UCLA with contributions from Harvard, UC San Francisco, Washington University School of Medicine and New York University — set out to determine how strong the research is on the effectiveness of medical cannabis and to offer evidence-based clinical guidance.
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The review found that evidence supporting most medical uses of cannabis or cannabinoids is limited or insufficient, the release stated.
“Whenever a substance is widely used, there is likely to be a very wide set of outcomes,” Alex Dimitriu, MD, double board-certified in Psychiatry and Sleep Medicine and founder of Menlo Park Psychiatry & Sleep Medicine, told Fox News Digital.
“Cannabis is now used by about 15 to 25% of U.S. adults in the past year, for various reasons ranging from recreational to medicinal. This study points to the reality that this widely used substance is not a panacea,” said Dimitriu, who was not involved in the study.
There are very few conditions for which cannabinoid therapies have clear, well-established benefits backed by high-quality clinical data, according to the researchers.
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The strongest evidence supports FDA-approved cannabinoid medications for treating specific conditions, including HIV/AIDS-related appetite loss, chemotherapy-induced nausea and vomiting, and certain severe pediatric seizure disorders.
The review identified significant safety concerns, with high-potency cannabis use among young people linked to higher rates of mental health issues. (iStock)
For many other conditions that are commonly treated with cannabis — such as chronic pain, insomnia, anxiety or post-traumatic stress disorder — evidence from randomized trials did not support meaningful benefit.
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The analysis also examined safety concerns — in particular, how young people using high-potency cannabis may be more likely to suffer higher rates of psychotic symptoms and anxiety disorder.
Daily inhaled cannabis use was also linked to increased risks of coronary heart disease, myocardial infarction (heart attack) and stroke when compared with non-daily use.
Daily inhaled cannabis use is associated with increased cardiovascular risks, including coronary heart disease, heart attack and stroke. (iStock)
Based on these findings, the review emphasizes that clinicians should weigh potential benefits against known risks when discussing cannabis with patients.
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The authors suggest that clinicians screen patients for cardiovascular risk, evaluate mental health history, check for possible drug interactions and consider conditions where risks may outweigh benefits.
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They recommend open, realistic conversations and caution against assuming that cannabis is broadly effective for medical conditions.
The review highlights the need for caution, urging clinicians to weigh risks, screen patients appropriately and avoid assuming cannabis is broadly effective. (iStock)
“Patients deserve honest conversations about what the science does and doesn’t tell us about medical cannabis,” Hsu said.
This article is a narrative review rather than a systematic review, so it did not use the strict, standardized methods that help reduce bias in how studies are selected and evaluated, the researchers noted.
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The review notes further limitations, including that some evidence comes from observational research rather than randomized trials, which means it cannot establish cause and effect.
The trial results also may not apply to all populations, products or doses.
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Chronic lateness is known to be a common annoyance, often leading to strain within relationships, experts have confirmed.
And for some people who struggle to be on time, the reasons may go far beyond poor planning.
Psychotherapist and author Jonathan Alpert told Fox News Digital that chronic lateness often stems from a combination of psychological patterns and neurobiological factors that people may not realize are influencing them.
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“For some people, it’s personality-driven. They’re distractible, optimistic about how long things take, or simply not tuned into the impact on others,” the New York-based expert said.
For others, the issue stems from neurobiological differences that affect how the brain manages time.
Chronic lateness may not stem from poor planning, but from psychological and neurobiological factors. (iStock)
That can make it harder to estimate how long tasks take or to transition from one activity to the next, leading to chronic lateness, according to Alpert.
Impact on relationships
In addition to disrupting schedules, chronic lateness may also strain relationships and create tension.
“Lateness erodes trust. Over time, it sends the message that someone else’s time is less important, even if that’s not the intent,” Alpert noted.
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Lateness can also become an issue in the workplace, where repeated delays can undermine teamwork and harm a person’s reputation.
These patterns are common among people with ADHD, who often experience what is known as “time blindness,” making it difficult to recognize how quickly minutes pass or how long tasks truly take.
“Adding 10 to 15 minutes of buffer between activities reduces the frantic rushing that leads to chronic lateness.”
ADHD is strongly associated with executive-function difficulties, which are the skills needed to stay organized, plan ahead and focus on essential details, according to the Attention Deficit Disorder Association.
When these abilities are weaker, it becomes more challenging to gauge time, follow a schedule and meet deadlines, which can impact personal and professional relationships, experts agree.
Frequent tardiness in a work setting can throw off group efforts and leave others with a negative impression of the employee. (iStock)
Underlying patterns
Anxiety, avoidance and perfectionism are patterns that Alpert most often sees in people who tend to run late, he noted.
“Many chronically late individuals don’t intend to be disrespectful. They’re overwhelmed, anxious or trying to squeeze too much into too little time,” he said.
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These emotional patterns often show up in different ways. For some, anxiety can make it difficult to begin even simple tasks, pushing everything behind schedule before the day has even started, according to Alpert.
For others, the struggle happens in the in-between moments. Shifting from one activity to another can feel surprisingly uncomfortable, so they linger longer than intended and lose time without noticing.
Anxiety is a major factor behind why some people have trouble being on time, according to experts. (iStock)
Others may get caught up in the details, as perfectionism keeps them adjusting or “fixing one more thing” as the minutes slip away, Alpert said.
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Another major factor, the expert shared, is that many people simply misjudge how long tasks take. Their internal sense of time is often inaccurate, which leads them to assume they can fit far more into a day than is realistically possible.
‘Time audit’
Alpert often recommends that his clients perform a simple “time audit,” where they track how long they think a routine task will take and then time it in real life. This can help them rebuild a more accurate internal clock, he said.
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“Adding 10 to 15 minutes of buffer between activities reduces the frantic rushing that leads to chronic lateness,” he said.
Many people with ADHD have a difficult time recognizing how quickly minutes pass or how long tasks truly take. (iStock)
Despite the challenges lateness can create, Alpert said people don’t have to be stuck with these habits forever. With the right support and consistent strategies, meaningful change is possible.
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“Strong routines, alarms, checklists and accurate time estimates compensate for traits that don’t naturally disappear,” he added.
People who find that lateness is affecting their everyday life and relationships may benefit from discussing their concerns with a healthcare provider or mental health professional.
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The holidays are known to be a source of stress, between traveling, preparing for family gatherings and indulging in lots of food and drinks.
The uptick of activity can actually put a strain on the heart, a phenomenon known as “holiday heart syndrome.”
Cardiothoracic surgeon Dr. Jeremy London addressed this elevated risk in a recent Instagram post, sharing how heart attacks consistently rise around the holidays.
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“Every year, like clockwork, we see a spike in heart attacks around Christmas and New Year’s,” the South Carolina-based surgeon said. “In fact, Christmas Eve is the highest-risk day of the year.”
This is due to a shift in behavior, specifically drinking and eating too much, moving less and being stressed out, according to London. “Emotional stress, financial stress, the increased pace of the holidays, increased obligations,” he listed.
Cold weather also causes vasoconstriction (narrowing of blood vessels), according to London, which increases the risk of plaque rupture and the potential for heart attack.
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Dr. Glenn Hirsch, chief of the division of cardiology at National Jewish Health in New York, noted in an interview with Fox News Digital that holiday heart syndrome typically refers to the onset of an abnormal heart rhythm, or atrial fibrillation.
This can happen after an episode of binge-drinking alcohol, Hirsch said, which can be exacerbated by holiday celebrations.
Binge-drinking at any time can drive atrial fibrillation, a cardiologist cautioned. (iStock)
“It’s often a combination of overdoing the alcohol intake along with high salt intake and large meals that can trigger it,” he said. “Adding travel, stress and less sleep, and it lowers the threshold to go into that rhythm.”
The biggest risk related to atrial fibrillation, according to Hirsch, is stroke and other complications from blood clots. Untreated atrial fibrillation can lead to heart failure after a long period of time.
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“The risk of atrial fibrillation increases with age, but also underlying cardiovascular disease risk factors increase the risk, such as high blood pressure, obesity, diabetes, sleep apnea and chronic kidney disease,” he added.
Christmas Eve is the “highest risk day of the year” for heart attacks, according to one cardiologist. (iStock)
Preventing a holiday heart event
Holiday heart syndrome is preventable, as Hirsch reminds people that “moderation is key” when celebrating.
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The expert recommends avoiding binge-drinking, overeating (especially salty foods) and dehydration, while managing stress levels and prioritizing adequate sleep.
“Don’t forget to exercise,” he added. “Even getting in at least 5,000 to 10,000 steps during the holiday can help lower risk, [while] also burning some of the additional calories we are often consuming around the holidays.”
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London agreed, stating in his video that “movement is medicine” and encouraging people to get out and move every day.
The various stresses of the holidays can have physical consequences on the body, doctors warn. (iStock)
It’s also important to stay on schedule with any prescribed medications, London emphasized. He encourages setting reminder alerts, even during the holiday break.
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“Prioritize sleep and mindfulness,” he added. “Take care of yourself during this stressful time.”
London also warned that many people delay having certain health concerns checked out until after the holidays, further worsening these conditions.
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“Don’t ignore your symptoms,” he advised. “If you don’t feel right, respond.”
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