We all know someone who’s constantly late, forgets deadlines, leaves tasks unfinished, or takes ages to start anything — maybe that someone is you. In classrooms, universities, and offices, this kind of behavior is often labelled as lazy or unmotivated. But what if it’s something else entirely?
As a clinical teaching fellow, I’ve worked with many students and young professionals who feel deeply frustrated with themselves. Despite having goals, intelligence, and even support, they struggle to “just do the thing.” Time and again, I’ve seen that what appears to be a poor work ethic is often a sign of executive dysfunction, not a character flaw.
What Is Executive Dysfunction?
Executive functions are your brain’s self-management system. They help you:
- Plan and organize tasks
- Start and finish activities
- Shift focus between tasks
- Control impulses
- Regulate emotions and motivation
When these functions don’t work well, the result is executive dysfunction — a breakdown in task initiation, time management, prioritization, and emotional regulation.
It’s not a diagnosis in itself, but it’s a hallmark feature of several conditions:
- Attention Deficit Hyperactivity Disorder (ADHD)
- Autism Spectrum Disorder (ASD)
- Depression
- Anxiety
- Traumatic brain injury
- Post-viral syndromes (e.g., long COVID)
One of the most straightforward explanations of executive dysfunction comes from CHADD, an organization that supports people with ADHD. They describe it as the brain’s equivalent of an air traffic controller — if the controller is overwhelmed, flights don’t land safely. Similarly, tasks don’t get completed efficiently.
Why It Gets Mislabeled as Laziness
There’s no blood test or X-ray for executive dysfunction. That’s why it’s so often misunderstood, especially in students or professionals who are otherwise capable.
A student once told me:
“I care deeply about my studies, but I sit in front of my laptop for hours, unable to start anything. I feel like a fraud.”
To others, it may appear to be procrastination. But under the surface, there’s often a storm of mental gridlock, as the individual battles guilt, distraction, and decision paralysis.
Worse, this cycle becomes self-perpetuating:
- Struggle to start the task →
- Feel guilty →
- Freeze further →
- Missed deadline →
- Internalize shame
Without the proper vocabulary, people often attribute it to laziness. But laziness is a choice not to try. Executive dysfunction is the inability to act, despite a desire to do so.
The Clinical Perspective
When someone presents with difficulty concentrating, forgetfulness, or low motivation, we don’t jump to psychiatric labels.
We start with a confusion screen — a standard medical workup that checks for:
- Vitamin B12 or folate deficiency
- Thyroid dysfunction (e.g., hypothyroidism)
- Electrolyte imbalances
- Infections (e.g., urine infection, sepsis)
- High calcium or low sodium levels
- Anemia
These conditions can impair concentration and mimic cognitive issues. I’ve had patients diagnosed with depression when, in fact, their B12 was severely low. This is why we start with blood work.
Once we’ve ruled out physical causes, we consider psychological ones:
- Burnout
- Depression
- Anxiety disorders
- Neurodevelopmental conditions such as ADHD
What Executive Dysfunction Looks Like
Here are some everyday experiences that may indicate executive dysfunction:
| Real-Life Struggle | How It’s Misunderstood |
| Sitting with an open laptop, unable to start | “They’re just lazy” |
| Forgetting appointments despite reminders | “They’re careless” |
| Avoiding emails or forms for days | “They’re unprofessional” |
| Zoning out in lectures or meetings | “They don’t care” |
| Leaving tasks half-done | “They’re disorganised” |
But if you’ve lived this, you know — it’s not about not caring. It’s the opposite. You care so much it paralyzes you.
Signs You May Be Struggling with Executive Dysfunction
Ask yourself:
- Do I want to complete tasks, but constantly get stuck?
- Do I feel mentally paralyzed by basic responsibilities?
- Do I need intense pressure (like a deadline) to start?
- Do I frequently forget what I was doing?
- Do I feel ashamed of my productivity — or lack of it?
If the answer is “yes” to several, executive dysfunction might be part of your experience.
What Actually Helps
Although there isn’t a single solution, these research-based tactics can be helpful.
1. Break Tasks Into Tiny Steps
Instead of telling yourself “write an essay,” try this:
- Open laptop
- Title the document
- Write one sentence
This reduces feelings of overwhelm and activates momentum.
2. Body-Doubling
Working alongside someone (even silently on a video call) boosts accountability. It helps bypass task inertia.
3. Use Time Tools
The Pomodoro technique is a popular time-management tool that divides work into manageable 25-minute blocks with brief breaks in between.
This method helps people with executive dysfunction feel less anxious about long workdays.
4. Externalize Memory
Use calendars, checklists, sticky notes, alarms — anything that takes the pressure off your brain to remember everything.
5. Get Professional Support
Expert support, such as cognitive behavioural therapy (CBT) and ADHD coaching, can provide strategies tailored to your brain’s operation. For some, medical treatment (e.g., stimulant medication for ADHD) can be life-changing, but should be guided by a specialist.
Why It Matters
Calling someone lazy doesn’t motivate them – It isolates them. The moment a student of mine heard the phrase “executive dysfunction,” he said:
“At last, I feel like I’m more than just broken. Perhaps there is a way forward, and there is a reason.”
Recognizing and understanding executive dysfunction can provide this sense of relief and hope. It is a glimmer of hope in what can seem like a dark tunnel.
Learning the language of people with executive dysfunction can be beneficial. It can cause us to refocus our attention from moral failing to mental health, enabling us to seek treatment rather than dwelling on our guilt.
It’s a helpful key that unlocks a deeper understanding of who we are and the challenges we face. By shifting the emphasis from moral failing to mental health, we encourage people to seek help instead of wallowing in their guilt.
Final Thoughts
If you’ve been telling yourself for years that you need to work harder, take a moment to reconsider.
What if the issue is executive function instead of effort?
You’re not lazy. You’re not alone. You’re not hurt.
You need tools, not shame.
Encourage rather than chastise—empathy, not condemnation. You are not travelling alone on this journey. Many people want to support you and sympathize with your difficulties.
Start by learning more about your brain. Talk to a GP or mental health professional. Ask questions. Read. Reflect.
And if you’ve ever whispered to yourself, “Why can’t I just do it?” — know that many others have asked the same thing.
It’s not laziness. It’s executive dysfunction.
And recognizing that might be the first step toward real change.
If you or someone you know experiences mental health issues, it is important to seek help from a qualified professional. Our Mental Health Resource Specialists can assist you in finding expert help and support in your community. Contact us now for more information on this free service.
About the Author: Varun Tyagi, MBBS, is a Clinical Teaching Fellow currently pursuing his IMT, with a background in General Medicine and a strong interest in Medical Education and Gastroenterology. Having worked in acute medical settings across the United Kingdom’s National Health System (NHS), he brings practical, hands-on experience to his teaching, aiming to bridge the gap between textbook knowledge and real-world clinical practice. Passionate about nurturing the next generation of doctors, Varun is dedicated to delivering high-quality, engaging medical education tailored to both UK graduates and international medical graduates (IMGs). His work reflects a commitment to evidence-based practice, professional development, and compassionate care.
Photo by Photo By: Kaboompics.com: https://www.pexels.com/photo/child-in-beige-hoodie-leaning-forward-on-table-feeling-exhausted-while-studying-6958532/
The opinions and views expressed in any guest blog post do not necessarily reflect those of www.rtor.org or its sponsor, Laurel House, Inc. The author and www.rtor.org have no affiliations with any products or services mentioned in the article or linked to therein. Guest Authors may have affiliations to products mentioned or linked to in their author bios.
Recommended for You
- I Thought It Was Laziness – But It Was Executive Dysfunction - September 15, 2025
- 10 Hobbies That Can Help Ease Depression - September 11, 2025
- ‘I Am Broken’ to ‘I Am Healing’: A Mindfulness Journey Towards Self-Compassion - September 8, 2025
