Ask HN: Has anyone been able to overcome crippling executive dysfunction?

Out of curiosity, how do you describe your medication making you hyper focus on anything other than work? My psychiatrist has told me that means it's working, yet I feel like it is just a different sort of dysfunction.

Ok, yeah, my underlying cause was everything. I had a bad case of everything bad that can happen happening at the same time (except personal death). Both my parents had previously died in my twenties and yet this period of time in my life was 10x harder than that in terms of grief and turmoil, I reverted to a child like state and had constant intrusive wishes that I could just lay my head on my moms lap and cry but of course I couldn't.

My cognitive capacity dropped so low that even my speech became nearly monosyllabic. The feeling of being depressed switched to the point where I was in a constant fog and I really felt like I was a passenger to the depression, like I no longer had depression but depression had me.

I was going to a therapist at the time who was very good and very expensive and he was quite clear about the need for intervention and to take things seriously. I had also recently stumbled across this paper: https://www.jcdr.net/articles/PDF/6186/13392_CE%28RA1%29_F%2... so even though I had depression my primary concern was the severity that had led to my cognitive decline.

I really didn't want to go on anti-depressants but I was willing to do so, I made a deal with my therapist that I would commit to biking every single day for the 3 weeks between sessions and if I didn't stick to that commitment I would start a prescription.

My dad had a terrible bout with depression when I was a teenager, caused by some very serious betrayal in business dealings by a close friend, for a time he didn't get out of bed, that short period of time spiraled our family life out of control and materially destroyed my life trajectory which took me decades of hard work to crawl out of because I started supporting our family full time at 15 out of necessity, because this was pre ACA and we had a lapse in coverage during which my mother was diagnosed with cancer. I won't go into the details here but basically I loved my dad but always felt a deep anger/rage at this period of not getting out of bed. So no matter what I would get out of bed.

I got on my road bike and biked twenty miles a day every day as hard as I could, I took a route that was ten miles and I left nothing for the ride back, then I would ride back, this was in the Texas August heat, I would drink 2 gallons of water and had to keep an ice bottle to keep my head cool, I rode like some sort of doomed machine trying to tear my own limbs apart.

For two weeks I did this, with no improvement, no incremental change, nothing. On my bike I would cry and sing (because of that pdf) like some kind of psycho barreling towards hell, because I have heart defects I am on medication that blocks adrenaline so there wasn't even a runners high and the first 30 minutes of riding I always felt like lead as my heart took time to keep up with the exertion (that is still and will always be the case for me). On the 16th day, after my ride, my mental fog lifted for one hour as i flipped back into the driver seat, i was still depressed but _I_ was depressed.

I never went on anti-depressants, the facts of my life were still what they were and everything fell apart and my whole life changed radically and permanently and I lost so much of everything a person can lose. But after 45 days of continuing to just get out of bed and step on my bike every single day, and singing and raging and just absolutely sounding nuts on this 20 mile ride in 90+ degree heat I finally had my first FULL day where I was depressed but my mind was working and the depression was no longer in the driver seat, I had ownership for the entire day.

And the whole thing felt impossible at each step, but really all it was was mechanically getting out of bed, getting my feet on my bike pedals and biking far enough away that I was finished but I still had to bike back.

I couldn't have done it on a treadmill, I couldn't have done it in a pool, I had to push myself as hard as I could. Fortunately on a bike 20 miles was two hours at first and later an hour.

As an aside, I've also found that certain protein shakes and collagen shakes cause brain fog, probably due to something in how my body spikes blood sugar from those products. I switched to 1% cottage cheese for getting sufficient protein without having to eat a lot.

Work is stupid. You have to realize that. Everyone that is working is just stupid, along with me, along with you. It's a stupid thing society came up with. Every time you see someone working on something, just go "my god, what a moron".

Given that, you have to realize your soul is telling you "I'm kind of tired of being stupid, and you and your brain seem to have stupid ideas for me - the soul".

It's a fight between your heart and your mind, and your mind is a slave to whatever reality demands. Now, your soul may be so depressed that it wants to sit and do nothing, but that's not going to work (no pun intended). So you have to have your mind and soul find a compromise, whatever that is.

The soul cannot lie, and it will stop you in your tracks. You better start talking to it. One thing my soul eventually conceded is that my body needs food and shelter at the bare minimum, so it capitulated a bit and worked together with my mind to get things done, but nothing more. Do not fuck with the soul dude, it's nothing to play with.

Executive dysfunction here, bordering overwhelming but never actually overwhelming. So I probably have it easier than you. Here's what's working for me.

1. Healthy food: I tend to freezer prep the healthiest meals for like a month. Think like an industrialist here, cook for scale.

2. Running: two or three 3 mile runs a week helps a lot

3. Sleep: without it, I'm fucked. With it, I might not be. But without it, there's no chance to do anything.

4. Love: my wife is my life (in a sense). I'd do anything for her, even overcome my executive dysfunction. If it's for her, I will fight and if she needs a functioning me, I will fight for it.

5. Therapy: it turns out I had trauma. We were able to cleanly heal half of that. The other half is more messy but it helped with everything.

6. Meditation: I don't do it a lot unless I'm at a retreat. Each retreat I go to helps, eventhough I hate going, haha. It really helps (checkout dhamma.org).

7. Combine training discipline with meaning and hope. I want to learn more math as I want to understand the secrets of the universe and I think it's in math and coding and AI. Well, it's one avenue, it's in more of that but those 3 topics are already huge. I'm learning math now because I want to know the secrets of the universe (I'm a playful whimsical romantic person like that). Learning math requires me to utilize more discipline than I'm used to. I will fight for it. For if I can't even have a shot at this, I don't see much of a point other than living for my wife. So yea, I have to do this, I have to understand more about the nature of reality. Because it's awesome. It just so happens that it helps me to stay focused at work.

8. Pick a job that plays to your strenghts and is below your level. I'm currently a data analyst and I'm overqualified to do that job. I could've started as a junior data scientist 7 years ago (if anyone would've had me back then). Doing data analyst stuff right now is easy peasy. Linear regression? Done. Some coding? I'll tackle it as a software engineer (I was one before this). Creating dashboards with Tableau? I did frontend with React before this. Doing some SQL? Sure. Doing some presenting? I love presenting! I could do this job even when I'm sleep deprived as it doesn't tax me cognitively, being a software engineer does.

9. Train discipline. Related to 7 but just the advice to do your best to train discipline.

10. Love yourself, foregive yourself, go easy on yourself. You're trying, you're doing your best. That's all you can do. Beating yourself up about it will only mean you have to do more damage control.

11. Look for role models. I only found partial ones, but I've seen similar neurodiverse people tackling life's challenges better than I did. I emulated them a bit and it helps.

12. Attack this problem from the angle that you'll tackle it from a 1000 different perspectives.

13. Journal and reflect. I'm not great at this. I write a lot in my Apple Notes, that's great. I almost never read it though. I do tend to read my journals when I have to write a how to guide to myself. I write guides like "how to sleep" or "how to be good at dating" (thank god I'm married now!), basic life stuff. It really helps.

14. Play to your strengths. One of mine is that I'm incredibly curious. Half the time reframing something as an experiment as opposed to a task I have to do will make me do it. But that's because I'm incredibly curious and need to know the outcome of that experiment.

15. I tried some ADHD medication. It supresses my feelings and fixes my focus at a particular "zoom level". So if I need to mix convergent and divergent thinging - like with math - I can't. Basically, I've noticed that with programming taking ADHD medication helped. But in retrospect, it helped because agile culture kind of sucks. I know this now because ever since I'm working as a data analyst, programming is more fun. I program as much as a software engineer but it's more fun. Why? Because no one tells me that I need to write perfect code, I get to decide that. No one tells me when or what to code, I get to decide that. No one tells me what business problems to solve with code, I get to decide that.

I've learned so much being a data analyst about what's good and bad with agile culture, it's insane. I am now much more firmly in the camp of that software engineers aren't programmers, they're consultants that are capable of solving business problems either manually or through automation (i.e. programming). Consultants in this sense are problem solvers, not people with slide decks that then leave.

I hope some of this helps.