How to Navigate ADHD Under Pressure

There’s a growing body of research focusing on how emotions can impact executive functioning with ADHD.

Note on this article: Sometimes, I wonder why I keep returning to the topic of executive functioning. But then (as I mentioned to Will Curb on an upcoming episode of Hacking Your ADHD), this is one of the fundamental building blocks of our neurodiverse brains.

Let’s dive in!

Like many people, I struggle under pressure. Whether typing while sharing my screen on Zoom or handling Q&A after a talk, it feels like simple tasks become much harder when I’m stressed. 

If you feel this, too, you’re not alone. There’s a growing body of research focusing on how emotions can impact executive functioning with ADHD. A recent study even conducted an exploratory literature review to combine current research and make sense of this area [1].

They called it hot and cold executive functioning. 

What is Hot and Cold Executive Functioning?

Hot executive functioning is when you try to complete a cognitively complex task under emotionally salient conditions. Aka, you are trying to do something, but you feel frustrated, sad, confused, etc. Cold executive functioning, on the other hand, is when you’re trying to do a cognitively demanding task, and you're under no such pressure. 

As a reminder, there is no perfect definition of executive functioning. However, in this case, the paper described it as a "largely interdependent process necessary for goal-directed behavior." It noted that working memory, set-shifting, and inhibition are the primary executive functions required to accomplish tasks [1]. Many definitions of executive functioning exist, but this one is pretty standard.

The review found some evidence to suggest when people with ADHD feel emotionally stressed and do a task that requires restraint; performance tends to drop. 

What does that look like…

Imagine getting bad news and then being asked to read off a list of names, only calling out the ones highlighted in red. Or getting bad news and then being asked to drive! It can feel impossible to switch into functional mode.

So, does this mean we must be emotionally balanced before we do anything? 

While that would be nice, it’s not, unfortunately, very realistic. 

However, there is something that could help…And it’s probably something you’ve heard of before. 

Mindfulness

Mindfulness teaches us to use a top-down strategy for processing our emotions, which is very helpful for moving away from that hot executive functioning  [2]. Practicing this top-down approach during periods of calm can allow us to use this technique more effectively when stressed [3].

Can We Do Mindfulness With ADHD?

Yes! 

But with a caveat. 

For a lot of people with ADHD, the idea of meditating conjures up images of silent rooms… and a lot of anxiety and boredom. 

But it doesn’t have to be that way. Mindfulness can be an active practice. You can mindfully wash your dishes, mindfully rock in a chair, or mindfully take a walk. 

And it doesn’t have to be for a long time, either. Even just trying a minute or two can help you start. It’s just about building a moment between your thoughts to make them easier to observe. Focus on the physical sensations of the activity as a starting point. 

And let me know how it goes managing your hot executive functioning!

Wishing you a focused, balanced day.

Skye

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References

1. Smith, J. N., Jusko, M. L., Fosco, W. D., Musser, E. D., & Raiker, J. S. (2023). A critical review of hot executive functioning in youth attention-deficit/hyperactivity disorder: Methodological limitations, conceptual considerations, and future directions. Development and Psychopathology, 1-15.

2. Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotion dysregulation in attention deficit hyperactivity disorder. The American journal of psychiatry, 171(3), 276–293.  https://doi.org/10.1176/appi.ajp.2013.13070966

3. Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotion dysregulation in attention deficit hyperactivity disorder. The American journal of psychiatry, 171(3), 276–293.  https://doi.org/10.1176/appi.ajp.2013.13070966