Like most areas of mental health, neuropsychologists seem to have experienced an uptick in the number of people seeking services in the last year.
I think one of the reasons is that the pandemic and related issues have stressed our executive functions. Executive functions are higher order functions that are generally associated with the frontal lobe of the brain, an area that continues to develop well into our 20’s. Executive functioning includes planning and organizing, task initiation, task completion, working memory, and inhibiting impulses. In short, executive functioning skills underlie our ability to achieve at work and at school.
There seem to be two main ways that the pandemic has affected executive functioning. First of all, the pandemic has globally increased stress and anxiety. When we feel stressed, our executive functioning breaks down. Think of a time that you felt extremely anxious and overwhelmed. I bet everyday tasks seemed daunting and overwhelming. One example I like to share with patients is my personal experience at the beginning of the pandemic. Prior to March 2020, when I left my house, I had a list of essentials items that I would repeat to myself, “Keys, wallet, phone.” This is my executive functioning skills ensuring that I did not forget these essential items. All of a sudden, this list evolved into, “Keys, wallet, phone, Clorox wipes, mask, hand sanitizer.”
“The very act of needing to wear a mask and having Clorox wipes in my car increased my level of anxiety. I was so focused on needing these new items that there were many times in April and May 2020 that I left my house with Clorox wipes and a mask but without my keys or phone. ”
Secondly, without much warning, the pandemic shifted the way that we worked and attended school.
The physical setting of a workplace or school adds structure that supports our executive functioning.
For example, there are built in times in high schoolers’ days to go to their locker and switch out materials for class. An elementary student who spaced out when directions were given and is now unclear about what materials are needed for a science project, can look around the classroom and see what his neighbors are doing.
Your workday had more structure to it, with physical meeting times, and maybe even a scheduled lunch break. Suddenly, these external structures were no longer in place. Even some of the strategies we used independently were no long relevant or helpful. Without these strategies and structure, many people who have inherent executive functioning difficulties have really struggled.
In short, the pandemic has shed light on difficulties that people were previously able to manage independently. A neuropsychological evaluation can help pinpoint and quantify these difficulties, identify the etiology of these struggles (something like anxiety versus ADHD), and identify recommendations to help you or your child.
This will be particularly important as we return to a modified version of in-person learning or work.