Executive Function & Mental Health: A Delicate Dance
This month, in honor of Mental Health Awareness Month, I’m focusing on the ways executive function support can complement mental health treatment—especially when it comes to early intervention. I’ll be sharing the story of one student who dealt with medical issues, depression, and EF challenges. As her coach, I worked closely with her team to create a system to track her energy and motivation, helping us act before things spiraled. But, before we get there.
In 2021, the U.S. Surgeon General issued an urgent advisory: youth mental health had become a national crisis. While the COVID-19 pandemic worsened the situation, the warning signs had been appearing well before. For example, in 2012, 11.6% of youth were diagnosed with anxiety—a 20% increase from just five years earlier. By the time the pandemic hit, we were already seeing significant increases in depression and anxiety. The World Health Organization (2022) reported a 25% global increase in anxiety and depression during the first year of the pandemic alone.
Even now, we haven’t seen those numbers come down.
As an Executive Function (EF) coach, I’ve come to recognize the deep connection between mental health and executive functioning. Over the years, I’ve worked with many students who come to us not just because they’re disorganized or missing assignments—but because their mental health is affecting their ability to initiate tasks, maintain energy, and follow through.
In fact, a 2023 study found that fatigue and energy loss were the strongest links between depression and executive dysfunction. I see this play out all the time. When a student is struggling with fatigue and low motivation, it’s not always laziness—it may be the first sign of something deeper.
Let me introduce you to a student I worked with over several years. She came to me in high school while navigating three intersecting challenges:
1. A chronic medical condition
2. Executive function struggles
3. Ongoing mental health concerns, including depression
Each challenge impacted the others. A medical flare-up often led to an emotional downturn. When that happened, her motivation plummeted, fatigue spiked, and her ability to get started on tasks disappeared. But the sequence wasn’t always the same. Some weeks her fatigue would hit first, other times her mood would drop without warning. We knew we couldn’t prevent every episode—but we could create a system to recognize the warning signs early. Here’s what we did:
🧠 Executive Function & Mental Health Support System:
• Weekly Energy & Motivation Tracking: Every Monday, we recorded how she was feeling—physically and emotionally—and tracked her motivation levels. This gave us a baseline and helped identify early shifts.
• Collaborative Check-Ins: I worked closely with her therapist and psychiatrist. If her motivation dipped or fatigue increased beyond normal patterns, we communicated right away to adjust her emotional and medical support.
• Tutor Coordination: Her academic tutor and I reviewed her assignments weekly. We would:
o Prioritize essential work
o Modify the workload as needed
o Increase or decrease tutoring sessions depending on her bandwidth
• Flexible Planning: We used an adjustable calendar that included “must-do,” “should- do,” and “could-do” tasks. This allowed her to scale her workload up or down without falling behind or feeling overwhelmed.
• Emotional Checkpoints: She was able to name when she was entering a depressive state, which gave her more control. Sometimes just recognizing the shift was enough to slow it down.
• Clear Routines: We kept our Monday sessions consistent so that she always had a predictable time to reset, reflect, and re-prioritize.
While no system can eliminate mental health challenges, this structure gave her something to lean on. When everything else felt like it was slipping, she had a clear map and a supportive team in place. As EF coaches, we’re not therapists—but we play a critical role in helping students organize, activate, and connect their support systems. We can be the eyes that notice subtle shifts, the hands that help structure the week, and the voice that advocates for the student when things get hard.
This Mental Health Awareness Month, I hope we all remember: support doesn’t always look
like a solution. Sometimes it looks like connection, collaboration, and consistency.
