Impairments in Planning and Inhibition Skills in Severe Mental Illness

In the intricate system of cognitive functioning, the abilities of planning and inhibition help to guide us through complex interactions and life decisions. Yet, for individuals experiencing severe mental illnesses like psychosis, schizophrenia, and bipolar disorder, this guidance may become erratic. Impaired planning and inhibition skills can lead to profound challenges in navigating daily tasks and interactions. On this page, we delve into the impact of severe mental illness on planning and inhibition skills, highlighting the interplay of cognition and mental health.


An Introduction to the Science

To comprehend impairments in planning and inhibition, we must first look into the realm of neuroscience. In conditions like bipolar disorder and schizophrenia, dysregulation of neurotransmitters like dopamine can profoundly impact emotions and behavior. Dopamine contributes to feelings of satisfaction and motivation. However, it also plays a part in regulating various cognitive functions, including executive functions like planning and inhibition.

Bipolar disorder is characterized by fluctuations in mental health from manic highs to depressive lows. In this condition, dopamine levels can fluctuate widely. During manic episodes, elevated dopamine levels may heighten impulsivity, reducing executive functions such as the abilities to inhibit behaviors and plan ahead. Conversely, during depressive episodes, decreased dopamine levels may lead to apathy and lethargy, also hampering cognitive flexibility and planning abilities.

Schizophrenia operates in a different way. It is theorized that excess dopamine activity contributes to positive symptoms like hallucinations and delusions. However, cognitive deficits observed in schizophrenia, including impaired planning and inhibition, are often attributed to irregularities in the prefrontal cortex.

Understanding Executive Dysfunction

Planning and inhibition are part of a set of cognitive processes known as executive functions. These functions encompass a wide array of abilities, including working memory, cognitive flexibility, planning, problem-solving, and impulse control. In severe mental illness, impairments in various executive function skills disrupt the orchestration of thought and behavior.

Individuals with bipolar disorder may struggle with impulsivity during manic episodes, for example by engaging in reckless behaviors without considering the consequences. A sense of grandiosity and heightened self-esteem characteristic of mania may distort judgment, reducing the ability to formulate and execute coherent plans or inhibit harmful behaviors.

Similarly, schizophrenia presents its own cognitive challenges. Disorganized thinking is a common trait of the condition. This can sabotage the planning and problem-solving processes, rendering even simple tasks too daunting to approach. Additionally, hallucinations and delusions can hijack attention and memory skills, diverting focus away from goals, routines, and plans.

Coping Strategies and Interventions

Despite the obstacles posed by severe mental illness, there are interventions that may mitigate the impact on planning and inhibition skills. Learning about the traits of the illness can play a pivotal role, empowering individuals and their loved ones with knowledge about the nature of the condition and the cognitive challenges that come along with it. Cognitive-behavioral therapy (CBT) can equip individuals with practical tools to challenge maladaptive thought patterns and enhance impulse control. Additional cognitive therapy, such as Occupational Therapy, can help individuals to build routines, rebuild cognitive skills that have been impacted, and regain control of their daily lives.

Medication is often a vital part of treatment. Pharmaceutical inverventions can address the underlying neurochemical imbalances. Mood stabilizers and antipsychotics may help temper the extremes of mood and thought, improving neurochemistry until it is conducive for cognitive functioning. However, finding the right medication regimen is often a delicate balancing act, with clinicians striving to alleviate symptoms while minimizing side effects.

Beyond clinical interventions, lifestyle modifications can also improve cognitive resilience. Habits such as regular exercise, adequate sleep, and a healthy diet nurture both body and mind. Mindfulness practices, such as meditation and deep breathing exercises, may offer a sense of balance amidst the turbulence of mental illness, helping individuals develop a sense of inner calm and clarity.


In severe mental illness, the journey towards healing can be difficult. Conditions such as bipolar disorder and schizophrenia impair skills such as planning and inhibition, and these impairments to cognitive functioning may make day to day life feel insurmountable. However, with appropriate treatment such as cognitive therapy, individuals may find opportunities for growth, resilience, and connection. By fostering compassion and understanding, we hope for the stigma surrounding mental illness to dissipate. Through mental health awareness and treatment, we hope that all individuals can be valued and supported in their journey toward well-being.

Aly Castle

Aly is HappyNeuron Pro’s Content Specialist. She is passionate about mental health and well-being and loves utilizing her design background to share important cognitive information clearly and understandably.

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