What Is Pathological Demand Avoidance (PDA?)

What is Pathological Demand Avoidance (PDA?)

author/ amanda/ august 14, 2023

Pathological Demand Avoidance, shortened to PDA, is a term used to describe a profile of behavior associated specifically with autism. It is not a separate diagnostic category, but rather a term used within the autistic community to describe a specific pattern of characteristics and challenges. Basically, PDA is characterized by an extreme avoidance of demands and expectations from others. Autistic girls and women with PDA may exhibit high levels of anxiety and difficulty coping with everyday tasks and activities that involve demands or requests. For example, let’s say you wake up motivated with a goal to take out the trash and finally do those dreaded dishes. As soon as you walk downstairs to do those tasks, a family member says, “Can you please take out the trash? Also, I’d really love it if you could get to those dishes today.” Motivation? POOF. gone. Energy? Nonexistent. Now, no matter how much you actually wanted to complete those tasks today, you absolutely cannot because someone told you to do them. Does this sound familiar?

You might have Pathological Demand Avoidance!

Please know that you are not purposefully trying to be difficult. Oftentimes, the demands are simple tasks or activities that you would normally find manageable when done via your own volition. It’s when it is presented to you by another person, no matter how kindly, that the PDA kicks in and the task becomes impossible to complete and you avoid it like the plague. It’s important to mention that this is a “can’t” kind of situation, not a “won’t.” By this I mean you physically and mentally cannot complete the task. Your body and mind will not let you, or will not let you without extreme levels of internal coaxing. It’s not simply because you are choosing not to do said task, as it’s far more complex than that. Others may view you as lazy or disagreeable because of this and it can be heartbreaking to a girl or woman with PDA autism to be misunderstood in this way. If you have PDA autism, you may respond internally or externally. This can involve shutting down when given a demand, trying to escape the situation entirely, or lashing out. Lashing out may look like yelling or a good mood immediately turning sour. Some neurotypicals may see this as “having an attitude” or “becoming moody.” Oftentimes, this is not the way you intended to act in the slightest. You may harbor guilt for acting this way towards the people you love and care about the most, but you can’t always stop yourself.

I just CAN'T!

PDA is often associated with high levels of anxiety and the need for a sense of control over your environment. When someone tells you to do a task, your body may see this as a threat to your autonomy and your flight, flight, fawn, or freeze responses may be triggered as a result. This is not only difficult in the home, but also in places such as work and school. When others such as higher ups or teachers give directions and tasks for completion, it can be extremely stressful for the autistic girl or woman to deal with. Also, due to the nature of PDA autism, girls and women can easily go misdiagnosed and strapped with incorrect labels such as Bipolar Disorder (BPD) or Oppositional Defiant Disorder (ODD.) The main difference between Pathological Demand Avoidance and Oppositional Defiance Disorder is that PDA is always accompanied by autism, but ODD is a separate diagnosis that can stand by itself.

It’s important to mention that PDA is not actually officially recognized as a separate diagnosis in the DSM-5. It is under the umbrella of autism though. However, it’s still important to know this term as it is helpful in understanding and supporting yourself when you know the specificities of this behavioral profile.

Demands

There are a variety of different demands that are present in day to day life. What some people don’t realize is that a demand does not necessarily need to come from another person, they can also come from within yourself. Also, demands do not have to be direct. Here is a list of some demand examples that someone with PDA autism may struggle with:

Holding in your pee and avoiding going to the bathroom because your body is telling you that you have to go.
Not brushing your teeth or cooking yourself dinner because you “have to.”
Being asked a question that you are expected to reply to on the spot and you don't want to respond.
Becoming “grumpy” or even nonverbal in class when asked to move to a new seat out-of-the-blue and you are uncomfortable with the new change.
When a family member says, “Oh, look who finally came downstairs” when you enter the room. Now, you want to immediately make yourself scarce and go right back to your room.
Avoiding doing your hobby because of the self-imposed perfectionism you placed on yourself and now it’s too overwhelming to start the hobby you usually love.
Becoming mentally “paralyzed” when needing to make a decision and ultimately not making a decision in the end.
When a family member says, “Go over there and hug your grandparents” and you really didn’t want to hug anyone in the first place, but now you are required to.
Avoiding going to that party you previously said you would attend because now the day has arrived and they expect you to be there.
Avoiding dating and getting into a relationship because of the everyday demands, expectations, and changes that come with having a new person in your life.
Avoiding going to the post office because you have to send out a letter or package and the task is overwhelming.

These are just a few examples about what demands might look like in your life, though there are countless more. It’s important to recognize that demands are widespread and may not always appear to be a demand outright. It’s not always possible to change your behavior in relation to PDA, but striving toward recognition and acceptance will be valuable as you move forward in life. If possible, work towards recognizing what your triggers look like and do your best to talk through this with the people in your life. Tell them what works well for you as well as what is extremely unhelpful. Accepting yourself for who you are can be a challenge, but take small steps over a long period of time. Any progress is good progress, no matter how small. Try to find methods of coping that work for you specifically so that you can work towards completing the tasks that you want to do. You may even have to go so far as to trick yourself into completing tasks. This may look like roleplaying or creating an entirely different persona within yourself. For example, if you need to clean the dishes but absolutely CAN’T, turn on some medieval tavern music, dim the lights, and pretend you are but a lowly scullery maid in a far away village. Talk out loud to yourself and pretend to have conversations with the travelers and adventurers visiting the tavern. You need to do what works for you, no matter how quirky. Ultimately, you need to be compassionate with yourself. Many neurotypical people will not understand this struggle and say things such as, “It’s not even that hard, just do it.” If those around you are unwilling to understand you and accommodate you and your needs, you need to be on your own side.

If only one person is on your side, let it be you. <3