Discover the signs and coping strategies for PDA (Pathological Demand Avoidance).

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Welcome back to the Women's Mental Health Podcast with Randi and Jess, two licensed psychotherapists where we talk about mental health, well being, and strategies for coping with life's challenges. And

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how it's all normal and you're not alone.

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In this episode, we're diving into a topic that's gaining more attention in the mental health community, understanding PDA or pathological demand avoidance and its impact on mental health.

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PDA is a lesser known condition, but it can have significant implications for mental health and overall well being.

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And for those who think PDA is public displays of affection, this is not the PDA of your parents generation.

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PDA is a subtype of Autism Spectrum Disorder, or ASD. So buckle up, ladies, because we're going to dive into this.

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Find us and more resources on womensmentalhealthpodcast. com. Have you

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ever had these thoughts? What is PDA? Is PDA a form of autism? How does PDA affect mental health? What are the signs and symptoms of PDA? How is PDA

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diagnosed?

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Can adults have PDA? What are

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some coping strategies for individuals with PDA?

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How can loved ones support someone with PDA?

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Are there resources available for learning about PDA?

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How can I seek professional help for PDA? We'll talk about these questions more in depth at the end of the podcast.

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All right. Let's break down what PDA is.

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We are seeing it on TikTok more and more and social media challenges. And so we really wanted to talk about this. Jess had never heard of it before.

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Never. She sent me this TikTok and I was like, what is this? And I was like, PDA is this personal? No, that's not public display of affection. What does that have to do with it? So we did have to deep dive into this and I thought it was really interesting because I sent it off to a friend of mine. And I went, Oh. Look this word up, because I think this might be your kiddo. PDA is a condition in which a person really resists and avoids the ordinary demands of life, even when being compliant is in their best interest. So one of the reasons I didn't know what PDA was is it's not something that we look at here in the U. S. It's an interesting concept. It's not something we're taught. It's not in our DSM our diagnostic Manual. It's used a lot in the UK. It's used in Australia. It's used in other countries. And I wish the U. S., honestly, after reading this, would get on board with it a

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little bit more. Well, let's be honest. Other countries are definitely more progressive in their mental health.

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I, just, I, did you hear my eye roll? You should have heard my eye roll on that one. It just rolled right off the table

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here. But that's why a lot of therapists especially therapists who have this profile are talking about it more in social media because they want more awareness about it and they want to bring it to the DSM and to the U. S.

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Let's talk a little bit

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more about it. Individuals with PDA have a distinctive profile within the autism spectrum. It's characterized by an extreme avoidance in everyday demands and expectations. It's just things are just too much, and you just don't want to do those everyday things you need to get done.

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So let's talk first about the signs of PDA. How do we recognize

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it? So people with PDA typically display avoidance behavior such as trying to distract like the authority figure or person who's made the request. My child does this, making excuses, withdrawing into fantasy, kind of like living in like, you know, Minecraft world. Yeah, a Minecraft world and avoiding meaningful conversations.

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And so a lot of times, these behaviors will end up leading into meltdowns or panic

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attacks. so common signs in PDA are, like we said, the resistance and avoidance of everyday demands, including those that are perceived as minor or routine, like maybe like you brushing your teeth, just gonna say that brushing your teeth, I hate brushing my teeth showering. Yeah. Like. Things like that, that you know you need to do, you know they're good for your health, you know you're going to get cavities if you don't do this, you're going to smell if you don't do this, but you just cannot make yourself do it. You're just avoiding it. And so this leads to also an overwhelming need to be in control or to avoid being controlled by others. Mm

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hmm. It's also using social strategies as part of their avoidance really bright coming up with different ways to kind of like avoid this. I think

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because people always ask me like if I was like a lawyer because I could talk my way out of different situations and I think I would just had PDA.

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Yeah, I was just thinking I was talking, avoiding things, right? I was talking to the friend yesterday and I was like, man, your kid's going to be a great attorney. Mm hmm. Be a great attorney.

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It also seems like you're really good at social things on the surface, despite having difficulties with social interactions.

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Hmm. So maybe like masking. Mm It has obsessive behavior, often focused on other people, or it can be focused on performance demands. Usually due to like acute anxiety.

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So like maybe something along like schoolwork, like you get like hyper focused on maybe your grades or things like that.

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Or even having to attend school, not getting in trouble at school. Having to actually show up at school every time. Also appears comfortable in role play, which I thought this was really interesting Appears comfortable in role play and pretend and sometimes to an extreme extent

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So what do you think that

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looks like? You know, It reminded me a couple years ago We were walking downtown back when everybody was doing the Pokemon thing right when it came out We were all downtown with our phones trying to find the Pokemon there was an individual walking around with a friend, I think it was a sister the individual, she, I don't know if it was a girl or boy, I'll be real honest, I don't know who it was, had a big stuffed mask on their head. So cosplay. Like cosplay. Yeah. But only had the mask. They were wearing normal PJs and gloves. So

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cosplay, furries, that type of thing. I'm seeing this like a pattern. Yeah. So you're comfortable living and kind of like we were talking about like that fantasy role playing. And I think that's why like gaming and things like that is really comfortable for a lot of people because you can live almost in this alternate. role playing life. Mm hmm.

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Well, and a lot of these avoidance behaviors stem from anxiety which lead to these challenging behaviors. So I can imagine if you're role playing, you're in a different world. It is another form of literally masking, and so it makes it easier for you to be that person versus being

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you. So how does PDA really relate to autism?

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the relationship between PDA pathological demand avoidance. It's an aspect of autism spectrum disorder. I think it's still unclear, which is why the U S hasn't picked up, It does refer to a group of behaviors that can be used to describe many people who do fall under the autism umbrella.

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And so some of those behaviors can be like, verbal outbursts or physical outbursts, or like we said, avoidance strategies, but they're like so good at like avoiding situations or manipulating the situation and controlling it. Thank you.

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It is really, really important to recognize that these behaviors are not intentional. They're not doing it to be a dick. I'll be real honest. it's more of a drive or a need to avoid the demands that trigger their anxiety. It's like they get so anxious. They're going to do anything. everything to do it. And that's why a lot of times it looks almost like ODD, oppositional defiant disorder, because it's very similar. So when we talk about oppositional defiance disorder, we also call that ODD There's a difference between ODD versus people with PDA the main difference is people who have oppositional defiant disorder It is a willful choice to disobey their willfully saying I don't want to do this. I'm not doing this. And there's no other reason. They just don't want to do it. People with PDA, it's a crippling inability to comply. And so it's really important to understand that some of these kids who get labeled as oppositional defiant disorder They are really not willfully saying no. They just can't because it's so crippling anxiety.

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They know that they should be doing these things. Yes. They know that it's good for whether it's benefit for their education or their health or their self worth, but almost like you can't get over that hurdle. And they want to. Right. They want to. They want to comply, but they just can't because there's just, like you said, like there's this pressure, this crippling anxiety or this crippling worry that you can't get over where versus oppositional defiant disorder. It's just, no, it's a big screw. I don't F I don't F and care. I don't care that I'm supposed to do this. I don't. Whereas with PDA, you care. But you're just, you're almost like hitting a wall. And

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one of the really big ways you can tell the two apart is that children with ODD, oppositional defiant disorder, do respond to consistent behavioral interventions and positive support plans. And so with ODD, it is considered a pretty big diagnosis, but they can, you can work with them and you can do it where people with PDA, it's really just the crippling anxiety. And so it's even harder. You can't just do behavioral interventions and get them to do it. It takes a lot more work,

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it really impacts mental health because living with PDA can be so stressful for individuals and their family. There's the constant tension between what society demands and the need to avoid them. So then it leads, to heightened anxiety, depression, and even low self esteem.

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Exactly. And a lot of people with PDA, they struggle to engage in typical activities like attending school or doing their work or even going to a job. So this obviously will impact their self worth and mental health because you're like, How hard is it to go to school? Just go to school. We do this every day. Just go

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to school. And I just had this conversation. I'm looking right at Randy going, I was like, I don't understand why it's just so hard to do these things. And I'm like, Okay, yes, nevermind. I do understand why it's so hard to do these things. And that's why it's important to talk about this because misunderstanding and misdiagnosis of behaviors can really contribute to feeling shame about this or isolating yourself.

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Mm hmm. And what we're talking about is there are kids who have a hard time going to school, ends up being school refusal. And you're like, why is this so hard? We've been doing this every day for the last 12 years. Why is this so hard? And sometimes there are days where it's just really hard. So we want to educate. Ourselves and others out there to look at this, they're not being a pain in the ass on purpose. It's just something that is triggering their anxiety to the point of where they cannot go

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right and learning about this and the causes can really help family, the education system and professionals. Be more empathetic and provide support that is really more effective.

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let's talk about some strategies for individuals with PDA. if you have an adult child or a friend who you think or you know, has. PDA. One of the best things is to make sure you have a good relationship with them, It's the build rapport with them. You want to gain permission to help first. So many of us are like, here, let me do this for you. Ask permission first learn how to use what we call declarative language, It's like asking permission versus demanding, that's it, yeah, do this, do

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this, go to school

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Would you like to do this how would you like to do

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this, if we do it this way, would this

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help get them in the driver's seat, what that means is let them be in charge. So many of us, it's so easy. much easier for us just to do it, but when we get them in the driver's seat and we let them be in charge, most times they're going to be successful. You also want to help support their executive functioning challenges. Find ways to encourage them and their executive functioning, What is it their daily tasks? What is it their, their habits their routines? And lastly, really be patient and flexible because that is the hard part. It is not your way or the highway. Sometimes you have to roll with it. You just have to be like, Oh, my favorite line. Is that what we're doing now? Okay, actually, no, that's my husband's line with me. Is that what we're doing now? That's totally what he says all the time to me. That's funny. I just, dawned

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on me. Yeah. So some strategies for kids with PDA would be to plan ahead, giving them plenty of time to understand what's going on, We want to give them the idea or the suggestion that it's their idea.

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Which cookie would you like of these two same cookies?

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And that's what leads into offering choices, giving choices to kids. And I've always done that too with my kids. that also helps with language and communication when you offer choices. Do you want this? And especially with kids that are on the autism spectrum. So many choices might be overwhelming. So narrowing the focus so they choose one or the other can help. And this also helps with avoiding power struggles. especially with PDA, because if they are avoiding tasks and avoid those that are seen in a, power position, this can help. And also make things interesting. Kids on the autism spectrum often are bored easily. And so you want to kind of like spice up things, give them a challenge and learn to go with the

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flow. I'm also smiling over here because I had a friend, her child, who's autistic, hurt her ankle and walking on crutches wasn't going to be it. And they were on a rolling chair, desk chair. And it was the best thing ever. She thought it was so much fun to roll around because a wheelchair wasn't going to work and they didn't need a wheelchair. So they're like, here we go, we're on an office chair rolling around and it was like the best thing

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ever. Yeah. So she turned that challenge into something that was so positive and turned out to be so fun by going with the flow and getting outside of the box.

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Absolutely. How do we support ourselves and loved ones who have pathological demand avoidance?

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Empathy and flexibility are key, like we were just talking about those strategies, just being kind, taking a deep breath, and just rolling with it.

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Recognizing that individuals with PDA have unique needs and triggers can also help reduce anxiety and the challenging behaviors that they have.

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making sure that you come at the situations as kind of like a collaboration rather than a strict demand can often help with being more successful.

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also let's not forget the importance of mental health support, either for yourself or for whoever you're helping. You both could benefit from therapy and counseling to help manage anxiety and to also help learn some new coping strategies.

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Yeah. You definitely need a toolbox. Yes. Communication is another vital aspect, just encouraging that open, honest communication about feelings and needs can really help build trust and reduce anxiety, and this goes for both, like those with PDA and their caregivers or their community and support networks.

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And really, truly, finally, it's essential to advocate for increased awareness and understanding of PDA. we need to know more about this and it needs to be normalized.

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The more we talk about it, the less stigmatized it becomes and the easier it is for those with PDA to access support and accommodations and to feel like they can step out into the community about it.

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In conclusion, we're going to wrap up today's episode of Women's Mental Health Podcast. We really hope this discussion has shed a lot of interest and education on what PDA is and really emphasizing the importance of empathy and

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support. Thank you for joining us, and remember, understanding and compassion can make a world of difference in the lives of individuals with PDA and other mental health

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struggles. Until next time, remember to take care of yourself.