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Key Takeaways
- PDA is a proposed behavioral profile often associated with autism. Individuals with PDA may experience an intense drive for autonomy and resistance to demands.
- Researchers are still studying PDA, and have not yet arrived at a conclusive definition, list of characteristics or treatment and support recommendations for it.
- Many strategies may help manage feelings of PDA, including reducing and eliminating demands, disguising demands and building flexibility into tasks and chores.
- Neurodiversity-affirming therapy likely can help PDAers with tailored support for their unique needs and circumstances.
Does the thought of day-to-day chores make you feel paralyzed? Does your phone pile up with unread emails and unanswered texts you can’t make yourself respond to? There are many reasons why people might struggle to meet the demands of daily living, but for those who identify with the experiences associated with pathological demand avoidance, all demands can feel oppressive and anxiety-inducing.
Sometimes called pervasive drive for autonomy, PDA is a behavioral profile most commonly associated with autism spectrum disorder (ASD). PDA is said to be different from simply disliking certain tasks or being asked to do something. It’s natural for people to put off or avoid certain demands—however, some individuals experience a more intense and pervasive drive for agency and resistance to demands, which can impact their daily lives and mental health.
PDA was first proposed as a unique subtype of autism spectrum disorder, but is now most often understood as a possible profile of autism, meaning a pattern of behaviors and traits present in some autistic people. To date, researchers have yet to reach a consensus on how to categorize PDA or on its definition, characteristics and support strategies. PDA advocacy, however, has grown as a field, and advocates have advanced many recommendations for support based on PDA individuals’ lived experiences.
If the proposed PDA autism behavioral profile resonates with you, read on for tips to manage it.
How can I manage PDA?
Pathological demand avoidance can feel incredibly taxing and lead to frequent or chronic burnout.It may cause trouble with emotional regulation, taking a toll on mental health. Several strategies may be helpful to PDAers reduce their overall stress levels, limit demands and navigate demands that can’t be eliminated.
Manage demands
Reducing the volume of demands in your day-to-day life is key to managing PDA. While some demands can’t be eliminated, reducing the number and frequency of demands may offer you some relief from extreme anxiety. When demands can’t be eliminated, it may help to disguise them or find ways to make them more bearable.
It can feel overwhelming to consider all of the demands you face and decide what can be cut out. Tools like the Eisenhower matrix can help you structure the demands you are facing, identifying which ones you may be able to eliminate, as well as those you can postpone or delegate.
When confronting a demand, it’s helpful to be flexible. Give yourself permission to leave the task unfinished, which will take some of the pressure off. You can also create choices for yourself—for example, allowing yourself to prioritize tasks that feel less distressing at present, even if other tasks are more pressing.
Reframing demands can also make them feel a little more approachable. Try removing the “should” from demands where possible—for example, noticing that “the dishes are in the sink” rather than “I should do the dishes.” Some people also find it helpful to gamify demands, making them more fun and engaging while deemphasizing the obligation of it all. Apps like Finch can help with this, making it part of a game to complete tasks, and depersonalizing them by redirecting the focus to caring for a virtual pet.
Designate demand-free time
Carving out demand-free time can be an incredibly important way to rest, recharge and tend to yourself. For some PDAers, it could also help with the distress that comes with PDA—although others may not find that demand-free time provides the same relief.
Consider how frequently you can create demand-free time in your schedule, and commit to blocks of time where you give yourself permission to set aside demands and do whatever you’d like—ideally in a space with fewer visual reminders of looming unmet demands. If you’re comfortable doing so, you can enlist loved ones to support you during this time, making sure they don’t ask anything of you during these blocks, or assist in setting up a truly demand-free space.
Reduce stressors and mental load
Life stress may amplify feelings of demand avoidance. Feeling stressed or overwhelmed can heighten a person’s need for control over their own life, possibly making demands even more distressing. Addressing other stressors and reducing your mental load may make PDA more manageable and improve your overall quality of life.
Take a moment to consider what recurring stressors, big or small, are present in your life. These stressors may or may not be demands. Start by making a list of what causes you anxiety on a regular basis. As an example, it may include some things like:
- Sensory stressors in your environment
- Tasks that require high levels of executive functioning
- Household responsibilities or obligations
- Social interaction-related stress and anxiety
- Difficulty with self-care activities like showering, eating, etc.
- Physical health challenges
- Nervous system dysregulation
- Burnout
- Lack of time or the inability to rest and recharge
Once you’ve identified what contributes to your mental load and overall stress and/or dysregulation, determine what’s in your power to reduce their impact. It’s easiest to start small—you probably won’t be able to recover from autistic burnout immediately, but making sensory adjustments to your home and routines can take a little weight off your nervous system and slow the progression of burnout.
In particular, it may help to take tasks off your plate wherever possible. This can help you pace yourself, conserve your energy and reduce the anxiety of high demand and high mental load. A few helpful changes might include:
- Delegating tasks to others where possible
- Giving yourself permission to deprioritize or let go of tasks that aren’t essential or time-sensitive
- Reducing the executive function required by demands
Tools like AI can take the brunt of executive functioning out of many tasks. Goblin Tools was designed specifically for neurodivergent people, and includes specific functions like breaking down the steps required to complete a task, generating a quickly digestible summary of a topic, gauging the tone of an email and helping with your reply.
It can also be helpful to automate your responsibilities where possible. For example, if you can, set up your bills on autopay. Reduce your mental load by setting recurring calendar reminders for responsibilities that may feel difficult to remember, like changing the litter box or doing laundry.
Let your support people know how to help
Having people close to you who are informed about your needs is thought to be very important for PDAers. If you feel safe sharing with support people or trusted individuals, talk to them about how they can help you manage demands. Some ways they may be collaborators in managing demands can include:
- Offering choices (“Do you want to call the doctor’s office back before or after we eat lunch?”)
- Disguising demands (“What do you think we should do now?”)
- Presenting demands indirectly (“I wonder if we could go to the grocery store tonight.”)
Discussing your specific needs with support people and loved ones, and encouraging them to further educate themselves on strategies that you have found to be helpful with your experience of PDA can go a long way. It may take some time to figure out systems and approaches that allow them to show up for you in the way you want and need. Keep them informed on what is and isn’t working for you as you try new things so they can learn, too.
Plan in advance
Having a support plan or a toolkit of strategies and skills may help you manage moments of distress. It’s best to think through what may help when you're feeling calm and thinking clearly. In particular, it’s helpful to practice a support and coping strategy when your stress levels are lower, since it will be easier to remember and access a skill while in distress if you’re already comfortable using it.
Work with a neurodiversity-affirming therapist
Psychotherapy can be a truly impactful intervention for autistic individuals and perhaps especially for those who identify with experiences of PDA. Neurodiversity-affirming therapists are very familiar with autism spectrum disorder and PDA. They can work with you to better understand your unique needs and think through what strategies may work best for you.
Treatment approaches like cognitive behavioral therapy (CBT), which helps individuals identify and replace harmful behavior and thinking patterns, can be supportive to this end. Psychotherapy may also help PDAers address other life stressors and improve their overall mental health, potentially making PDA experiences more manageable.
How Prosper Health can help you manage PDA
It can feel challenging to get help with experiences of PDA, since not all therapists understand it, and many people fear being judged or misunderstood by a new provider. If you’re an autistic adult who identifies with some of the characteristics of the proposed PDA profile, Prosper Health can help.
Prosper Health's neurodiversity-affirming therapists specialize in autism spectrum disorder in adults and have extensive experience supporting autistic clients and other common mental health challenges. They can work with you to create a support plan that meets your specific needs and works for your life.
Therapy with Prosper Health is covered by insurance and 100% remote. If you're ready to get started, click the button below to connect with a therapist in just a few days.
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Pathological Demand Avoidance: Understanding PDA and its Relationship to Autism
Do you feel frozen whenever you feel like you should be doing something? Do the demands of day-to-day tasks make you feel like the walls are closing in? If demands cause you severe anxiety that gets in the way of completing daily activities, you might be experiencing demand avoidance. Pathological demand avoidance (PDA) is most commonly connected to autism, contributing to the great diversity of the autism spectrum. However, allistic (non-autistic) individuals can also align with a PDA profile. PDA can have significant impacts on a person’s life, but broader social awareness of PDA is still limited. Many support strategies, including neurodiversity-affirming therapy, can help PDA individuals manage demands and move through life with less anxiety.
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