Rachel Loftin

Picture this: you come home from a long day at work, and become frozen by even the idea of cooking dinner, or cleaning up your home, or taking a shower. You know you have to be doing something, but even thinking about another task ratchets up your anxiety to the point you feel like you can’t function. If this sounds like something you’re dealing with, you aren’t alone: you might be experiencing demand avoidance. 

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Pathological Demand Avoidance (PDA) is a behavioral profile most often connected to autism, where demands trigger an intense need to resist or avoid. ‍This can happen for different reasons: sometimes demands become genuinely overwhelming (like eating, sleeping, showering, or even turning off the lights), leading to freezing up or distress. But demands can trigger avoidance even when they're not overwhelming because they threaten autonomy or control.

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While PDA isn't a formal diagnosis, it's recognized as part of a constellation of behaviors often associated with autism or other neurodevelopmental profiles like ADHD.

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Other more affirming names for PDA have been suggested, such as Persistent Drive for Autonomy, Extreme Demand Avoidance (EDA), and Rational Demand Avoidance (RDA). However, for the purposes of this article, it will be referred to as Pathological Demand Avoidance, as this is the most common term in the US.

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Read on to learn what PDA is, what it feels like, and why it’s often misunderstood.

Self-stimulatory behavior, or "stimming", is a physical behavior used by autistic and other individuals (including those who are allistic) to regulate emotional or sensory stress, sensory seek, and/or express their emotions. In autistic people, stimming is often repetitive and is a way to calm their minds and bodies. 

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Personally, I have stimmed my entire life in many ways. Notably, I am always carrying a rolling stim toy with me. It helps to ground me when I get anxious, or when the noises in a room are too loud or overwhelming.

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Everyone stims, whether they realize it or not. If you’ve ever bounced your knee while bored, or clicked a pen open and closed, you’ve stimmed. But for autistic folks, stimming serves a key role in sensory and emotional management. It’s not something to fix, but rather something to understand. 

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In this article, we’ll explain what stimming is, why it happens, and how to support yourself or someone around you who stims. 

Autism is known to co-occur with several health conditions—but what does this mean? What other diagnoses are most prevalent among autistic individuals, and does an autism diagnosis inform treatment of co-occurring conditions?