Reply To: Pathological Demand Avoidance Syndrome

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This condition caught my eye in the past just because the name alone summarizes a huge problem that I have.

It’s a proposed but unaccepted condition considered to be part of the autism spectrum (or more recently, pervasive developmental disorder) although it’s significantly different than the diagnostic criteria of autism. Here is an informative page about it.

If you’re wondering about this because you or someone you know seems to have a pathological avoidance of demands… That kind of problem happens with impairment of the “initiation of actions” aspect of executive functioning (also called “self-motivation” in articles like this one). Therefore, conditions that impair executive functioning, including ADHD, can involve this. It seems to be related to low dopamine levels. It’s a really strange problem, sometimes described like “weird urge to not do things” or “feeling paralyzed” or “constantly fighting with myself.” Unfortunately, it tends to get called things like “lack of motivation” in ADHD resources, which is pretty misleading, not to mention demoralizing. It’s not an official symptom, which is a shame, since ADHD medicines seem to be able to help it. Unlike the descriptions of PDA, this problem doesn’t apply purely to demands caused by other people. Unlike descriptions of the problem in ADHD, the problem can still apply to things that we are interested in. Here’s a page about initiation impairment.