Pathological Demand Avoidance Syndrome

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    • #75746

      Has anyone heard of this and know anything about it?

    • #75966

      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.

      • #75996

        Wow!! This is my 13 year old son you just described. Is there any treatment plans? We just tried concerta for about three days and he said he didn’t like how it made him feel. He also struggles with rather large mood swings. One day he is happy, the next he is crying in bed.

        We had to pull him from school in January due to overwhelming social anxiety. He is at home doing Florida Virtual School. He’s a straight A student and his conduct is always perfect. We really want to integrate him back into public school next year, high school. Are there any Herbal supplements that could help with Anxiety, depression, and focus? We are open to anything and everything…

      • #174453

        Hi Cyllya, reading this has given me a ‘lightbulb moment’ in that it totally describes me. Could you please direct me toward the source of your information?

    • #80558

      This has been gaining traction in forums for a year or two. It seems to be more accepted in the U.K. as a “girl” manifestation of autism. My daughter has a “classic boy” version of ADHD, but does seem to fit with PDA. But until it is accepted as a real “thing”, there isn’t much you can do about it. In the US they tend to label it as ODD.

      I agree with the above poster who mentioned dopamine levels. FWIW my DD doesn’t respond well to SSRI’s (even though anxiety levels seem to be at the root), but has had a lot of success with Strattera which is an NRI, and norepinephrine is the precursor of dopamine. I am also finding a couple of supplements that supposedly help with dopamine levels are helping DD to be less combative.

    • #175654

      That sound exactly like what I’m being told is part of ADHD. I’ve just been diagnosed. For years, I thought I suffered from depression and I self-treated. I thought I was doing well with exercise, supplements, etc. But I never felt I met many of the symptoms of depression. I didn’t feel sad, down, or hopeless…just frustration, failure and anger. I continued to have what I could only describe as the “don’t wants”. I constantly struggled to “initiate” and get started at anything. After 20+ years of miserable jobs that weren’t right for me, I believed it was just normal to “fight” against doing stuff you hate. But then I found a job I love and I’ve been struggling even more with self-motivation. And now struggling with fun stuff that it is extremely interesting to me! When I couldn’t make myself get started on a work related activity, I began telling myself I should just do something I enjoy because that was better than sitting around doing nothing and feeling frustrated. I love gardening and yard-work, but I couldn’t make myself go outside and get started. I love anything creative and have tons of projects in mind or unfinished, but I couldn’t go into my studio. In the past, those were activities that helped me cope with the miserable feelings about work. This problem seems to be at its worst when I feel overloaded. Which is now all the time because I’m constantly under-achieving, frustrated and angry at myself for failing. And trying to deal with all the stressful life changes with Covid and related PTSD anxiety, I completely shut down and couldn’t initiate anything. I realized I needed help and I’ve been diagnosed with ADHD. My therapist also has ADHD and says that’s all part of it and meds will change my life. My first dose of Aderall went dangerously bad, so Monday, I’ll start looking at alternatives.

      The two supplements I have found helpful are 5-HTP and L-Theanine (making sure it’s “Suntheanine” and usually combined with caffeinated tea). When I first learned about 5-HTP, it was hard to find locally and I ordered 50 mg online. I was able to start a new exercise program, a healthy eating plan, and actually cooking my own meals. But I can’t remember that brand. More recently I got 100 mg 5-HTP “extra” by Irwin from CVS. Either it’s junk or my problem has just reached a level where supplements aren’t enough.

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