A few years ago, at what I thought was the peak of my career, my life started to unravel. I had always been an anxious person, but after securing a new job with a lot of responsibilities, something unexpected happened: I completely froze.
Not just at work, either. It was my everyday life that suffered. I stopped being able to do… anything.
The more something felt like a “should” — I should brush my teeth, I should go for a walk, I should finish this work report, I should cook dinner — the more anxiety it caused me, and the less likely I was to do it. Sometimes, a simple request could feel absolutely agonizing.
It didn’t take long before I was spending most of my time in bed, completely immobile and filled with dread.
Having been diagnosed with ADHD in my early twenties, struggling with task initiation and motivation wasn’t exactly new to me. But this breaking point felt distinct. Even the things I desperately wanted to do, including my hobbies and interests, felt like too much pressure.
The panic became constant, confusing, and extreme. I fell into a shame spiral, convinced I was lazy, incompetent, and broken. Not long after taking it, I left the job that had caused me so much stress, but I continued to feel as stuck as I was before.
I was fortunate to find a therapist through Alma who specialized in working with adult clients who have ADHD and autism, and was neurodiversity-affirming. She confirmed that what I was experiencing was called demand avoidance.
Demand avoidance can happen for many reasons — all human beings resist demands to some extent! But in more persistent cases like mine, where the avoidance greatly interferes with your quality of life, it’s what’s called “pathological demand avoidance,” or PDA.
Some advocates have proposed that, rather than pathologizing PDA, it’s better described as a “pervasive drive for autonomy,” because much of the resistance stems from a need to maintain control and agency.
While more research is needed, experts seem to agree that pathological demand avoidance is linked to autism and ADHD. Some propose that PDA is a possible subtype of autism, or a series of symptoms associated with autism, while others suspect it is more closely connected to ADHD.
While it’s not yet recognized by the DSM or other diagnostic manuals, the PDA Society has proposed some key criteria for identifying PDA, including the resistance and avoidance of ordinary demands, intolerance of uncertainty, using social strategies (like distracting others, negotiating, or procrastinating) to avoid demands, and excessive mood swings and impulsivity.
Unlike other presentations of autism, PDAers also tend to be more sociable (at least on the surface).
Pathological demand avoidance can vary in intensity and presentation, too, depending on different factors like one’s environment, stressors, other co-occurring conditions, and even trauma history.
In my case, I’ve always grappled with PDA, but the stress of taking on a new role at work made it more severe.
For those of us who struggle with it, we often want to follow through on the demands. I certainly didn’t want to leave my job, stop eating, abandon my hobbies, or avoid showering!
But when we’re triggered, the internal resistance and anxiety is very painful; the panic is akin to the “fight or flight” response that our nervous systems experience when we’re in danger.
A simple demand can feel suffocating on its own, but it can be especially hard if the demands we’re faced with are accumulating. As the tasks of everyday life continued to stack up, and I fell further and further behind, my overwhelm only increased until I completely shut down.
I can’t tell you how many times I Googled things like “too anxious to do anything” and “overwhelmed and shutting down.” I became terrified, convinced I would never be able to function again, which only made the panic worse.
Having a therapist validate for me that what I was experiencing was not some uniquely terrible thing about me came as a huge relief. I wasn’t lazy or crazy — I was being triggered, repeatedly, and there were ways I could manage my triggers.
While this is by no means an exhaustive list, these are some of the ways I’ve personally learned to cope with demand avoidance.
Building stronger self-awareness is the first step in navigating demand avoidance. It helps to slow down, identify what demands are triggering for you, and recognize when you’re engaging in avoidance behaviors. This booklet by the PDA Society is a great primer to start with.
When reflecting on your triggers, it’s important to remember that demands aren’t always direct requests.
It could be as simple as a compliment at work (which can trigger anxiety about future expectations), the need to get out of bed or get dressed, going to the grocery store or pharmacy, and even things we want to do and typically enjoy doing (like our hobbies or favorite activities).
It’s true, too, that things that might not have felt like demands in the past may be triggering later on. What feels like a demand, and what triggers our avoidance, is going to be unique to each individual.
I’ve learned to accept that there will be days when I just… can’t. We can’t always “push through,” and sometimes pushing can be risky, because it might lead us to completely shut down or burn out.
Being kind to ourselves, and respecting our capacity on a given day, is crucial. Having compassion for myself, and not trying to “bully” myself into doing things, has been an important part of my process.
We’re so used to the idea of working harder and ignoring our discomfort — or worse, trying to shame ourselves to act in the absence of motivation. In reality, what we often need in a moment of panic is to first slow down and self-soothe.
Sometimes our anxiety can convince us that every single demand needs to be met immediately.
This can lead to overwhelm and confusion, as many of us with pathological demand avoidance struggle with prioritization. If everything feels equally important, it can feel impossible to know where to start.
When I’m met with a demand, I try to ask myself, “Does this just feel urgent, or is it actually urgent?”
Sometimes my anxiety tricks me into thinking that something needs to happen right now, when in reality, I can afford to delay until I’m more emotionally resourced and better equipped to deal with it.
By lowering the stakes, and recognizing when something is not actually critical, we can work to reduce the anxiety we feel around the demand.
Sometimes I have to coach myself — literally talking to myself out loud, slowly and gently, as if I were a toddler — to get through a dreaded task.
I used to be self-conscious about my monologuing, but I’ve since started to embrace doing things my own way. Even if that means dancing while doing dishes, furiously tapping my feet while working (something my school teachers used to hate!), and rocking back and forth when I’m stressed.
A lot of neurodivergent people engage in “masking,” where we try to conceal the things that we believe make us different or unusual. But masking can take its toll, often requiring a lot of emotional resources that can hasten burnout. It can also worsen demand avoidance, especially if we are avoiding demands because the task itself requires us to mask.
I recommend getting familiar with Dr. Devon Price’s work on unmasking and autism if you’re curious and want to learn more!
Confession: I have disposable toothbrushes and flossers in my desk drawer.
I was struggling to brush my teeth in the morning, so I found a way to make it easier for myself by removing unnecessary steps. Now, on the days when I’m feeling overwhelmed, I have an easy plan B, always available to me where I work and spend a lot of my time.
No shame in working with this brain!
Sometimes coping with demand avoidance is as simple as modifying the demand itself in a more accessible way.
It could be keeping easy-to-prepare foods on-hand for those days when you can’t cook (I should honestly be an Amy’s frozen meals influencer by now). It can look like having dry shampoo when you’re avoiding washing your hair, or using disposable plates and cutlery when cleaning the dishes doesn’t feel achievable.
If you know a particular task is hard for you, it’s worth considering if there’s a more creative way to tackle it. Even removing one or two steps in the process can make a demand feel more approachable!
Beware of the dreaded “should”! More often than not, there’s no such thing as “should” — and by telling ourselves we “should” do something, we set ourselves up to avoid the demand.
Reframing demands can look like…
When I was a kid, cleaning my room was often a huge struggle for me. To make it more fun, I threw my toys across the room into my toy box, not unlike a game of basketball. I also found that if my parents set a timer and I had to race to “beat the clock,” it felt more like a game than a demand.
This is wisdom I now apply as an adult. I’m always looking for ways to “dress up” demands, making them more fun or novel.
I have multiple flavors of toothpaste to choose from, making brushing my teeth more interesting. I buy aromatherapy dish soap in different scents that I love, making dishwashing less of a sensory nightmare.
Podcasts and nightlights have made my showers more enjoyable. And if I’m really avoiding something, sometimes all it takes is some “body doubling” — I Facetime a friend to do the task alongside me.
I’m often asking myself, “How would I get Kid Sam — or any kid, really — to do this?”
How can I change the sounds, smells, tastes, and textures to make a particular task more enjoyable, or at least more tolerable? How can I make this into a game or keep myself distracted while I do it? How can I build in rewards and novelty to make this more entertaining?
(If you don’t know where to start, I’ve used Dani Donovan’s “Anti-Planner,” a genius guide to doing sh*t we don’t want to, to gamify nearly every aspect of my life.)
If you feel willing to approach a demand, I recommend breaking it down into the smallest possible steps, and commit to taking just the first step. If the first step is too intimidating, consider breaking it down even more (like for studying, as an example, the first step might be “open the book”).
If you don’t know about goblin.tools, I’m excited to show it to you! Goblin.tools is an AI to-do list maker that breaks down tasks into smaller steps, designed with neurodivergent people in mind.
All you do is type in the task, and the AI will write out all the steps, offering to break them down even further if you find yourself stuck on a particular step.
Sometimes PDAers become avoidant when we’re overwhelmed. By breaking things down into the simplest possible steps, we give ourselves more options on how to approach a task, and help clarify some of the cognitive overwhelm that keeps us stuck.
Taking breaks is okay. Stopping and deciding to finish at a different time is okay. Moving at a slower pace is okay. Finding “shortcuts” is okay.
Because so many of us with pathological demand avoidance have experienced others pushing us beyond our limits, it’s important that we not replicate this trauma by treating ourselves the same way.
Whenever you decide to approach a demand, be sure to give yourself an “out.” Full permission to slow down or stop, at any point in the process, can help reduce panic and maintain a sense of control.
I’ve learned that any time I am working with a demand that I especially dread, I need to schedule downtime afterward. And more specifically, there needs to be zero expectations around how I spend that time and how productive I am.
Rest is important for all of us, but for PDAers especially, prioritizing “demand-free” rest is critical.
Knowing how you recharge — and noticing when and under what circumstances you feel rested — is a crucial skill that ensures you have the energy needed to approach demands when it’s time to.
While extra support is not accessible to everyone, it may be worth budgeting for if you can.
I know to budget more for takeout and pre-prepared foods, for example, because cooking takes a lot out of me.
There are certain chores that I outsource during stressful times, and I’ve even hired cleaning help when I’ve fallen too far behind. There is no shame in needing extra support!
Finding a therapist that is familiar with the neurodiversity paradigm (especially ADHD and autism) can be life-changing.
I’m also extremely fortunate to work with a life coach who specializes in supporting neurodivergent brains. I am medicated for my ADHD as well, and there is a noticeable difference in my demand avoidance when I don’t take medication for it.
After originally publishing this article, I also underwent a nervous system intervention called the Safe and Sound Protocol (SSP).
The SSP has been, by far, the most impactful support I've ever received. I would go so far as to say I experience very little demand avoidance after completing the SSP.
When it comes to demand avoidance, it takes a village. And that’s okay! Wherever possible, assembling a care team can make a huge difference.
For me, having grown up in an authoritarian household — where doing what I was told was non-negotiable and questioning my parents was seen as disrespect — it makes perfect sense that I’m driven to assert my autonomy, even to my own detriment.
I didn’t have any control.
In a way, pathological demand avoidance was a protective factor that allowed me to maintain a sense of agency in a very rigid, strict environment.
I grew up learning that I wasn’t allowed to say “no” or ask questions, so I became an adult that struggled with feelings of being controlled (and feeling out of control).
Knowing this, I can have a lot more compassion for myself. I understand now that PDA will surface more intensely for me at times when my life feels unmanageable.
“Respecting” PDA means validating where it comes from and how it might be serving us (or has served us in the past!).
And importantly, I’ve come around to the fact that my life is not going to look like anyone else’s.
There will be toothbrushes in my desk, and my dinners won’t always be made from scratch, and sometimes (read: most of the time) I’m going to need help with the laundry, and that’s all okay.
There will be days when I’m productive and days when I’m not; there will be days when I’m able to take care of business, and others when all I can do is focus on taking care of myself.
As my coach Alexis Rockley often talks about, there are seasons for everything. Learning more about PDA and how I function has allowed me to identify the seasons I’m in, and to work in alignment with my body and brain as they are, instead of how I wish they would be.
Since leaving that job a few years ago, I’ve found meaningful work that aligns perfectly with my passions and working style (a strategic role that gives me decision-making abilities and de-emphasizes hierarchies).
What I thought was the “peak of my career” was actually just the beginning of better things to come!
These days, I’m less concerned with creating a life that looks good to everybody else, and more concerned with building a life that feels good for me, the person living it.
And honestly? I’m a thousand times happier than I was before.