You have to get things done today—simple things, like brushing your teeth, attending a meeting, and replying to an email. An overwhelming sense of resistance takes hold, making even the smallest tasks feel burdensome and stressful, causing you to resist them. If this scenario resonates with you, you might be experiencing Pathological Demand Avoidance (PDA), a behavioral profile increasingly recognized in adults, especially those with Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD).
What Is Pathological Demand Avoidance?
Important vocabulary:
- “Pathological” implies that a behavior is caused by physical or mental disability or disease.
- “Demand” in this context refers to any expectation, obligation, or perceived requirement—whether external (from others) or internal (from yourself)—to do something.
- “Avoidance” means evading thoughts, situations, tasks, or responsibilities.
Pathological Demand Avoidance is characterized by an extreme avoidance of everyday demands and expectations, driven by high anxiety levels. Initially identified in children, PDA is now acknowledged to persist into adulthood, affecting daily functioning and interpersonal relationships.
PDA involves consistent and intense mental, emotional and sometimes physical resistance to demands. This resistance is present even if the demands are things that are self-imposed or typically enjoyable activities.
Pathological Demand Avoidance, or Procrastination?
While procrastination and Pathological Demand Avoidance may look similar on the surface—both involve putting off tasks— their roots are fundamentally different. If you procrastinate, you’re often just delaying a task because it feels boring, difficult, or overwhelming. You usually still intend to complete it eventually.
With PDA, the avoidance is driven by a deep, often unconscious anxiety response to the demand itself, even when the task is something you want to do. With PDA, you may no longer have the objective of completing the task once it starts to feel overwhelming.
Unlike procrastination, PDA can trigger intense emotional distress, and the avoidance can feel involuntary—like your nervous system is shutting down in the face of pressure, not just resisting productivity.
Consider this example: your friends are all out at the park and they are asking for you to come join them. They will only be there for an hour, so you need to get up and head out of the house soon.
If you are someone who procrastinates, the desire to head out of the house to go see your friends may motivate you to take action; the action being, getting ready to leave. You may feel the desire to distract yourself from the task at hand, yet ultimately the pressure to get going before they leave will drive you to completing the task.
If you are someone who struggles with PDA, knowing that you have to leave soon or else you won’t get to see them may make you feel overwhelmed and anxious, so you end up avoiding the task for so long that you don’t see them at all (even though you wanted to).
If you are someone who struggles with procrastinating, check out this resource to help you find a root cause and give you strategies to navigate procrastination.
How Someone with Pathological Demand Avoidance Avoids Demands
Avoiding demands doesn’t just take the form of not doing something that you’re told to do or feel a pressure to do. The ways in which avoidance shows up are often more complex and varied. Here is what they may look like:
- Using social skills for avoidance: You may find yourself distracting others or negotiating to get out of fulfilling demands.
- Instead of saying “no” to something outright, you may divert attention to other things, or make a conversation about something else entirely different than the demand that is expected to be met.
- Mood variability: Experiencing rapid mood swings in response to perceived demands.
- When a demand is placed on you, you may feel irritable, overly stressed, or anxious around what needs to be done and the person asking you of things. This can be clearly seen when demands are placed on you at work or school, when asked by roommates to do personal chores around the house, etc.
- Finding comfort in role-play: Engaging in imaginative play or adopting personas as a coping mechanism in response to demands.
- If a demand is causing intense anxiety, it may feel alleviating to imagine yourself as someone else. You may feel more control over the situation set before you if you slip into pretending you are someone else who does not have that demand placed on them.
- Resistance to authority: Challenging rules and expectations set by others who are presenting demands.
- You may find yourself questioning why certain rules and standards exist or attempting to undermine authority to get out of having to complete tasks or meet expectations.
- Self Sabotage or Overcomplication: Creating unnecessary obstacles to meeting demands, or reasoning that a demand cannot be fulfilled because of exaggerated steps in a process.
- Instead of the task at hand being one or two steps, the task feels like it will take many more to be able to complete even though that is not exactly the truth. One example of this may be thinking you have to clean your workspace to be able to get your work done, then spending hours cleaning the space rather than using that time to work.
- Shutting down: Some demands cause such intense or anxiety that you shut down completely.
- This usually manifests in feeling “frozen”, like laying in bed and staring at the ceiling, ghosting people you need to text back, skipping appointments, or mindless scrolling on social media.
Pathological Demand Avoidance's Impact on Relationships
If you are an adult living with pathological demand avoidance, daily responsibilities like maintaining employment, managing finances, or nurturing relationships can become daunting. The persistent avoidance behaviors may lead to others perceiving you as uncooperative or defiant. This misinterpretation can strain relationships, leading to isolation and increased anxiety.
It is important to remember that someone who struggles with PDA may experience distress surrounding demands, often feeling pressure and anxiety that are not felt by their neuro-typical peers. Signs and symptoms of PDA can often bring hardship and strife for the affected person and their peers. Having understanding and support from those around them, as well as navigating symptoms, is crucial in overcoming these challenges.
So, how do we navigate living with pathological demand avoidance?
6 Effective Strategies to Navigate Pathological Demand Avoidance
Managing PDA involves adopting tailored strategies to reduce anxiety and improve functioning. Here are helpful things you may want to practice to navigate PDA:
1. Break the Task Down into Micro-Steps:Instead of saying, “I need to write this paper,” tell yourself, “I’ll open my laptop.” That’s it. Once you start, the momentum often builds naturally. You can reduce the mental friction by keeping your expectations low and achievable.
2. Incorporate Special Interests: Engaging in activities related to personal interests can serve as a motivational tool. Integrating these interests into tasks can make them more appealing and less anxiety-inducing.
3. Develop Coping Mechanisms: Learning stress-reduction techniques, such as mindfulness or deep-breathing exercises, can help manage the anxiety associated with demands. Regular practice of these techniques can enhance emotional regulation.
4. Seek Professional Support: Working with therapists familiar with PDA can provide personalized strategies and interventions. Therapeutic approaches like Cognitive Behavioral Therapy (CBT) can be adapted to address the unique challenges of PDA. Here at Makin Wellness, we can help you manage anxiety through CBT. Our licensed therapists are here to help you learn to manage the signs and symptoms of PDA and navigate the difficulties of living neurodivergent. Click here to see our therapists.
5. Reward Yourself for Intentional Effort:
Praise effort, even if the task wasn’t finished. Just confronting the demand, even internally, is a success. Positive reinforcement can gradually retrain your brain to reduce panic around expectations, eventually helping you work up to completing the task.
6. Work During “Low Demand” Periods:
Track your energy and anxiety patterns. If there is a time or situation that makes you more or less anxious, keep this in mind as you plan your work. Some people with PDA experience clearer focus late at night or in certain low-stimulation environments. It may be helpful for you to intentionally plan to meet demands during times you know you’ll feel less anxious.
Managing PDA is a marathon, not a sprint. By understanding that your symptoms stem from deep-rooted neurological wiring—not laziness or defiance—you can show yourself the compassion and strategic flexibility you deserve.
How to Talk to Someone Who Has PDA
If someone close to you struggles with Pathological Demand Avoidance, it can be confusing and, at times, frustrating. You might feel like they’re avoiding responsibility or pushing you away on purpose. In reality, what you’re really seeing is a protective, anxiety-driven pattern that they may not even fully understand.
Here’s how to communicate with empathy and clarity:
- Avoid Commanding Language and Opt for Indirect Language
- Instead of “You need to do this now,” try saying, “I was thinking about this—what’s your take?” or “Is there a way you’d feel comfortable doing this?” Language that offers autonomy helps reduce perceived burden and keeps pressure at a minimum.
- Don’t Take Their Reaction Personally
- Remember that for someone living with PDA, even mild expectations can be received as pressure. This is not because of poor character or lack of effort, but a neurological difference. When you stay calm and grounded in a situation regarding unmet demands, the affected person can be reassured that the relationship is not at stake if they cannot meet your demands in the time and way that you are wanting.
- Offer Choices, Not Ultimatums
- Saying “Would you prefer to do this today or tomorrow?” is far more effective for someone with PDA than “You have to do this now.” Having a sense of autonomy keeps the anxiety that triggers PDA at bay. Letting them participate in the decision lessens their need to control through avoidance.
- Listen Without Judgment
- When they express distress, avoid adding more pressure to them in effort to help. Just reflect back what you’re hearing: “It sounds like that felt really overwhelming.” In the midst of intense anxiety around pressing demands, it does not help the person with PDA to hear that you think they need to get it together, rather they will feel alone, anxious, and have a further aversion to fulfilling demands. Being heard reduces internal escalation.
- Frame Tasks as Collaborations, Not Orders
- Feeling part of a team reduces the pressure that gets perceived as an emotional threat. Try saying: “Can we tackle this together?” or “Would you help me figure this out?” Use inclusive language like “Let’s see what would make this easier” instead of “You have to…” to encourage them towards completing tasks.
- Offer Written or Visual Prompts Rather than Verbal Ones
- Seeing a queue to complete a task and meet a demand can feel less intimidating than being told something has to be done. Consider leaving a sticky note with something like, “If you feel up for it, there is laundry in the dryer to be folded”.
Remembering that the person with PDA is not trying to be difficult, cause damage to relationships, or be lazy. They have a neurological difference that causes them anxiety surrounding demands, which is why they struggle to complete tasks. Keeping this in mind will help you as you learn to adjust your vocabulary to be able to meet them where they’re at.
What should you do if you think you struggle with PDA?
Journaling your avoidance patterns and emotional responses to everyday tasks can help clarify whether what you’re experiencing aligns with PDA traits. This will be helpful to keep in mind as you consider next steps moving forward.
You may also consider seeking an evaluation or support from a mental health professional familiar with PDA or neurodivergent presentations. Managing PDA can be difficult without professional help because of the way it affects your education, health, familial relationships, and more. Understanding how to curate a flexible and individualized approach to your needs will benefit you in many facets of life.
PDA isn’t officially recognized in the DSM-5, which is short for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. This is the official classification system used by mental health professionals in the United States to diagnose mental health conditions. With that being said, not every clinician may be equipped to recognize it. Ask specifically if they have experience with demand avoidance behaviors, autism spectrum profiles, or anxiety-based avoidance before you go to see a therapist.
In the meantime, try low-demand coping strategies: break tasks into micro-steps, frame tasks as choices instead of obligations, and celebrate even small efforts. PDA isn’t about laziness—it’s a stress response that can be managed more effectively with understanding, support, and the right tools. You’re not alone, and it is possible to build a life that works with your brain instead of fighting against it.
Support doesn’t mean pushing—it means showing up with understanding. Your relationship can thrive when PDA is approached not as defiance, rather as a signpost pointing to deeper emotional needs.
At Makin Wellness, we are committed to providing compassionate and specialized support for individuals experiencing Pathological Demand Avoidance. Our team of experienced therapists offer online therapy and can work with you to develop personalized strategies that address your unique needs and help you lead a fulfilling life.
