Advice on coping

Hi and welcome to the community! 

Firstly and most importantly, congratulations on getting clean. (I’m nearly up to 18 months free of alcohol myself). 

In respect of some of the difficulties that you mentioned, and also your upcoming assessment, you might find the strategies in these resources helpful:

NAS - Demand avoidance

NAS - Anxiety

NAS - Socialising and relationships

NAS - Assessment and diagnosis -  including “What can I do while waiting for an autism assessment?”

alterpop said:

once i'm formally diagnosed for the PDA (already ADHD diagnosed)

Just to clarify, whilst some assessors might, when diagnosing autism or another condition, add a reference to “PDA”, this would only be an unofficial descriptor, not a formal diagnosis of PDA.

No one can be formally diagnosed with PDA, either as a standalone condition or as a profile of autism, because it doesn’t exist in the manuals as a recognised clinical condition or profile. This is explained in more detail in the demand avoidance article above. I mention this only because it can be a contentious topic, so it can help to be aware of the details when discussing the subject with others.

Similarly, it’s also worth mentioning, as the article again explains, that some of the latest research suggests that such PDA issues seem to be much more commonly associated with ADHD than with autism.

Yeah I do understand the distinction and how PDA is a type of traits of autism rather than a diagnosis in itself so to speak. Like I say I was diagnosed as child with ADHD but due to a lifetime of drug and drink addiction i've neither dealt with or coped very well with it at all. I recently looked at PDA autism and to say the cap fits is the biggest understatement ever. I know I need to get this assessment to understand better what's going on but have no doubts that i'm neurodivergent, I guess I just want to work out how for once and deal with it. Thanks for replying, I do struggle with social interaction of any kind and get a lot of anxiety from it and hopefully getting some answers will help. Thanks again for replying and well done on your not drinking.

alterpop said:

I recently looked at PDA autism and to say the cap fits is the biggest understatement ever. I know I need to get this assessment to understand better what's going on but have no doubts that i'm neurodivergent, I guess I just want to work out how for once and deal with it.

You can reach a conclusion on whether you are autistic without having to wait for an official diagnosis - there are loads of online tests that should give a result to indicate if you are likely to be diagnoses with a reasonably high confidence level.

Just use your web search engine of choice with the terms "free online autism test" and try a few.

It will tell you at the end your score and what the score is to be diagnosed so you should have a good indication if autism is one of your issues.

Autism has a range of traits of which ADHD and PDA are amongst them.

Bunny said:

No one can be formally diagnosed with PDA, either as a standalone condition or as a profile of autism

This is not a diagnosis in its own right but is a neurodevelopmental condition all on its own. The following article describes how your 3 conditions can co-exist:

Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and Pathological Demand Avoidance (PDA) are distinct neurodevelopmental conditions.

https://dynamicneuro.wordpress.com/2025/05/08/recognising-the-complex-presentation-of-adhd-asd-and-pda-a-new-perspective/

With these three conditions present you have a particularly challenging position which will need an experienced and skilled therapist to help you navigate them.

I doubt the NHS will have this sort of specialist available so do you have the resources to go privately? Prices probably be £60-10/hour and I would expect you to need dozens of hours to completely work through your issues.

How would you decide to approach any treatment to improve your situation, whether or not you get a diagnosis?

Bunny said:

This is further misinformation. Autism diagnosis has existed in its current, unified form for only about six years (ICD-11, 2019) and three years (DSM-5-TR, 2022).

I was referring to the DSM5 (not the update) which was started in 2000:

https://www.psychiatry.org/psychiatrists/practice/dsm/about-dsm/history-of-the-dsm

You can decide to quote whatever release dates, pulication dates or revision dates you want.

Bunny said:

Whilst we're all entitled to our personal opinions, the diagnostic status of PDA isn’t a matter of opinion; it’s a matter of record.

Such absolutist thinking. PDA is widely talked about as connected to autism even by NAS but has yet to be included in any of the regular DSM revisions.

The point of the revisions is to include new findings I think you will find.

What is the point of your denial of these "conditions" (I put the word in quotes so you can see I am not claiming it is a clinical term here)? Are you just grinding your axe with some personal beef with me or do you really believe it is helping these people to deny them?

Bunny said:

ADHD isn’t a “trait of autism"; it’s a separate neurodevelopmental condition.

Are you being deliberately absolutist here? There are many traits shared between autism and ADHD which are commonly described as ADHD traits - this is what I was referring to.

This is why I inclided the diagram showing the traits and their overlap. Why are you attacking me over this?

Bunny said:

PDA isn’t a recognised diagnostic entity in either manual. There’s no scientific consensus that it’s a “trait of autism", or even that it constitutes a definable condition.

I would refer you to the NAS article on this subject:

https://www.autism.org.uk/advice-and-guidance/topics/behaviour/demand-avoidance

demand avoidance is widely acknowledged as a characteristic experienced by and observed in some autistic people

It may not make the cut as an official diagnostic element yet, but as you point out the diagnostic criteria are changing at a remarkably rapid rate so discounting it as an autistic trait is folly.

I fear that your take of such absolutism about what can and cannot be described as autism is harmful and is not accepting to those with these issues. Please show some more compassion.

Iain said:

ADHD and PDA are known traits of autism and while ADHD is also its own diagnosis

Iain said:

Autism has a range of traits of which ADHD and PDA are amongst them.

That’s another grossly inaccurate claim (made twice).  

ADHD isn’t a “trait of autism"; it’s a separate neurodevelopmental condition. Autism and ADHD are distinct diagnoses that can co-occur, but one does not form part of the other.

And as I'd already clarified, PDA isn’t a recognised diagnostic entity in either manual. There’s no scientific consensus that it’s a “trait of autism", or even that it constitutes a definable condition.

Whilst some autistic people also have ADHD - and vice versa - and whilst some may present with "PDA"-like behaviours, it’s simply wrong to describe ADHD and PDA as “known traits of autism.”

It misleads readers who may not understand the distinctions between co-occurring conditions, informal profiles, and formally-recognised diagnostic conditions or traits.

Iain said:

ADHD and PDA are known traits of autism and while ADHD is also its own diagnosis

Iain said:

Autism has a range of traits of which ADHD and PDA are amongst them.

That’s another grossly inaccurate claim (made twice).  

ADHD isn’t a “trait of autism"; it’s a separate neurodevelopmental condition. Autism and ADHD are distinct diagnoses that can co-occur, but one does not form part of the other.

And as I'd already clarified, PDA isn’t a recognised diagnostic entity in either manual. There’s no scientific consensus that it’s a “trait of autism", or even that it constitutes a definable condition.

Whilst some autistic people also have ADHD - and vice versa - and whilst some may present with "PDA"-like behaviours, it’s simply wrong to describe ADHD and PDA as “known traits of autism.”

It misleads readers who may not understand the distinctions between co-occurring conditions, informal profiles, and formally-recognised diagnostic conditions or traits.

Bunny said:

ADHD isn’t a “trait of autism"; it’s a separate neurodevelopmental condition.

Are you being deliberately absolutist here? There are many traits shared between autism and ADHD which are commonly described as ADHD traits - this is what I was referring to.

This is why I inclided the diagram showing the traits and their overlap. Why are you attacking me over this?

Bunny said:

PDA isn’t a recognised diagnostic entity in either manual. There’s no scientific consensus that it’s a “trait of autism", or even that it constitutes a definable condition.

I would refer you to the NAS article on this subject:

https://www.autism.org.uk/advice-and-guidance/topics/behaviour/demand-avoidance

demand avoidance is widely acknowledged as a characteristic experienced by and observed in some autistic people

It may not make the cut as an official diagnostic element yet, but as you point out the diagnostic criteria are changing at a remarkably rapid rate so discounting it as an autistic trait is folly.

I fear that your take of such absolutism about what can and cannot be described as autism is harmful and is not accepting to those with these issues. Please show some more compassion.