Pathological Demand Avoidance syndrome and Self-harm

Imagine if you felt such profound anxiety every time someone demanded you to do something. At times it’s just a little sting here and there, other times it triggers anger and resistance. It gets so bad that even when no one is asking you do anything the possibilities of them again demanding something out of you race throughout your mind. You are in so much emotional turmoil that you feel it as a physical sensation in your body.

You know that you have to tell them but you’re worried about being faced with more resistance and those people demanding more out of you. It doesn’t matter how they react anyway because every time you reached that moment to explain it to them you can’t. It’s like there’s something in your brain blocking you from saying it.

But you have to get rid of the pain. You haven’t had a drink in three months and you know that touching alcohol now will make the situation worse. Then one day you can’t get the word ‘cutting’ out of your head. It’s something you’ve never done before and you know it will turn into a terrible addiction, one visible to other people. But you can’t take it, the thoughts are overwhelming and you find yourself grabbing for something sharp. At that last moment you grip it tight, but then decide to wrap your other palm around the spot you were going to make the incision. After a moment’s hesitation you sigh and drop that object.

You got through it this time but then it happens again. You’ve been depressed all day and people keep barking demands at you being unaware of the fragile condition you are in. So, you go back to your room, pick up that sharp object again and…you just can’t cut.

Well, so much for worrying about beginning a terrible and visibly ugly addiction. You think you’re fine now; the only problem left is what to do about the anxiety. You decide to book an appointment with your doctor next week.

Then hours later this person angers you again. No demands are made but there’s a possibility that there will be. And then sure enough it happens while you are boiling noodles over a hot stove. You get it over and done with quickly. And then…you realize the stirring fork in your hand is hot. You look at your wrist, you look back at the fork. You can feel the heat of it under your fingers. In one swift move it’s done. You shudder with relief and drop the fork in disgust into the bubbling saucepan. You feel much better, the racing thoughts and painful emotions are gone, but you just started another addiction. However, it’s an addiction few will be able to see.

This is a true story; my story. Since I was a child I would silently avoid or loudly resist people asking things of me. To me the demands are an attempt at people getting control over me. I’ve always felt like for most of my life people have forced me into things. I was a mute child, autistic and didn’t understand why people went to school or worked – I never really understood why I had to study and felt that being sent to TAFE college was just something else I was forced into and had no say in what my own future would be. Something they thought seemed so obvious to many others was never explained to me. I was always dragged along to one thing or another and had everything decided for me. As an adult these feelings have resurfaced, probably because on medication such as Ritalin I was much more submissive and willing to please people. Since going off it I’m faced with much more daily stress and anxiety and soothe myself over getting complete control over my environment with lists and order and a certain way of doing things, over and over again in the same way. No surprises. When this order is interrupted in the form of demands I feel a profound anxiety. I want this control back so much that I will go out of my way to do the exact opposite that’s being asked of me. My own thoughts turn to something more suitable to a person with an anti-social personality disorder. I want to tear the world apart. I want to destroy every object. I want to force people to stop putting me under so much pressure. But actually acting out these things is blocked as well. Just as well. If I ever did these things I could be institutionalized or arrested.

I should be. I self-harm and have constant thoughts of suicide when I go through this type of anxiety and depression. But I wouldn’t need to be if I was put on medication or given the treatment I desperately need.

Now I want you to imagine that in another country, the UK in particular, people get diagnosed for similar behaviour that I described above. They get treatment for it and medication. Now imagine yourself in a country with little awareness of PDA. It’s difficult to find a doctor who even knows what it is, believes it is real, or even agrees to diagnose it at all. That is the case with me. A mental illness, a personality disorder really, where any demand given to you gives you profound anxiety and depression, leads to self-harm and constant thoughts of suicide and will eventually lead to anti-social personality disorder – the diagnosis and treatment that could make my life so much easier is just out of reach because of a lack of awareness and stubborn doctors.

To top this all off I’m going through a hormone disorder, my continuous and paralyzing fear of change from autism which nobody seems to get through their heads, under medicated ADHD issues, suspected bipolar with rapid cycling moods and a resurgence of PTSD fears and flashbacks. And all the while people around me think I’m fine and if I tell them then I’m just self-diagnosing, making myself sound worse than I am and forgetting that ‘everyone else has problems but they just deal with it.’

And you wonder why I have turned to self-harm?

My fear of change makes me feel the same amount of anxiety and all I can really do is book an appointment with my doctor who consistently refuses to take my mood issues seriously. I need someone to take me to a doctor and I need them to do it very soon. I don’t think I can survive another week like this. And I can’t even tell them because of this block in my brain.

It’s too hard for anyone to understand that doesn’t go through it but people can have many phobias that don’t make sense. People engage in obsessive behaviour that doesn’t make sense. It’s a broken brain’s way of trying to make the environment around it make more sense by giving it some order, or like a virus it spreads and changes the environment into an exact copy of itself. But other people fight against it and this is what causes the severe anxiety.

I’ve had to deal with many forms of anxiety all my life, from the severe anxiety in select mutism to thought freezing social anxiety, to fearing for my own safety in PTSD and now I have demanding people being persistent when my avoidance withdrawals aren’t enough for them to leave me alone and it’s mixing with my mood issues which is containable until the hormone imbalances resurface. I’ve dealt with so much anxiety and I’m usually very good at working a way through it without medication but when it becomes such  a problem that I don’t want to live anymore, I know that I just can’t do it alone.