The Hardcore Self Help Podcast with Duff the Psych

431: Pathological Demand Avoidance & Persistent Low-Grade Depression


Listen Later

Episode 431: Pathological Demand Avoidance in Coaching & Persistent Depression

Welcome to another episode of the Hardcore Self Help Podcast with Dr. Robert Duff! In this Q&A episode, Dr. Duff tackles two insightful listener questions on very different but equally important mental health topics.

Question 1: Pathological Demand Avoidance (PDA) in Coaching

A listener working as an individual sports coach seeks advice on how to best support a talented but highly resistant student who displays signs of Pathological Demand Avoidance (PDA). Dr. Duff dives into:

  • What PDA is and how it manifests in individuals, particularly in relation to autism, ADHD, and other neurodivergent conditions.

  • The importance of reframing PDA as a high drive for autonomy rather than defiance.

  • Practical coaching strategies to work around demand avoidance, including collaborative goal setting, offering choices, and making training sessions more engaging and playful.

  • The significance of open-ended questions and genuine curiosity in understanding the root of a student’s resistance.

Question 2: Chronic Low-Grade Depression (Persistent Depressive Disorder)

A listener describes their struggle with long-term, low-grade depression despite attempts with medication and therapy. Dr. Duff provides insights into:

  • Understanding Persistent Depressive Disorder (formerly known as dysthymia) and how it differs from episodic major depression.

  • Behavioral activation as a treatment approach, including strategies for identifying and engaging in potentially enjoyable activities despite a lack of motivation or pleasure.

  • The five-minute rule to help overcome resistance to activities.

  • Medication considerations, including alternatives like Wellbutrin (bupropion) and the combination drug Auvelity, which may have fewer side effects.

  • Non-medication treatments such as Transcranial Magnetic Stimulation (TMS) and ketamine therapy.

  • The importance of evaluating life circumstances to identify external contributors to chronic depression, such as hidden identity struggles or unsatisfying relationships.

Chapters

[00:00] Intro and updates on Dr. Duff’s upcoming bipolar book [03:00] Question 1: Pathological Demand Avoidance (PDA) in coaching [12:00] Strategies for engaging students with PDA [14:00] Question 2: Chronic low-grade depression and treatment options [19:00] Behavioral activation and the five-minute rule [23:00] Medication alternatives and non-pharmacological treatments [27:00] Life circumstances and their role in persistent depression [28:00] Outro and listener support requests

Resources & Links
  • Dr. Duff’s website: http://duffthepsych.com

  • Email your questions: [email protected]

  • Follow Dr. Duff on Instagram: https://instagram.com/duffthepsych

  • Dr. Duff’s book “Hardcore Self Help: F**k Depression”: https://www.amazon.com/Hardcore-Self-Help-Depression/dp/B01J4H5A40

  • Previous episodes on TMS and ketamine treatments: http://duffthepsych.com/podcast

  • More on ketamine treatments: https://duffthepsych.com/ect-and-ketamine/

Thank you for tuning in! If you found this episode helpful, please consider sharing it with a friend or leaving a review. Your support helps the podcast grow and reach more people who need it. See you next time!

...more
View all episodesView all episodes
Download on the App Store

The Hardcore Self Help Podcast with Duff the PsychBy Robert Duff, Ph.D.

  • 4.5
  • 4.5
  • 4.5
  • 4.5
  • 4.5

4.5

959 ratings


More shows like The Hardcore Self Help Podcast with Duff the Psych

View all
The Overwhelmed Brain by Paul Colaianni

The Overwhelmed Brain

1,893 Listeners

The One You Feed by iHeartPodcasts

The One You Feed

2,511 Listeners

Savvy Psychologist by QuickAndDirtyTips.com

Savvy Psychologist

1,382 Listeners

Therapy Chat by Laura Reagan, LCSW-C

Therapy Chat

665 Listeners

10% Happier with Dan Harris by 10% Happier

10% Happier with Dan Harris

12,542 Listeners

Being Well with Forrest Hanson and Dr. Rick Hanson by Rick Hanson, Ph.D., Forrest Hanson

Being Well with Forrest Hanson and Dr. Rick Hanson

2,394 Listeners

Counselor Toolbox Podcast with DocSnipes by Dr. Dawn-Elise Snipes

Counselor Toolbox Podcast with DocSnipes

599 Listeners

Therapist Uncensored Podcast by Sue Marriott LCSW, CGP & Ann Kelley PhD

Therapist Uncensored Podcast

1,372 Listeners

The SelfWork Podcast by Margaret Robinson Rutherford PhD

The SelfWork Podcast

1,192 Listeners

UnF*ck Your Brain: Feminist Self-Help for Everyone by Kara Loewentheil

UnF*ck Your Brain: Feminist Self-Help for Everyone

5,074 Listeners

Therapy in a Nutshell by Therapy in a Nutshell -Emma McAdam

Therapy in a Nutshell

523 Listeners

Trauma Rewired by Jennifer Wallace & Elisabeth Kristof

Trauma Rewired

318 Listeners

Complex Trauma Recovery by Kina Penelope

Complex Trauma Recovery

174 Listeners

Adult Child by Andrea

Adult Child

1,781 Listeners

The Crappy Childhood Fairy Podcast with Anna Runkle by Anna Runkle

The Crappy Childhood Fairy Podcast with Anna Runkle

306 Listeners