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: <ul data-spread="false"> <li> What PDA is and how it manifests in individuals, particularly in relation to autism, ADHD, and other neurodivergent conditions. </li> <li> The importance of reframing PDA as a high drive for autonomy rather than defiance. </li> <li> Practical coaching strategies to work around demand avoidance, including collaborative goal setting, offering choices, and making training sessions more engaging and playful. </li> <li> The significance of open-ended questions and genuine curiosity in understanding the root of a student’s resistance. </li> </ul> 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: <ul data-spread="false"> <li> Understanding Persistent Depressive Disorder (formerly known as dysthymia) and how it differs from episodic major depression. </li> <li> Behavioral activation as a treatment approach, including strategies for identifying and engaging in potentially enjoyable activities despite a lack of motivation or pleasure. </li> <li> The five-minute rule to help overcome resistance to activities. </li> <li> Medication considerations, including alternatives like Wellbutrin (bupropion) and the combination drug Auvelity, which may have fewer side effects. </li> <li> Non-medication treatments such as Transcranial Magnetic Stimulation (TMS) and ketamine therapy. </li> <li> The importance of evaluating life circumstances to identify external contributors to chronic depression, such as hidden identity struggles or unsatisfying relationships. </li> </ul> 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 <ul data-spread="false"> <li> Dr. Duff’s website: <a href= "http://duffthepsych.com">http://duffthepsych.com</a> </li> <li> Email your questions: <a>duffthepsych@gmail.com</a> </li> <li> Follow Dr. Duff on Instagram: <a href= "https://instagram.com/duffthepsych">https://instagram.com/duffthepsych</a> </li> <li> Dr. Duff’s book “Hardcore Self Help: F**k Depression”: <a href= "https://www.amazon.com/Hardcore-Self-Help-Depression/dp/B01J4H5A40"> https://www.amazon.com/Hardcore-Self-Help-Depression/dp/B01J4H5A40</a> </li> <li> Previous episodes on TMS and ketamine treatments: <a href= "http://duffthepsych.com/podcast">http://duffthepsych.com/podcast</a> </li> <li> More on ketamine treatments: <a href= "https://duffthepsych.com/ect-and-ketamine/">https://duffthepsych.com/ect-and-ketamine/</a> </li> </ul> 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!

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431: Pathological Demand Avoidance & Persistent Low-Grade Depression

The Hardcore Self Help Podcast with Duff the Psych

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