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PDA- The Next Big Diagnosis? · Millennial Mental Health Channel

• 0:02
  Speaker 1: Welcome to MMHC, your go to mental health podcast.
• 0:06
  Speaker 2: I'm Eddie Cooreo, a licensed professional counselor.
• 0:08
  Speaker 1: And I'm Justin Romano, a Board certified Child and Adolescent psychiatrist.
• 0:12
  Speaker 2: We created MMHC to give listeners evidence based information directly
• 0:16
  Speaker 2: from professionals who work in mental health.
• 0:18
  Speaker 1: We're not influencers, we're not trying to sell you anything.
• 0:21
  Speaker 1: We just want to bring love, empathy, and understanding of
• 0:24
  Speaker 1: mental health into this world.
• 0:26
  Speaker 2: And we really think that learning about mental health should
• 0:28
  Speaker 2: be fun, interesting, and most importantly honest.
• 0:31
  Speaker 1: So thanks for tuning in. This is a show by
• 0:33
  Speaker 1: two millennials, but it is intended to be for everyone.
• 0:36
  Speaker 2: We hope you enjoy the show.
• 0:40
  Speaker 1: MMHC is a production of Speaker from iHeartMedia, I HEARTMA.
• 0:47
  Speaker 1: Think of an accent? Think of an accent? Oh I'm
• 0:50
  Speaker 1: blanking here. That's okay, Ready, Welcome to the podcast. We
• 0:55
  Speaker 1: have an extra special episode for you today.
• 0:59
  Speaker 2: I was gonna tell you, I don't know why I
• 1:01
  Speaker 2: thought of this. While you're saying, think of an accent.
• 1:03
  Speaker 2: I went to the bank the other day. Uh and
• 1:05
  Speaker 2: and like as I was like doing my transaction, the
• 1:09
  Speaker 2: guy like looks at me. He's like, oh, should you
• 1:10
  Speaker 2: watch the game yesterday? And I froze and I was like,
• 1:13
  Speaker 2: what the fucking game was yesterday? And then I realized
• 1:16
  Speaker 2: he was talking about the Mexico game, like the opening
• 1:18
  Speaker 2: of the World Cup, and then it was like and
• 1:20
  Speaker 2: then I immediately was like, wow, he assumes I'm Mexican.
• 1:24
  Speaker 2: And then I remembered that my first name is Jose,
• 1:27
  Speaker 2: so obviously I'm Mexican. And he had my ID in
• 1:31
  Speaker 2: front of him.
• 1:34
  Speaker 1: So but I take it, and I watched the game.
• 1:36
  Speaker 2: Yeah, of course I did. Let's fucking go to zero.
• 1:40
  Speaker 2: Let's go see said that's right, we got South three tomorrow.
• 1:45
  Speaker 1: Let's go cool. It's been fun. World Cup has been good.
• 1:49
  Speaker 1: It has been Yeah, Usbai good game.
• 1:53
  Speaker 2: Yeah that was rougher. Yeah, not for the US, but.
• 1:57
  Speaker 1: One.
• 1:58
  Speaker 2: Yeah, it's been it's been cool to just randomly turn
• 2:01
  Speaker 2: on the TV and watch watch the World Cup games.
• 2:05
  Speaker 2: If you're anyone that has Peacock, that's the NBC subscription
• 2:09
  Speaker 2: service through like Exfinity or whatever. It's actually not I
• 2:13
  Speaker 2: get it for free throw Infinity that's what it is,
• 2:14
  Speaker 2: not just for Exfinity. But if you have it, you
• 2:17
  Speaker 2: get every game. It's just that it's the Spanish broadcast.
• 2:21
  Speaker 2: But if you're someone who's been watching the games, you
• 2:24
  Speaker 2: notice that they do a hydration break. Have you been
• 2:26
  Speaker 2: watching the games? Have you seen that the hydration break
• 2:29
  Speaker 2: for the English or Spot or Fox cast they go
• 2:34
  Speaker 2: to commercials, But if you watch the Spanish version on Peacock,
• 2:37
  Speaker 2: no commercials. So to consider just throwing it out there,
• 2:41
  Speaker 2: a little plug for Telemundo and Peacock. See I said,
• 2:48
  Speaker 2: I think I can't remember his name. This is terrible.
• 2:50
  Speaker 2: They got the the announcer, the very famous soccer announcer.
• 2:54
  Speaker 2: He's Argentinian. I watched the final four years ago when
• 2:57
  Speaker 2: Argentina won and it was very emotional. He was so anyway,
• 3:01
  Speaker 2: so cool.
• 3:03
  Speaker 1: Yeah, go sports.
• 3:06
  Speaker 2: It just sounds like, oh yeah, the Knicks one toy,
• 3:09
  Speaker 2: like lots. This is not a sports podcast, is all.
• 3:13
  Speaker 1: This is a mental health podcast.
• 3:15
  Speaker 2: We have talked about to I would say, yeah, you know.
• 3:20
  Speaker 1: We have talked about like athletes in the past and
• 3:22
  Speaker 1: the special uh like just how hard it is on athletes,
• 3:26
  Speaker 1: especially that transition out of their sport once they're retiring.
• 3:30
  Speaker 1: So yeah, I go check out the athlete episode. It's
• 3:33
  Speaker 1: way back now. That was like what three four years ago.
• 3:36
  Speaker 2: Now we did. It might be more, Yeah, it might
• 3:38
  Speaker 2: be more.
• 3:39
  Speaker 1: That was when I was in Omaha. It's been a while.
• 3:41
  Speaker 2: I'll throw out there too, since we're talking about sports
• 3:43
  Speaker 2: and podcasts.
• 3:44
  Speaker 1: Uh.
• 3:45
  Speaker 2: The Journal, it's by the Wall Street Journal. They did
• 3:48
  Speaker 2: a two part series. I just listened to both episodes
• 3:50
  Speaker 2: today where they talk about the intersection of money, corruption, power,
• 3:55
  Speaker 2: and FIFA and the World Comes and everything. Very good.
• 3:59
  Speaker 2: Two episodes about forty minutes each one. If you want
• 4:01
  Speaker 2: something interesting to learn about the World Cup a little
• 4:04
  Speaker 2: more before it keeps going on for the rest of
• 4:06
  Speaker 2: this month, the next month, something to check out.
• 4:09
  Speaker 1: Yeah, I've always heard that FIFA is like one of
• 4:11
  Speaker 1: the most corrupt organizations in the world.
• 4:15
  Speaker 2: That's that's putting it lightly. It's a yeah, did you
• 4:19
  Speaker 2: know that? You know?
• 4:20
  Speaker 1: I did not know that. That's wild considering how they make.
• 4:24
  Speaker 2: Yeah, they are expecting to make about fifteen billion dollars
• 4:27
  Speaker 2: in this World Cup. Wow, and they're a nonprofit.
• 4:31
  Speaker 1: Yeah.
• 4:31
  Speaker 2: Okay, take with that, which you will, well.
• 4:34
  Speaker 1: Yeah, I'll take it with a grain of salt.
• 4:37
  Speaker 2: Yeah.
• 4:39
  Speaker 1: So, Eddie, when I say p DA, what immediately comes
• 4:43
  Speaker 1: to mind.
• 4:45
  Speaker 2: Public displays of affection and was there not a I'm
• 4:51
  Speaker 2: gonna sound I'm gonna try to do this live while
• 4:53
  Speaker 2: I while I ramble. Was there not like you remember
• 4:56
  Speaker 2: back in the day when cell phones were like starting
• 4:58
  Speaker 2: to really like take off. We didn't have smart phones yet,
• 5:00
  Speaker 2: but we had like the little.
• 5:02
  Speaker 1: Uh personal data assistance.
• 5:05
  Speaker 2: Yeah, is that what it was? I think?
• 5:07
  Speaker 1: So, yeah, I forgot about.
• 5:09
  Speaker 2: I'm gonna look this up. Let's go. I thought of
• 5:11
  Speaker 2: that too.
• 5:13
  Speaker 1: I had forgotten you about. Is it personal data assistance?
• 5:17
  Speaker 2: It sure is good couch car According to Google, Gemini
• 5:21
  Speaker 2: and the AI Overview, Uh, it is a personal digital assistant.
• 5:25
  Speaker 2: A PDA was a handheld mobile device that functions as
• 5:29
  Speaker 2: an electronic organizer. So they were popularized in the nineteen
• 5:32
  Speaker 2: nineties and early two thousands. They let you manage your schedule, contacts, tasks,
• 5:37
  Speaker 2: acting as a digital day planner before the widespread adoption
• 5:41
  Speaker 2: of modern smartphones. The Palm Pilot. Yeah yeah, damn okay,
• 5:48
  Speaker 2: but that's not what we're talking about.
• 5:50
  Speaker 1: No, we're not talking about the Trapper Keeper was another winner,
• 5:53
  Speaker 1: but they made fun of that one on South Park.
• 5:54
  Speaker 2: Yeah.
• 5:55
  Speaker 1: Anyway, yeah, you do that. I'm gonna look to this
• 5:59
  Speaker 1: is there's a special episode because we're talking about PDA,
• 6:04
  Speaker 1: but it's neither public displays of affection or personal data assistance.
• 6:08
  Speaker 1: It's actually a mental health diagnosis that I had not
• 6:12
  Speaker 1: learned about in residency at all. But over the last
• 6:15
  Speaker 1: three years working as a clinical child and adolescent psychiatrist,
• 6:20
  Speaker 1: parents have asked me about it multiple times and it's
• 6:23
  Speaker 1: something that comes up quite frequently. So it's something that
• 6:26
  Speaker 1: I've had to learn about on my own, something that
• 6:28
  Speaker 1: I feel like is important for me to learn about
• 6:30
  Speaker 1: because so many parents are looking for guidance on this
• 6:34
  Speaker 1: and PDA stands for a pathological demand avoidance or sometimes
• 6:40
  Speaker 1: people call it a persistent drive for autonomy.
• 6:44
  Speaker 2: Very close pervasive drive for autonomy that is in the
• 6:48
  Speaker 2: neurodiversity advocates world. And I don't want to sound like
• 6:53
  Speaker 2: too much of an expert on this. I'm literally learning
• 6:55
  Speaker 2: about this as Justin has had the episode notes, so
• 6:58
  Speaker 2: this is brand new to me too, And as I
• 7:00
  Speaker 2: think about it, I'm like, oh, this kind of I
• 7:03
  Speaker 2: probably see this is a lot more than I thought.
• 7:05
  Speaker 2: I didn't know there was a name for it, so
• 7:06
  Speaker 2: this is good.
• 7:08
  Speaker 1: This is good to know, And that's a great point.
• 7:11
  Speaker 1: So listeners out there keep your ears open to the
• 7:13
  Speaker 1: fact that this is an interesting thing. Because it's not
• 7:17
  Speaker 1: like a formally recognized we'll talk about it, but that
• 7:19
  Speaker 1: doesn't mean that we should just completely neglect it. Sometimes
• 7:23
  Speaker 1: there are these things that people have to describe first,
• 7:26
  Speaker 1: and we gain like social acceptance before we realize like, yeah,
• 7:29
  Speaker 1: this is a real thing.
• 7:30
  Speaker 2: So yes.
• 7:32
  Speaker 1: According to Reframingautism dot org, PDA was first described in
• 7:37
  Speaker 1: nineteen eighty three by Elizabeth Newsen, a psychology professor at
• 7:41
  Speaker 1: the University of Nottingham and the United Kingdom. We still
• 7:45
  Speaker 1: do not know the full prevalence of PDA, how many
• 7:49
  Speaker 1: people have it, because there's no real standardized assessments for it.
• 7:54
  Speaker 1: There are six core components of PDA, and we'll take
• 7:57
  Speaker 1: turns listing them off to that Reframing Autism website. First
• 8:02
  Speaker 1: one is resistance and avoidance in everyday demands, including those
• 8:07
  Speaker 1: that are perceived by others as trivial or routine.
• 8:11
  Speaker 2: The other core component is an overwhelming need to be
• 8:14
  Speaker 2: in control and avoid being controlled by others, leading to
• 8:18
  Speaker 2: extreme mood swings.
• 8:21
  Speaker 1: The use of social strategies as part of their avoidance.
• 8:25
  Speaker 2: Surface social communication abilities. Despite difficulties with social interaction and understanding.
• 8:31
  Speaker 1: Obsessive behavior often focused on other people or can be
• 8:35
  Speaker 1: focused on performance demands.
• 8:37
  Speaker 2: And then the last one is appearing more comfortable in
• 8:40
  Speaker 2: role play and pretend than in reality, and sometimes to
• 8:43
  Speaker 2: an extreme extent. I will say, as I was reading
• 8:47
  Speaker 2: through this, I had to think, like, hmm, how can
• 8:51
  Speaker 2: I explain PDA to someone that maybe just needs it
• 8:54
  Speaker 2: an easier terms, And that someone is me? So I
• 8:57
  Speaker 2: want to share what it looked up and what I
• 9:00
  Speaker 2: had found. So let's see in plain terms, PDA is
• 9:04
  Speaker 2: a nervous system response where every day requests and expectations
• 9:09
  Speaker 2: trigger severe anxiety or a fight flight or freeze reaction.
• 9:14
  Speaker 2: So for someone with a PDA profile and everyday requests
• 9:17
  Speaker 2: something like taking out the trash or going to do
• 9:19
  Speaker 2: your homework, or just something that we feel is very
• 9:22
  Speaker 2: typical in a day to day setting, it's not just
• 9:26
  Speaker 2: an annoyance or a chore to them. Their brain literally
• 9:29
  Speaker 2: interrupts it or interprets it as an actual physical threat
• 9:33
  Speaker 2: to their autonomy or safety, so they feel like they're
• 9:36
  Speaker 2: in danger. But what I really want to point out
• 9:39
  Speaker 2: is what I've learned in my quick research with all
• 9:41
  Speaker 2: of this. Something we've talked about previously. When it comes
• 9:43
  Speaker 2: to like trauma, someone can say that something was traumatic
• 9:47
  Speaker 2: for them and we can hear about it and be like, oh,
• 9:49
  Speaker 2: that's really not that big of a deal. That doesn't
• 9:51
  Speaker 2: matter when it comes to something like PTSD diagnosis. It's
• 9:55
  Speaker 2: someone's perceived danger. They're perceived. How they perceive the traumatic
• 10:00
  Speaker 2: experience to them is really what least of the diagnosis
• 10:02
  Speaker 2: what not, not what you and I think about it,
• 10:05
  Speaker 2: So just something to think about. It may seem like
• 10:07
  Speaker 2: a very surface level like, oh, this is just kids
• 10:10
  Speaker 2: that don't want to do things and they just want
• 10:12
  Speaker 2: to defy. They're defiant. There are oppositional defiant. It's it's
• 10:18
  Speaker 2: more than that. It's not just that simple. It's something
• 10:20
  Speaker 2: for us to consider. And just as we were talking
• 10:22
  Speaker 2: about this in these last ten minutes, it's something that
• 10:25
  Speaker 2: my brain's kind of shooting all over the place of
• 10:26
  Speaker 2: like students and clients that have had previously, they're like, oh,
• 10:29
  Speaker 2: maybe this, maybe this better describes their behaviors and their
• 10:33
  Speaker 2: actions more than just being oppositional defiant, which again, remember right,
• 10:38
  Speaker 2: I hate that diagnosis. So yeah, that's my that's my
• 10:41
  Speaker 2: ramble for right now.
• 10:43
  Speaker 1: Very good point is that we're always trying to help kids.
• 10:47
  Speaker 1: We're trying to help understand kids so that they can
• 10:49
  Speaker 1: help themselves and we can get them in a better
• 10:52
  Speaker 1: position to succeed. And this is kind of a cool
• 10:55
  Speaker 1: diagnosis that gives an understanding of why some kids are
• 10:59
  Speaker 1: the way that they are, why it's really hard to
• 11:02
  Speaker 1: get them to do anything, and why they resist demands
• 11:05
  Speaker 1: from parents from teachers. So we've given a couple of definitions,
• 11:10
  Speaker 1: but I think it's important. Like there's one from the
• 11:11
  Speaker 1: Child Mind Institute that says PDA is a pattern of
• 11:15
  Speaker 1: behavior in which kids go to extremes to ignore or
• 11:18
  Speaker 1: avoid anything they perceive as a demand. It is seen
• 11:22
  Speaker 1: most often in people diagnosed with autism.
• 11:25
  Speaker 2: Typically, yeah, it's often theorized to be anxiety driven. So
• 11:30
  Speaker 2: these demands and expectations lead to avoidance of the demand.
• 11:34
  Speaker 1: Basic tasks are a battle getting dressed, putting on your shoes,
• 11:38
  Speaker 1: brushing your teeth, stuff that kids should do every day.
• 11:42
  Speaker 1: That it's an everyday extreme battle, and.
• 11:45
  Speaker 2: There's usually a strong need for autonomy and control, so
• 11:47
  Speaker 2: to feel like they get to make decisions that impact
• 11:50
  Speaker 2: their day to day. With these kids, there's a strong
• 11:52
  Speaker 2: need for that and anytime that that gets threatened, they
• 11:56
  Speaker 2: take it as like, I don't know, maybe we can't say.
• 11:58
  Speaker 2: Maybe they do experience it like a life or death situation,
• 12:02
  Speaker 2: like a very high stress, high danger situation.
• 12:06
  Speaker 1: Yeah, certainly a fight or flight response or fight fight
• 12:08
  Speaker 1: or fleet freeze response for sure. So why is this
• 12:12
  Speaker 1: such a unique thing, Like why are we bringing it up?
• 12:14
  Speaker 1: Why didn't I learn about it in residency. It's because
• 12:18
  Speaker 1: it is not formally recognized yet in the Diagnostic and
• 12:21
  Speaker 1: Statistical Manual the DSM, where we base most of our
• 12:25
  Speaker 1: mental health and psychiatric diagnoses. So there's only like one
• 12:30
  Speaker 1: real country that does recognize it, and it's the UK,
• 12:34
  Speaker 1: where it was first described. Most people do see it
• 12:37
  Speaker 1: as like a subset of autism.
• 12:40
  Speaker 2: I know we're about to get to it, but I
• 12:42
  Speaker 2: can totally see this as like a something that pops
• 12:46
  Speaker 2: up on TikTok and then like makes its rounds and
• 12:48
  Speaker 2: people are like, oh, yeah, I just you know, And
• 12:50
  Speaker 2: then you try and bring this to like a practitioner,
• 12:52
  Speaker 2: a clinician, they're just like, no, we're you're just getting
• 12:55
  Speaker 2: stuff from social media, but this is like a very
• 12:57
  Speaker 2: real thing. There's an article and that's probably what triggered
• 13:00
  Speaker 2: my comment from the Australian Psychological Society website. It's titled
• 13:05
  Speaker 2: how Pathological Demand Avoidance blew Up Online. So the argument
• 13:09
  Speaker 2: is that there's not enough high quality research to include
• 13:12
  Speaker 2: this into the DSM five text revised. It's basically an
• 13:16
  Speaker 2: example of how people are noticing trends and collaborating online
• 13:19
  Speaker 2: to identify patterns in young people. Something that they note
• 13:22
  Speaker 2: of PDA is that Google traffic for PDA has grown
• 13:26
  Speaker 2: by forty percent over the year, So it's a big
• 13:30
  Speaker 2: group of people that are checking in on this or
• 13:31
  Speaker 2: looking up, looking this up, trying to see if this
• 13:34
  Speaker 2: is something that defines that better defines either their own
• 13:37
  Speaker 2: behavior or their child's behavior, to really give them a
• 13:40
  Speaker 2: reason of why certain behaviors are happening in their home.
• 13:44
  Speaker 1: That's the thing that I think I find the most
• 13:46
  Speaker 1: fascinating about this is that this is not coming from
• 13:50
  Speaker 1: the mental health world as much as it's coming from
• 13:53
  Speaker 1: the pop culture pop psychology world. Like people are noticing
• 13:58
  Speaker 1: this so much in kids these days, is that they're
• 14:01
  Speaker 1: hoping to make it a part of the mental health world,
• 14:03
  Speaker 1: a part of the DSM instead of the other way around.
• 14:06
  Speaker 1: So I think that's kind of cool that the focus
• 14:08
  Speaker 1: is shifting. And I know that we tend to pooh
• 14:11
  Speaker 1: pooh social media a lot on this show, and because
• 14:15
  Speaker 1: it is terrible for the mental health of young people,
• 14:18
  Speaker 1: but this is one avenue where social media is helping
• 14:21
  Speaker 1: people organize and be able to collaborate and say like, hey,
• 14:25
  Speaker 1: I'm seeing a similar thing. What worked for you with
• 14:28
  Speaker 1: your kid? How can I help my kid? And people
• 14:31
  Speaker 1: are starting to really come together online as a community.
• 14:35
  Speaker 1: So one thing that we had read about and I
• 14:38
  Speaker 1: was very interested in is also just the impact of
• 14:41
  Speaker 1: screens on pathological demand avoidance, because a lot of researchers
• 14:46
  Speaker 1: and people just discussing PDA have noticed that and observe
• 14:51
  Speaker 1: that people with PDA really struggle to put screens down.
• 14:55
  Speaker 1: And I think it's because screens are easy. Screens are
• 14:59
  Speaker 1: typically low to demand on people, and so kids love screens.
• 15:04
  Speaker 1: Screens are comforting because screens don't tell them what to do. Typically,
• 15:10
  Speaker 1: screens are entertainment, screens are fun. Screens are lots of dopamine.
• 15:15
  Speaker 1: And for parents when they say like, hey, I need
• 15:17
  Speaker 1: you to go do X, Y and Z, it's hard
• 15:20
  Speaker 1: for kids to put those screens down and go do
• 15:23
  Speaker 1: the task when the screen is so easy to stay
• 15:25
  Speaker 1: on and is releasing so much dopamine and they're somewhat
• 15:29
  Speaker 1: addicted to it, they don't want to put it down.
• 15:32
  Speaker 1: So I thought it was important to just bring up
• 15:34
  Speaker 1: the fact that I think screens probably are contributing to
• 15:38
  Speaker 1: the fact that the kids these days are having a
• 15:40
  Speaker 1: hard time with completing demands and tasks because screens take
• 15:44
  Speaker 1: up and monopolize so much of their time and it's
• 15:47
  Speaker 1: hard to put them down.
• 15:56
  Speaker 2: Something I'm thinking about is that if or as we seen,
• 16:00
  Speaker 2: like kids and teens, they're on a screen, they have
• 16:02
  Speaker 2: a hard time putting it down to go do what
• 16:03
  Speaker 2: they're supposed to do. Because of that, because we have
• 16:07
  Speaker 2: that viewpoint or we've seen that it lumps everybody into
• 16:11
  Speaker 2: the same category. It's just a kid on their damn
• 16:13
  Speaker 2: screen that doesn't want to get off, instead of there
• 16:16
  Speaker 2: are kids on their damn screen that don't want to
• 16:19
  Speaker 2: get off. But they also might be kids who are
• 16:22
  Speaker 2: on their screens but struggle with this with PDA, and
• 16:25
  Speaker 2: that might better explain why they're having a struggle. If
• 16:29
  Speaker 2: you remember in the DSM five or probably back to
• 16:31
  Speaker 2: the other ones too. But let's talk specifically about the five.
• 16:35
  Speaker 2: One of the final criteria on all, if not most,
• 16:38
  Speaker 2: of the diagnoses is that it's not better explained by
• 16:42
  Speaker 2: another diagnosis. So with all of this, we may now
• 16:47
  Speaker 2: have an opportunity to better explain some of these behaviors,
• 16:50
  Speaker 2: whereas before we didn't. Because it's popped up a lot more,
• 16:53
  Speaker 2: it should be something that we try to pay attention to.
• 16:55
  Speaker 2: The more people can share about this, the more normalization
• 16:58
  Speaker 2: can happen, and the more potential treatment at least understanding
• 17:01
  Speaker 2: can happen for these kids and their families.
• 17:04
  Speaker 1: So I know we've talked a lot about it. We've
• 17:06
  Speaker 1: talked like definitions and what it is. So if anyone
• 17:09
  Speaker 1: is interested out there or feel like man that kind
• 17:11
  Speaker 1: of fits the pattern of my child. There's lots of
• 17:15
  Speaker 1: resources out there and online, especially because that's where a
• 17:19
  Speaker 1: lot of these communities are growing to learn about it.
• 17:21
  Speaker 1: So Facebook has a lot of parent support groups. There's
• 17:25
  Speaker 1: also educational and support groups like at Peace Parents, And
• 17:30
  Speaker 1: essentially what at Peace Parents tries to teach is that
• 17:33
  Speaker 1: there are different strategies for phrasing things and communicating things
• 17:38
  Speaker 1: with their children to get them to follow it. More so,
• 17:41
  Speaker 1: it doesn't feel like such a demand, it doesn't feel
• 17:43
  Speaker 1: like such a threat. Promotes more of that autonomy and
• 17:47
  Speaker 1: gets kids to be a little bit more coherent, a
• 17:50
  Speaker 1: little bit more adherent. So instead of saying like you
• 17:54
  Speaker 1: need to go brush your teeth, go brush your teeth now,
• 17:56
  Speaker 1: it's phrasing it more, or is it all right? Brush
• 18:00
  Speaker 1: your teeth, we're like, hey, can you brush your teeth
• 18:02
  Speaker 1: right now? Which, as a parent of a toddler, that's
• 18:07
  Speaker 1: so hard because sometimes if you give them the choice,
• 18:10
  Speaker 1: the answer is no, and then where do you go
• 18:14
  Speaker 1: from there? And then you say like, well, well, I
• 18:16
  Speaker 1: know I asked you that question, but really you gotta
• 18:19
  Speaker 1: go brush your teeth like it's time.
• 18:22
  Speaker 2: But just you talking about this is making me, like
• 18:25
  Speaker 2: multiple students from probably just this school year's popping up
• 18:29
  Speaker 2: in my head of like, yeah, maybe if we approached
• 18:31
  Speaker 2: it with a different lens or a different just like path,
• 18:35
  Speaker 2: maybe we could have gotten to a resolution a little quicker.
• 18:38
  Speaker 1: And that's that's the whole goal, is how do we
• 18:40
  Speaker 1: get kids motivated to get some of these things done
• 18:43
  Speaker 1: because they're good for them, and therapies can help. There's
• 18:47
  Speaker 1: some evidence out there that says occupational therapy, CBT, Applied
• 18:52
  Speaker 1: behavioral analysis ABA, parent child interaction training. They can be
• 18:57
  Speaker 1: somewhat useful. The tricky part is I read online like
• 19:01
  Speaker 1: you should try and find a therapist who's well versed
• 19:04
  Speaker 1: in PDA, and it's like where, Like how do you
• 19:07
  Speaker 1: find Because it's not a recognized part, it's gonna be
• 19:11
  Speaker 1: really hard to find. If you can find someone good, yay,
• 19:15
  Speaker 1: But people might not advertise that they know this stuff,
• 19:19
  Speaker 1: they might not put it on their credentials, so it
• 19:21
  Speaker 1: might be hard to find a therapist who work specifically
• 19:24
  Speaker 1: with it.
• 19:25
  Speaker 2: It's already hard enough to find a therapist, I mean
• 19:27
  Speaker 2: trying to find one that's like understanding that something like
• 19:30
  Speaker 2: PDA could be even tougher down on here. We also
• 19:32
  Speaker 2: have medicines. Anxiety medication seems to be something that could
• 19:35
  Speaker 2: be helpful. My guess would be, and you could probably
• 19:37
  Speaker 2: better explain, but my guess would be, if they feel
• 19:39
  Speaker 2: less anxious and on edge when something gets brought up
• 19:43
  Speaker 2: or a quote unquote demand gets brought up, they're not
• 19:45
  Speaker 2: as anxious, they're not as quick to have a severe
• 19:49
  Speaker 2: and negative response because they're at kind of like a
• 19:51
  Speaker 2: lower baseline compared to other times.
• 19:54
  Speaker 1: For sure. And I've had a handful of cases where
• 19:57
  Speaker 1: PDA did get better with the U use of anxiety medications,
• 20:02
  Speaker 1: and so that's one area where I feel like firsthand,
• 20:05
  Speaker 1: because parents brought it up with me, I've thought like, okay, yeah,
• 20:09
  Speaker 1: I mean they do kind of fit all the criteria
• 20:11
  Speaker 1: from what the UK researchers have put down for the
• 20:15
  Speaker 1: criteria and reading about it, like, Okay, there's no specific
• 20:19
  Speaker 1: medicines for autisms, we can't treat that route. Sometimes there's
• 20:23
  Speaker 1: an ADHD component in there too, and treating the ADHD
• 20:27
  Speaker 1: can also help, But that's also really tricky too, because
• 20:30
  Speaker 1: then you're crossing the line of like what is oppositional
• 20:33
  Speaker 1: defiant disorder and what is PDA? And I think the
• 20:37
  Speaker 1: child's mindset is what makes that biggest difference, and I
• 20:41
  Speaker 1: think we're going to talk about that a little bit
• 20:42
  Speaker 1: more later in the discussion part. But overall, yes, I've
• 20:47
  Speaker 1: had a little bit of luck with anxiety medicines and
• 20:49
  Speaker 1: it seems like it's helping.
• 20:50
  Speaker 2: Yeah, tell me more about PDA North America dot org.
• 20:54
  Speaker 1: Would you PDIA north America dot org more resources for
• 20:57
  Speaker 1: you guys, if you guys are interested. They had some
• 21:00
  Speaker 1: good information on their website, but also a little bit
• 21:03
  Speaker 1: of information I found a little bit suspicious on their
• 21:05
  Speaker 1: website where it was talking, yeah, you know, you gotta
• 21:09
  Speaker 1: look at everything with a critical eye.
• 21:11
  Speaker 2: A good consumer of information. I like it. Yeah.
• 21:14
  Speaker 1: On their website it was talking about how the blue
• 21:16
  Speaker 1: light theory has been debunked, which essentially says that the
• 21:21
  Speaker 1: blue light from screens impairs your brain's ability to release
• 21:24
  Speaker 1: melatonin and that's why screens are bad for sleep. But
• 21:28
  Speaker 1: that's not true. That hasn't been debunked at all. If anything,
• 21:31
  Speaker 1: it's actually been proven a couple of different times. So
• 21:34
  Speaker 1: I wasn't totally thrilled on this website from PDA North America.
• 21:38
  Speaker 1: So maybe avoid that one. Go for at Peace Parents.
• 21:42
  Speaker 1: I've heard good things about that one. But on PDA
• 21:45
  Speaker 1: North America they also argue that neurodivergent kids and with screens.
• 21:51
  Speaker 1: They were like, hey, screens might not be a bad
• 21:53
  Speaker 1: thing for a bedtime routine, and I was like, maybe sure,
• 21:58
  Speaker 1: Like I've got i' got some neurodivirgin kids, especially with ADHD,
• 22:03
  Speaker 1: that tell me they want to sleep with something that's
• 22:06
  Speaker 1: just mildly stimulating, Like a lot of my ADHD kids
• 22:09
  Speaker 1: will say, like, I turn the TV on and it
• 22:11
  Speaker 1: helps me fall asleep, or I listen to music, or
• 22:14
  Speaker 1: I listen to a podcast, like and it helps me
• 22:16
  Speaker 1: fall asleep. Because I think with people with ADHD, they
• 22:19
  Speaker 1: need that just a little bit of stimulation to calm
• 22:22
  Speaker 1: their mind down a little bit, just focused enough to
• 22:24
  Speaker 1: help them fall asleep. So maybe, but also I'm like,
• 22:29
  Speaker 1: I don't know if we should be saying more screens
• 22:31
  Speaker 1: for kids before bed.
• 22:33
  Speaker 2: Do you think that's kind of similar to like when
• 22:36
  Speaker 2: someone has like ADHD and they're not medicated and they
• 22:39
  Speaker 2: consume caffeine, and then the caffeine is like the stimulant
• 22:42
  Speaker 2: that like helps mel them out for a little bit
• 22:45
  Speaker 2: and then feel like they're more able to take on
• 22:47
  Speaker 2: the world. Is that similar?
• 22:49
  Speaker 1: Yeah, Like people with ADHD, their brain tends to react
• 22:52
  Speaker 1: to the opposite to stimulation that a neurotypical persons would,
• 22:56
  Speaker 1: So usually a TV would keep most people up, but
• 22:59
  Speaker 1: people with ADHD, the TV actually calms them down.
• 23:03
  Speaker 2: Interesting other websites we got Parents Helping Parents, Journeys with PDA,
• 23:09
  Speaker 2: PDA Parents and PDA Society, just a bunch of resources
• 23:13
  Speaker 2: that doctor Justin has helped us find for this one.
• 23:15
  Speaker 1: Now, one thing we used to do a lot of
• 23:18
  Speaker 1: on the show is talking about celebrities who actually have
• 23:21
  Speaker 1: the specific diagnoses. This one is a little hard because
• 23:25
  Speaker 1: it's not a formally recognized diagnosis. But there were actually
• 23:29
  Speaker 1: a couple of people who I had even never heard before.
• 23:32
  Speaker 1: And I'm usually pretty good at pop culture, but hey,
• 23:36
  Speaker 1: if you've heard of Demi Burnett, more power to you.
• 23:40
  Speaker 1: And according to Yahoo, so very credible source. Obviously, this
• 23:45
  Speaker 1: is a bachelor star who has discussed her autism diagnosis
• 23:50
  Speaker 1: with a PDA profile. She has actually said that her
• 23:54
  Speaker 1: PDA comes from a need to control her anxiety. So
• 23:57
  Speaker 1: someone who is on a major television program in the
• 24:01
  Speaker 1: United States who has come out and actually talked about
• 24:03
  Speaker 1: the diagnosis of PDA specifically for herself, so kind of cool.
• 24:07
  Speaker 2: I'm looking to prove both of these people.
• 24:12
  Speaker 1: You've never heard of Izzy jud.
• 24:15
  Speaker 2: I cannot say that I have. But Izzy is married
• 24:17
  Speaker 2: to Harry Judd, who is in the band McFly, who
• 24:21
  Speaker 2: I am not familiar with. Surprisingly, she has said that
• 24:27
  Speaker 2: their child has PDA and has said letting go of
• 24:30
  Speaker 2: direct commands in foster and empathy and autonomy has helped,
• 24:34
  Speaker 2: Which will bring me to My next point that I
• 24:36
  Speaker 2: want to look up on my search of like how
• 24:38
  Speaker 2: to make this as easy digestible for anybody, mostly me
• 24:43
  Speaker 2: as possible. The big takeaway that I found in this
• 24:45
  Speaker 2: research of the kind of the big take hold message
• 24:48
  Speaker 2: was that a person with PDA isn't just being naughty.
• 24:51
  Speaker 2: They're not lazy, They're not just stubborn. They're dealing with
• 24:54
  Speaker 2: a brain that mistakenly treats basic daily life expectations like
• 24:58
  Speaker 2: a predator attack. Traditional parenting or management styles focus on
• 25:02
  Speaker 2: strict rewards and punishment usually backfire completely, whereas collaboration and
• 25:08
  Speaker 2: low demand environments help them thrive. Yeah, things to consider.
• 25:13
  Speaker 1: We do have some parenting strategies that are a little archaic.
• 25:17
  Speaker 1: We've changed a lot as a society obviously, but maybe
• 25:21
  Speaker 1: for specific kids in certain situations, especially in PDA, it's
• 25:25
  Speaker 1: worth it to try some different things, some different strategies
• 25:28
  Speaker 1: to get your kids to be a little bit healthier.
• 25:30
  Speaker 1: Follow directions, because that's life.
• 25:33
  Speaker 2: A lot of.
• 25:33
  Speaker 1: Times you have to follow instructions to be successful in life.
• 25:37
  Speaker 1: And not that everyone has to fit a mold, but
• 25:40
  Speaker 1: like brushing your teeth, taking your medicine, like stuff that's
• 25:42
  Speaker 1: good for you, that you just cannot do because you
• 25:45
  Speaker 1: just resist all demands. If you can learn to get
• 25:47
  Speaker 1: over that, that can be a useful thing in your life.
• 25:50
  Speaker 1: So some other examples of like mental health issues that
• 25:55
  Speaker 1: were have like grassroots movements in the past, but weren't
• 25:59
  Speaker 1: formally wrecked until years after they were brought into the
• 26:03
  Speaker 1: social culture. PTSD it wasn't actually officially recognized until the
• 26:09
  Speaker 1: nineteen eighties or until nineteen eighty itself.
• 26:13
  Speaker 2: Yeah, not crazy, it's like crazy you think about it.
• 26:16
  Speaker 1: In war like obviously people had that, and I think,
• 26:21
  Speaker 1: what do they call it, like nostalgia or like a
• 26:24
  Speaker 1: like war nostalgia. So there's an old term for it
• 26:27
  Speaker 1: for like World War One or something like that. So
• 26:29
  Speaker 1: it was around for decades before it actually got the
• 26:32
  Speaker 1: official recognition in nineteen eighties.
• 26:35
  Speaker 2: Asked her to say something about PTSD real quick. Oh,
• 26:37
  Speaker 2: go for it. This this is just a story of
• 26:39
  Speaker 2: a gentleman. And anytime I think about this, I anytime
• 26:43
  Speaker 2: PTSD comes up, I think about him. I met him
• 26:46
  Speaker 2: at some point in my life through I don't even
• 26:49
  Speaker 2: know the best way to describe it, because I don't
• 26:50
  Speaker 2: want to make this as like identifying, but just a
• 26:52
  Speaker 2: gentleman that i'd met back in the day. I was
• 26:54
  Speaker 2: talking with him and I told him that I was
• 26:56
  Speaker 2: a therapist. He told me that he was in one
• 26:58
  Speaker 2: of the wars, and he told me that he was
• 27:00
  Speaker 2: pretty sure he had PTSD and that thankfully he was
• 27:03
  Speaker 2: not struggling with that anymore. And I said, wow, that's
• 27:06
  Speaker 2: great to hear. What was helpful. He looked me dead
• 27:10
  Speaker 2: in the eye and he said, oh, I just drank
• 27:12
  Speaker 2: myself to sleep every night, and some nights I'd wake
• 27:15
  Speaker 2: up in a cold sweat, but eventually it just stopped.
• 27:18
  Speaker 2: So I just wanted to throw that out there that
• 27:22
  Speaker 2: I think, given this as PTSD was not really recognized
• 27:26
  Speaker 2: until the nineteen eighties or nineteen eighty, he I think
• 27:29
  Speaker 2: was in the category of before nineteen eighty where this
• 27:32
  Speaker 2: was a it was not a thing, and he had
• 27:35
  Speaker 2: to kind of just deal with it by himself. Thankfully,
• 27:37
  Speaker 2: according to him, he'd worked past it. But yeah, I
• 27:41
  Speaker 2: always thinking about that whenever the PTSD diagnosis comes up.
• 27:45
  Speaker 1: Good, good story to nail home a point. But that
• 27:49
  Speaker 1: just goes to show you that in just two generations, right,
• 27:53
  Speaker 1: no one really even formally recognizing it to almost every
• 27:56
  Speaker 1: child that I talk about knows what PTSD is.
• 27:58
  Speaker 2: Yeah, you amazing. Yeah, it is good. It's good. People understand,
• 28:04
  Speaker 2: even kids understand.
• 28:05
  Speaker 1: Another one is Asperger's, which was originally identified in nineteen forty,
• 28:10
  Speaker 1: but it didn't make it into the DSM four until
• 28:12
  Speaker 1: nineteen ninety four, so it was around for a long time,
• 28:17
  Speaker 1: for fifty four years before it actually made it into
• 28:20
  Speaker 1: the diagnosis. Well, then they took it out again and
• 28:24
  Speaker 1: put it all into ATO. Some spectrum disorder and red headed.
• 28:28
  Speaker 2: Steps came around. Yeah, thirteen was a big year then
• 28:31
  Speaker 2: because the next two I did not realize we're not
• 28:34
  Speaker 2: in the DSM until then. So the first one is
• 28:36
  Speaker 2: BEINGI ind disorder was not recognized until twenty thirteen, and
• 28:40
  Speaker 2: neither was pre menstrual dysphoria disorder, so PMDD also not
• 28:44
  Speaker 2: until twenty thirteen. I don't want to sound I should
• 28:48
  Speaker 2: know this, but I just want to make sure I'm
• 28:50
  Speaker 2: PMDD is kind of the increase of depressive like symptoms
• 28:54
  Speaker 2: around the time that a individual was experiencing in their period.
• 28:59
  Speaker 2: Is that about correct or yeah, swings or mood shifts.
• 29:04
  Speaker 1: Yeah, honestly, yeah, I've got some patients with really bad
• 29:08
  Speaker 1: PMDD where they get super depressed, even sometimes suicidal, like
• 29:13
  Speaker 1: before their period, and then when their period starts, it
• 29:15
  Speaker 1: starts to get better. But man, I mean it is
• 29:18
  Speaker 1: it is intense. Like sometimes these poor girls they just
• 29:22
  Speaker 1: go from being like pretty normal have maybe a little
• 29:25
  Speaker 1: bit of depression to being full blown severe depression because
• 29:29
  Speaker 1: of their hormones are so strong.
• 29:31
  Speaker 2: Yeah, but again it's twenty twenty six. It's only been
• 29:34
  Speaker 2: like a recognized name for the last thirteen years. That's wild, Yeah,
• 29:38
  Speaker 2: pretty wild.
• 29:40
  Speaker 1: So yes, main points of this podcast today is we
• 29:44
  Speaker 1: wanted to talk about something that has become very popular
• 29:47
  Speaker 1: online as kind of a pop culture pop psychology diagnosis,
• 29:51
  Speaker 1: raise awareness of it, get people talking about it, getting
• 29:54
  Speaker 1: people thinking about it, start a discussion on it, with
• 29:58
  Speaker 1: the hopes that we could potentially cha the way we
• 30:00
  Speaker 1: treat certain kids. That what we have learned working with
• 30:04
  Speaker 1: kids is that it's very rare that a kid's actually lazy,
• 30:08
  Speaker 1: even though we throw that term around all the time
• 30:11
  Speaker 1: as a society, When you actually dig in and find
• 30:15
  Speaker 1: out what's going on inside of their minds, usually there's
• 30:18
  Speaker 1: a more complete and cohesive answer than more than they're
• 30:22
  Speaker 1: just lazy. They need to learn how to work hard.
• 30:25
  Speaker 2: Every new and upcoming generation is always lazy. That's the thing.
• 30:30
  Speaker 2: We were the lazy ones at some point. Now the
• 30:33
  Speaker 2: kids we work with are the lazy ones, and the
• 30:34
  Speaker 2: kids that we're gonna work with the lazy ones. It's
• 30:37
  Speaker 2: the never ending cycle.
• 30:39
  Speaker 1: So if you guys want to talk to us, if
• 30:41
  Speaker 1: you guys have questions, if you guys want to send
• 30:43
  Speaker 1: us your stories, let us know. We would love to
• 30:46
  Speaker 1: hear from you and what you think about PDA, what
• 30:48
  Speaker 1: has worked for you, because we're learning in this stuff
• 30:51
  Speaker 1: too that it's not something that we have formally and
• 30:54
  Speaker 1: officially learned about in our education programs. We are picking
• 30:58
  Speaker 1: it up as we go. So if the more individual
• 31:00
  Speaker 1: stories we hear the better.
• 31:02
  Speaker 2: Yeah, which I think is good. We should be trying
• 31:04
  Speaker 2: to pick up things as we go, Like that's that
• 31:06
  Speaker 2: should be the standard for our field in our colleagues.
• 31:10
  Speaker 2: We we don't know everything, and we don't have to
• 31:11
  Speaker 2: know everything, but we should be open to new new information.
• 31:15
  Speaker 1: Becoming lifelong learners.
• 31:17
  Speaker 2: Bam, Yeah, that's cool.
• 31:21
  Speaker 1: It's like one of our residency criterias like, is this
• 31:25
  Speaker 1: fostering life long learning environments? So thank you Creighton Psychiatry.
• 31:34
  Speaker 2: Bay Go what's what's their mascot is the Blue Jays. Nice.
• 31:41
  Speaker 1: They're usually in March Madness every year. They're they're pretty
• 31:44
  Speaker 1: popular too.
• 31:45
  Speaker 2: I should put some respect on their name before I
• 31:48
  Speaker 2: wrap it up, I will say. And this kind of
• 31:50
  Speaker 2: ties up to the end. We've gotten some great messages
• 31:52
  Speaker 2: on social media just thanking us and giving us feedback
• 31:54
  Speaker 2: on our recent episode. So thank you guys. Feel free
• 31:57
  Speaker 2: to message us at any time. We appreciate it again.
• 32:00
  Speaker 2: You know where to find the podcasts Spotify, Apple Podcasts,
• 32:03
  Speaker 2: whatever other app you use. We are on their social
• 32:06
  Speaker 2: media at Millennial mhcmillennialimahc dot com. Follow us, like, subscribe,
• 32:13
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• 32:15
  Speaker 2: whatever it is, we'd appreciate it. We appreciate you all
• 32:17
  Speaker 2: for taking the time to listen to us today. We
• 32:20
  Speaker 2: will see you next time, and remember take care of
• 32:23
  Speaker 2: all mentals.
• 32:24
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• 32:27
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