What is Rejection sensitivity dysphoria or RSD?


Rejection sensitivity dysphoria (RSD) is a psychological condition that is often associated with Attention Deficit Hyperactivity Disorder (ADHD). It is characterised by an extreme emotional sensitivity and fear of rejection or criticism.

People with RSD experience intense emotional reactions to perceived rejection or criticism, which can lead to feelings of sadness, anxiety, anger, and shame.

RSD can cause people to avoid situations that might trigger their sensitivity, which can lead to social isolation and difficulty forming and maintaining relationships. It can also make it difficult to engage in activities that may involve criticism or rejection, such as public speaking, job interviews, or sports competitions.

While RSD is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it is a commonly observed phenomenon among individuals with ADHD and is recognised by many clinicians and researchers as a significant issue.

Treatment for RSD often involves a combination of therapy and medication to address both the emotional and cognitive aspects of the condition.



How does RSD present in individuals with ADHD?


Rejection sensitivity dysphoria (RSD) is often associated with Attention Deficit Hyperactivity Disorder (ADHD) and is thought to be a common experience for many individuals with the condition.

Here are some ways in which RSD may present in people with ADHD:


Emotional sensitivity

People with RSD may be highly sensitive to perceived rejection or criticism, which can trigger intense emotional reactions such as sadness, anxiety, anger, or shame. They may feel a sense of personal failure or humiliation even in response to minor setbacks or negative feedback.


Overthinking and rumination

People with RSD may spend a lot of time thinking about past interactions or events, replaying them in their minds and analyzing them for signs of rejection or criticism. This can lead to a cycle of self-doubt and negative self-talk.



People with RSD may try to avoid situations that might trigger their sensitivity, such as
social events or performance-based activities. They may also avoid people who they perceive as
critical or rejecting, which can lead to social isolation and difficulty forming and maintaining


Impulsive behaviors

People with ADHD may engage in impulsive behaviors as a way of coping with
RSD symptoms. This might include seeking out attention or validation from others, or engaging in
risky behaviors as a way of seeking stimulation or distraction from negative emotions.


Difficulty regulating emotions

People with ADHD and RSD may struggle with regulating their emotions, leading to mood swings, outbursts, and difficulty managing stress and anxiety.

It’s important to note that RSD can vary in intensity and presentation among individuals with ADHD. Some people may experience it more severely than others, and it can also be influenced by other factors such as past experiences, personality traits, and current life circumstances.


Surely everyone feels like this how is it different between neurotypical individuals and people with ADHD?


While everyone may experience feelings of rejection or disappointment at times, the experience of rejection sensitivity dysphoria (RSD) is thought to be different for individuals with Attention Deficit Hyperactivity Disorder (ADHD) compared to those who are neurotypical.

Here are a few reasons why:

Intensity: People with ADHD and RSD often experience emotions more intensely than those without
ADHD. They may feel a sense of overwhelming emotional pain in response to even minor setbacks or
perceived criticism.

Duration: The emotional response to perceived rejection or criticism may last longer for individuals
with ADHD and RSD than for neurotypical individuals. They may ruminate on the experience for days
or even weeks, which can interfere with their ability to focus on other tasks and activities.

Perceived frequency: People with ADHD and RSD may perceive rejection or criticism more frequently
than neurotypical individuals, even in situations where none is intended. This can lead to a sense of
hyper-vigilance and anxiety in social situations.

Impact on daily functioning: The emotional intensity and duration of RSD symptoms can interfere
with daily functioning for people with ADHD. It can affect their ability to engage in social
interactions, perform well at work or school, and maintain healthy relationships.

Coping mechanisms: People with ADHD and RSD may use maladaptive coping mechanisms to
manage their emotional pain, such as self-medicating with drugs or alcohol, engaging in risky
behaviors, or withdrawing from social situations.

It’s important to note that RSD is not limited to individuals with ADHD and can be experienced by anyone. However, the emotional intensity, duration, and impact on daily functioning may be more pronounced in individuals with ADHD


What are some things I can do at home to reduce RSD symptoms?


If you are experiencing rejection sensitivity dysphoria (RSD), there are several things you can do at
home to help reduce your symptoms. Here are a few suggestions:

Practice self-care:

Take care of yourself physically and emotionally by getting enough sleep, eating a
healthy diet, and engaging in regular exercise. You can also try relaxation techniques such as deep
breathing, meditation, or yoga to help calm your mind and reduce stress.

Build a support network:

Surround yourself with people who understand and support you. This can
be friends, family, or a therapist. Having someone to talk to can help you process your emotions and
provide a sense of validation and acceptance.

Challenge negative thoughts:

Negative thoughts and self-doubt can trigger RSD symptoms. Try to
identify and challenge these thoughts by questioning their validity and focusing on more positive,
realistic beliefs.

Develop coping strategies:

Create a plan for how you will respond when you experience rejection or criticism. This might include reminding yourself of your strengths and accomplishments, seeking validation from others, or engaging in self-care activities.

Seek professional help:

Consider seeking professional help from a therapist or counselor who can provide additional support and guidance. They can help you learn coping strategies and work through underlying emotional issues that may be contributing to RSD symptoms.

Remember, everyone experiences rejection and criticism at some point in their lives.

While it can be challenging, learning to manage RSD symptoms is possible with the right strategies and support.

If you are need of support please contact Boutique Psychology in South Melbourne 

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