Confronting Rejection Sensitive Dysphoria in ADHD

Rejection Sensitive Dysphoria (RSD) is particularly prevalent in adults with ADHD, manifesting as an intense emotional response to perceived criticism or rejection. This heightened sensitivity can lead to overwhelming feelings of sadness, shame, or anger, even from minor negative feedback. Addressing RSD involves recognizing these emotional patterns and employing coping strategies such as cognitive-behavioral therapy, mindfulness, and sometimes medication. It's crucial for individuals with ADHD to develop resilience and seek understanding from their support networks. Understanding and managing RSD is key to improving emotional well-being and interpersonal relationships for those with ADHD.

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Alice Gendron

Founder of The Mini ADHD Coach

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ADHD & RSD: Let's Talk About Rejection Sensitive Dysphoria

Have you noticed your ADHD behavior when it comes to criticisms? How about how you take rejections? There are moments when being rejected can be a struggle for some people with ADHD. It can be quick for us to take things personally when we do not know how to manage our emotions. For some of us, this can happen most of the time because of Rejection Sensitive Dysphoria. Want to learn more about this phenomenon? Read on 😉 

did you know that many people with ADHD struggle with RSD?

Because of ADHD, we may have a somewhat “faulty” emotional regulation. Our central nervous system differently manages emotional responses, and as much as we try to avoid instances of inappropriate or extreme emotional responses, they can still happen 🥺. It can be challenging for us to resolve relationship conflicts or accept mistakes and criticisms. Likewise, it can be challenging to control intense pain, physical or otherwise. Finally, we may be overly sensitive to loud noises, including shouting.

Having ADHD and RSD simultaneously can induce an overwhelming emotional response to other people. We may quickly react negatively to what others say, manage feelings differently, and build walls as our defense mechanism in handling perceived or actual rejection. 😔

What is Rejection Sensitive Dysphoria?

Rejection Sensitive Dysphoria (RSD) is a rising term coined to describe intense emotional pain or excessive emotional reactions resulting from perceived or actual rejection. It is a form of emotional dysregulation most often found in people with ADHD. RSD can manifest as feelings of low self-esteem, anxiety, depression, and irritability. In other words, when you have RSD, the impact of the rejection or criticism is beyond average and you may have a hard time bouncing back from feeling excessively down. 😭

Please note, however, that the Diagnostic of Statistical Manual for Mental Health Disorders does not recognize RSD and hasn't listed down an official list of symptoms. 

What is RSD?

When a person is extremely sensitive about rejection, any form of criticism can be taken too hard. Some people with ADHD may either have an emotional reaction of withdrawal 🛑, not wanting to face such instances, or have emotional outbursts, like uncontrolled, intense anger. These RSD symptoms can negatively affect a person with ADHD, causing them to think poorly of themselves, doubt their capabilities, and experience social anxiety.

RSD is used to describe how painful rejection can be to certain people with ADHD

Everything about Rejection Sensitivity Dysphoria, especially its connection with ADHD, is still vague. Medically, it isn't even considered an official symptom of the latter condition. However, many experts agree that RSD is a real phenomenon that needs to be addressed, especially for people with ADHD. 

The Effect of RSD on an ADHD Brain

Since we cannot process the overwhelming emotions we are subjected to, there's a bigger chance that RSD can affect how we interact with people around us 🥺. Our difficulty in regulating emotions can radiate into how we see and treat others. It can also show up in how we behave, especially when feeling down or anxious.

RSD can make you feel like you are a bad person, or a failure

Sometimes, having Rejection Sensitive Dysphoria has these core symptoms that can make things more complicated:

  • Low self-esteem
  • Social anxiety and social awkwardness
  • Anger outbursts or being emotional when criticized
  • Excessive sensitivity to real or perceived rejection
  • Fear of failure and uncertainties
  • Self-hate

These symptoms of RSD can sometimes be confused with the typical ADHD symptoms we often experience. It can be difficult to manage symptoms of ADHD & Rejection Sensitive Dysphoria (RSD) because they may happen simultaneously, overlap, or worsen each other.

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Extreme Emotional Sensitivity of an ADHD Brain

When we are faced with difficult situations, and we cannot avoid them altogether, we might feel that there's a high possibility that we will be subjected to scrutiny or perceived criticism 😵. Sometimes, our worst enemy is our ADHD brain 🧠 plus its complication with rejection sensitivity. It's not that we don't want to accept their feedback or that we're not trying to listen, but our brains are wired that way and we haven't developed our coping techniques yet.

RSD can make you feel deeply attacked by any criticism

Did someone you barely know already tag you as a lazy person or did anyone tell you that you're too unorganized with your valuables? People sometimes utter comments or criticisms based on what they observe at the moment. They don't know that our struggles are not our fault and we are doing our best to cope with our neurodivergent disorder. It’s just that our emotional response to these things might make us feel bad about ourselves.

Rejection Sensitive Dysphoria may make us build a higher wall against our environment because our nervous system might think we are constantly being attacked when criticisms and feedback come our way. We tend to feel defensive and react more emotionally because we are trying to protect ourselves from further hurt.

RSD, Social Anxiety, and Other Mental Health Conditions

The moment we fail to find our stress-relief strategies from other people's negative judgment towards us (regardless if it’s perceived or actual), we are more prone to withdraw from our own society to avoid peer rejection and social anxiety. Due to our emotional dysregulation and rejection sensitivity, we might often self-isolate and feel more comfortable when we're alone.

RSD can even lead you to withdraw from social life by fear of being judged or rejected

But, of course, that's not always the case with adult ADHD and RSD. There are also times that we can have intense emotional responses 😭 that lead to impulsive behaviors or reactions, such as saying hurtful words or becoming violent. We might do these things without first considering the possible consequences.

And when we filter out too many of these social interactions, we might end up feeling more depressed and anxious, making our mental health condition more affected than ever.

Managing Rejection Sensitive Dysphoria and ADHD

Remember that it isn't our fault that these things - ADHD and RSD - happen and that we can do something about it.

Experiencing Rejection Sensitive Dysphoria might be due to the emotional symptoms and distress resulting from our ADHD experiences. To manage and treat ADHD and RSD from worsening, here are some things that we can do:

  • Get the proper emotional support - it is best to find the right community that understands your struggles, especially in dealing with symptoms of RSD. Find the appropriate support that teaches coping techniques based on their personal experiences. 💏
  • Talk to wellness professionals - one of the best ways to tackle RSD is to let go of our suppressed emotions. Talking to a therapist, counselor, or any other wellness professional can help us process these feelings more healthily. Talk therapy can help us understand our reactions more and give us more insight into our condition. 👩‍⚕️
  • Practicing self-care - there may be times when the only thing we have is ourselves. In these cases, it is best to focus on our well-being and do things that make us feel good. Find a hobby or an activity that can help us relax and de-stress. It can be anything from reading, playing sports, listening to music 🎹, or even spending time with our pets.
  • Get a formal diagnosis - we cannot address what is wrong with us if we don't know exactly what's making our lives more difficult. Getting a professional diagnosis for Attention Deficit Hyperactivity Disorder from your mental health professional can help you manage the ADHD symptoms that you feel. Sometimes, RSD can also be mistaken with other mental disorders, such as Borderline Personality Disorder or Bipolar Disorder, which can further complicate treatment if not diagnosed correctly.
  • Avoid negative self-talk - the self-esteem of an adult with ADHD can sometimes plummet when we start to think that everything is our fault. To prevent this, it is best to avoid negative self-talk and focus on our positive traits. Making a list of our good qualities can help us remember that we are not just our ADHD or RSD diagnosis. 😘
  • Journaling and understanding yourself better - it is essential to remember the struggles we often face so that we may learn from them. However, we cannot entirely rely on our memory because ADHD affects how we remember things. It is best to take note of all the details and information regarding our challenges. Writing these down can help us keep track of our mental health condition and progress. 📝
Things that can help you deal with RSD

It is best to set realistic expectations, especially regarding our relationships with other people. We should remember that not everyone will like us, and that's okay. It is essential to focus on the quality, not the number, of our relationships 💪. We cannot please everybody. And the more we try to get them to like us, the higher the chance that we will end up feeling rejected.

We should try to improve our mental health conditions by managing our symptoms, triggers, and emotional reactions. We should also remember that we are not alone in this battle. Some people understand what we are going through, and there are ways to manage RSD. We need to be patient, proactive, and always keep fighting. 

Always try to protect your mental health. ❤️ 

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ADHD and RSD: FAQs (Frequently Asked Questions).

What is Rejection Sensitivity Dysphoria?

Rejection sensitivity dysphoria or RSD is the term used to describe the extreme or inappropriate reaction to rejection or criticism, be it actual or perceived. People who experience RSD may withdraw to themselves or have emotional outbursts. Also, they may have a hard time bouncing back from being too upset.

Is RSD a symptom of ADHD? Does one cause the other?

RSD is not yet clinically accepted. The Diagnostic and Statistical Manual of mental health disorders does not list it as a mental health condition nor a symptom of ADHD. However, reports say it is most commonly experienced by people with ADHD.‍

How do you manage RSD?

Since RSD is not yet a recognized mental health condition or symptom, there’s no official treatment for it as well. However, you can manage it through acceptance of your neurodivergent condition and understanding that some things are out of your control. Talking to a wellness or ADHD coach will also be a great help as they can help you manage your ADHD symptoms that might be contributing to your RSD.‍

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