Rejection Sensitive Dysphoria and ADHD

For anyone, experiencing rejection or failure can bring up a lot of negative and challenging emotions. For some people with ADHD, they may feel the pain of letting themselves or others down or receiving criticism in a deeper way than usual. These reactions may trigger more severe emotional sensitivity than for neurotypical people.

What is rejection sensitive dysphoria?

Also known as RSD, rejection sensitive dysphoria describes the experiences of people who feel severe emotional responses in relation to rejection or failure. The term dysphoria means ‘unbearable’, which alludes to the nature of RSD.

RSD is not an official clinical condition or symptom that can be diagnosed. Despite this, the phenomenon has been experienced often by people with ADHD, and as such is commonly understood to be a particular trait that some people with ADHD may identify with.

The term was coined by Dr William W. Dodson, who attributes its lack of official recognition to the fact that emotions aren’t always apparent, are often hidden, and are difficult to measure. It should be noted that as such, there is not a large volume of research or literature about what RSD is, how it presents, and how it affects people with ADHD.

What triggers rejection sensitive dysphoria?

RSD may be experienced when an individual perceives that they have been rejected, teased, criticized, disappointed someone, or let themselves down by failing to achieve a goal or reach a certain standard.

TikTok user @mindovermatterwithemma shared a short video explaining more about what exactly RSD feels like for them and what triggers it.

What does rejection sensitive dysphoria look like?

According to Dr Dodson, the intensity of the emotional pain can sometimes be described as “awful, terrible, catastrophic”, or otherwise unexplainable in its all-encompassing severity. Someone with RSD may appear to be experiencing symptoms similar to those of a depressive episode after being triggered by rejection or failure. This might look like a persistently low or depressed mood, or markedly diminished interest or pleasure.

Dr Dodson also describes a response that manifests as intense rage towards the situation or person the individual holds responsible as the source of their rejection or failure, including themselves.

People with RSD may become serial people-pleasers in order to counteract any possibility of rejection or criticism, and as a result may falter to work towards and achieve their own goals and aspirations. The risk of failing may be so difficult to bear that they struggle with trying new things. They may appear to be constantly striving to do better.

Can RSD be treated?

Because of the lack of research, there isn’t a known treatment for RSD in isolation. It may be managed by proxy, when the core condition of ADHD is treated with either pharmacological treatments or cognitive and behavioral therapies.

Are you experiencing RSD?

If you think you may be experiencing RSD or other symptoms of ADHD, it can be useful to track your symptoms in order to determine what triggers them, and if anything alleviates them.

Keeping a record of your symptoms and any treatments you may be taking might save you from trying to remember all that information under pressure during an appointment, and help give your clinician an accurate picture of your experiences, so that you can make more informed decisions about your care together.

Human Health is a free health tracking app that makes it easy to track the impact of your symptoms, and keeps a record of your treatments, as well as providing you with reminders about when they’re due. The app can provide you with key insights about how your symptoms are changing over time.

Click here to download Human Health.

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Emotional Regulation. Dr William W. Dodson, MD. Attention magazine.

Olivia Holland
Medical Writer