Rejection Sensitive Dysphoria (RSD): The Painful ADHD Symptom Nobody Talks About
What is Rejection Sensitive Dysphoria (RSD)? Learn more about how this intense emotional response shows up in people with ADHD and how you can actually manage it.
What Is Rejection Sensitive Dysphoria (RSD)?
RSD stands for Rejection Sensitive Dysphoria. It means your brain quickly reacts intensely to:
Criticism (even seemingly ‘small’ criticisms)
Rejection (real or imagined)
Failure or “letting people down”
Disapproval
Quick things to know:
Rejection Sensitive Dysphoria (RSD) is not officially in the DSM (but is a very common experience for many people with ADHD)
“Dysphoria” means deep, emotional distress.
You might not even know it’s happening — you just feel awful when it comes online.
How RSD Feels in Real Life
Small comments or actions like an ignored text, constructive feedback or a feeling like you’ve disappointed someone can feel completely devastating.
Sound familiar?
Feeling like crying or yelling and lashing out after someone says something critical — even if they didn’t mean it that way.
Catastrophising and spiralling for hours after a friend doesn’t text back
Avoid setting boundaries, people-pleasing, over-apologising or working yourself to burnout to avoid disapproval.
Emotionally shutting down, going numb, or avoid social situations altogether.
Overthinking small interactions or comments for hours.
Why RSD is So Common in ADHD Brains
Emotional regulation:
ADHD brains process emotions differently to neurotypical brains.
Emotional regulation is your brains ability to manage and respond to an emotional experience or state.
For people with ADHD, regulating emotions is more diffiuclt due to neurological differences in the brain.
This means emotions are more intense, harder to manage and longer lasting.
Emotional might be quicker and bigger than wanted or expected.
It can take longer to recover from heightened emotions caused by rejection, failures or criticism.
This is due to structural differences in the brain and is not due to a lack of effort.
Life experiences:
Rejection sensitive dysphoria or RSD is not just about how your brain manages emotions, its also shaped by lived experience with ADHD.
1. Repeated criticisms and messages from childhood:
Past frequent experiences from childhood of being told they are either “too much” or “not enough” or they dont “measure up" or “fit in”.
Repeated external criticisms of “just try harder”, “why cant you just focus” or “you’re so disorganised” accumulate and become internalised.
This may show up as self doubt, self criticism or that feeling like youre always doing something wrong
As a result, people may feel extra sensitive or ‘reactive’ to feedback or hypervigiliant to perceived rejection.
2. Past experiences of social rejection:
Past experiences of interrupting someone without meaning to, zoning out or either being “too much” or “too quiet” in a social situation can lead to feeling misunderstood, awkward or doubting if people like you.
As a result, small social cues can trigger huge emotional responses
3. Masking and people pleasing:
To deter rejection, people with ADHD may "‘mask ‘ or overachieve to try and fit in with peers or meet neurotypical standards
This can lead to overworking, perfectionism or suppressing your own needs or emotions
As a result, people learn they must control themselves or perform to be accepted, which builds a constant low level fear of rejection
As a result, RSD reactions feel stronger and more frequent.
What does this mean for ADHD?
Rejection and failure hits harder for people with ADHD.
Small perceived criticisms of comments can result in huge emotional waves.
Feelings of rejection or failure linger for longer and are harder to move on from.
People with ADHD tend to mask to fit with peers to avoid rejection and overachieve just to feel “enough”
People with ADHD are more likely to act impulsively or ‘lash out’ when faced with rejection.
How RSD Can Affect Your Mental Health and Relationships
If you’ve got rejection sensitive dysphoria, you might:
Feel like your “too much” or “not good enough”
Emotional responses may feel disproportional to people on the outside
Feel shame or guilt due to your emotional responses/.
Fear abandonment or feeling loved or worthy.
Withhold needs or try to suppress emotions.
Find communicating difficulties with loved ones to difficult.
Avoid close relationships out of fear of disappointing people.
Avoid situations that could pose a risk of rejection.
Either push people away when you perceive rejection or ‘cling’ to prevent rejection.
Struggle to control yourself when emotions are high and ‘lash out’ at people
Feel burnt out from trying to be perfect or overachive.
Feel misunderstood by people around you.
How RSD impacts the people around us:
Rejection sensitive dysphoria or RSD does not just impact the person experiencing it, it can also impact loved ones. They may feel:
Confused about how to give feedback or communicate without causing upset.
Surprised or confused by emotional responses that subjectively appear disproportionate.
Drained by frequent reassurance requests.
Like theyre walking on eggshells.
Real-Life Coping Strategies for RSD
So how do you cope with Rejection Sensitive Dysphoria?
Let’s keep this ADHD-friendly and low-pressure. You don’t need to do all of these — just take what works for you and leave the rest.
1. Start with the body.
Often RSD is felt within the body before it is understood. Ask yourself:
Where do I feel this most in my body right now? How am I feeling in my body? How is the RSD showing up for me right now?
I.e, is my heart racing or is my chest tight? Am i feeling tense, hot or nauseas? what emotion is coming online for me?
Describing the experience of RSD can help to build a picture of what RSD looks like and understand patterns so that its easier to recognise when it shows up.
2.Name The Pattern When It’s Happening
Naming the RSD when it comes online - “Is this the RSD talking?”
Naming it outloud or in your mind can help to create distance between yourself and the emotional reaction and move towards self-compassion over self-blame.
3. Challenge the Thought Spiral
Often RSD can accompany many negative catastrophic thoughts.
Asking yourself - what am I thinking or telling myself right now? ie “They hate me”, “Theyre mad at me” or “I’m going to get fired”
Consider all other perspectives or ways of looking at the problem.
Ie, someone not responding to a text - automatic response may be ‘they’re mad at me”. However, other rationales for them not responding could be, they are doing something else, phone out of battery, busy, already on the phone to someone else, their notifications off, no access to their phone etc.
5. Talk to loved ones about it.
Spend time with safe people who “get it”
Share resources or articles with partners, family or close friends.
Talk to trusted loved ones know about specific things that may trigger the RSD and think together about what would be helpful for both parties to do next time.
Practice saying it in the moment ie “I know this might not have been your intention but I’m feeling sensitive to rejection right now, can I take a moment and come back to this” or “i think my RSD could be showing up her, can we slow it down?”
Check in with loved ones again post conflict to repair and reconnect.
6. Try ADHD Therapy
ADHD therapy can help to:
Understand your ADHD brain more.
Recognise RSD when its happening
Build emotional regulation tools.
Re frame unhelpful thoughts, beliefs or internalised shame
Teach how to set boundaries (and not feel guilty when applying them)
Move towards self-compassion instead of self-criticism.
Provide a safe, non judgemental space to talk openly about the RSD.
Not sure what kind of support is right for you? book a free consultation here to figure it out - XXX
7. Consider Medication.
Some people with ADHD find taking medication can help manage their rejection sensitivity. This is because ADHD medication can help regulate emotional responses and potentially reduce intensity.
Talk to a specialist psychiatrist about what specific medication could be helpful for you if youre partiuclarily struggling with rejection sensitivity dysphoria
When to Get Support
It’s time to reach out if:
You’re avoiding people or jobs because of fear of criticism
Your emotional reactions feel overwhelming or unmanageable
You feel like you're constantly failing — even when you're trying your best
You deserve support that helps your brain work with you — not against you.
Final Thoughts: You Are Not Too Much
Rejection sensitivity dysphoria is not just about being “too much” or “too sensitive”
If you've been told you're overreacting, “too emotional,” or “too sensitive” — we see you.
Rejection sensitive dysphoria is real. You’re not broken. You’re just wired differently.
Need Support for ADHD and RSD?
Whether you’re someone with ADHD who struggles with RSD, supporting someone who has it or just wanting to know more about it. CBT for ADHD can help.
👉 Book a free consultation here
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