Rejection Sensitivity Dysphoria RSD with ADHD

RSD is an extreme emotional response resulting from the perception that you have disappointed people in your life and they will withdraw their love and approval.  It causes fear of being rejected, teased, and criticized.  It occurs with ADHD, partially due to an overactive nervous system.

1. They become people pleasers. They scan every person they meet to figure out what that person admires and praises. Then they present that false self to others. Often this becomes such a dominating goal that they forget what they actually wanted from their own lives. They are too busy making sure other people aren’t displeased with them.

2. They stop trying.  If there is the slightest possibility that a person might try something new and fail or fall short in front of anyone else, it becomes too painful or too risky to make the effort. These bright, capable people avoid any activities that are anxiety-provoking and end up giving up things like dating, applying for jobs, or speaking up in public (both socially and professionally).


Easily embarrassed

Rumination and perseveration

Relationship issues - feeling constantly attacked and defensive

RSD episodes happen suddenly and without warning

Episodes are extreme, intense, and feel like physical pain- feels like being punched in the chest or gut

Low self-esteem, self doubt, sense of failure

Anxious in social settings

Anticipate rejection so become vigilant about avoiding it

Fear of rejection can result in staying in unhealthy relationships

Hide things think will be shameful, ashamed of vulnerability

Get angry when feel someone has hurt or rejected them

Set high standards for self that can’t meet - self-sabotage

Sometimes the criticism is real and sometimes it is their perception -  ADHD researchers estimate that by age 12, children with ADHD get 20,000 more negative messages about themselves than other kids their age.

Feel like a failure because have not lived up to other people’s expectations

Feel there is something wrong with them and gain comfort in knowing this happens to other people

Strategies that may help

Get interested in something new or captivating can help end an episode

Look at the big picture - if it will not matter in 5 years, don’t give it 5 minutes

Employ a Growth Mindset

Be reflective- what did I learn from this?

Take perspective - is this really rejection or am I just perceiving it to be?  Listen to the words that are being said.  

Verbally Process - Talk through your feelings with someone or write in a journal

Reduce overall stress level - eat well, get sleep, exercise, yoga

Accept emotions and that you are not perfect

Practice self-compassion - 5 steps 

  1. Practice forgiveness
  2. Employ a growth mindset
  3. Express gratitude
  4. Find the right level of generosity
  5. Being mindful

Treatment:  Self-compassion

Getting involved in something new and fascinating can help end an episode

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