Rejection Sensitive Dysphoria (RSD)


    What is Rejection Sensitive Dysphoria (RSD)?

    Rejection Sensitive Dysphoria (RSD) is an excruciating fear of rejection; extreme emotional pain is linked to feelings of rejection and shame and is commonly associated with children and adults with ADHD.

    At times, this is emotional pain is indescribable, other than to use the term 'unbearable', which is literally what the term 'Dysphoria' means, being Greek for 'unbearable'. It's literally emotional dysregulation.

    RSD is the most unrecognised, ignored, overlooked or dismissed and can be the most debilitating part of ADHD, and therefore, doesn't get the exposure and recognition it deserves.

    How Rejection Sensitive Dysphoria (RSD) Impacts Emotions

    • Those with ADHD have more than usual and intense and heightened emotions and around frustration, impatience and excitability often reacting in explosive ways not correlating to the issue/event.

    • These emotional traits of our ADHD can be linked back to the main pillars; impulsivity (not thinking through solutions and often making things worse), hyperactivity (doing what needs to be done without thinking to make things better) and inattention (misreading or missing crucial information as a result of being distracted by something or thinking about something else at the time because something they said made you think of something else).

    • How we respond and react when our RSD is triggered, manifests it from being not only a neurological/pathological condition to a mood condition or challenge with our overreacting and intense feelings over something you really care about. It's the hyperarousal part of ADHD where we struggle to distinguish between dangerous threats and minor problems.

    • Females (especially) with ADHD tend to be people-pleasers, over workers and perfectionists doing all we can to ensure there's no room for criticism. It's about applying for jobs below our capabilities because we are scared we won't be able to do what's being advertised (even if it's the same specifications and description of our previous role), we downplay our abilities in an attempt to lower other people's expectations of us, so we can meet them.

    • RSD is also being easily embarrassed, setting standards and expectations so high that no one (especially you) can't meet them, low self-esteem and anxiety (generalised and social). Social anxiety is the anticipatory fear that you're going to do or say something that will be embarrassing or be scrutinised afterwards. In some cases, the RSD person that they know people around them, want them to be, or worse, live a solo existence out of the fear they'll be rejected so they self-sabotage relationships and friendships to avoid their imagined rejection.

    Neurobiology of Rejection Sensitive Dysphoria (RSD)

    • The neurotransmitters in ADHD brains are scurrying to find dopamine to calm down the cognitive and behavioural parts of our ADHD and the emotions are left to fend for themselves. This may also manifest into social anxiety, with RSD coming into play with its negative and intrusive thoughts around how we're being perceived by those in our lives from family, friends, peers and colleagues (which is often incorrect), leading to social isolation or self-sabotaging conduct ensuring the walls you've got up, stay up.

    Why Rejection Sensitive Dysphoria (RSD) is NOT a listed ADHD Trait

    The frustration, impatience and excitability of RSD also impact the Reward Deficiency Syndrome where efforts and focus are on things that provide a person with immediate satisfaction i.e. impulsivity. If the reward seems too far away, interest levels feign and attention is shifted elsewhere. Because 'adults don't have ADHD, outgrowing it with their childhood', calls to question the number of misdiagnosed, or missed-diagnosed, felons, family abusers and substance abusers.

    RSD is not mentioned listed in The Diagnostic and Statistical Manual of Mental Disorders (DSM–5), as part of ADHD or a stand-alone condition, as the DSM is statistical information for researchers and not for patients and are based upon behaviours that can be seen by an observer. RSD is not a behaviour, it's an emotion. And emotions can't be measured.

    Resources about Rejection Sensitive Dysphoria (RSD)

    Articles to read

    How ADHD Ignites Rejection Sensitive Dysphoria

    ADDITUDE Inside the ADHD mind

    New Insights Into Rejection Sensitive Dysphoria

    ADDITUDE Inside the ADHD mind