ADHD & Rejection Sensitive Dysphoria

ADHD & Rejection Sensitive Dysphoria

RSD (rejection sensitive dysphoria) is a pretty common ADHD symptom, and I talk about it almost daily with clients. And yet, I still manage to discover new ways for it to show up in my own life: like disappointment.


What is RSD? 


ADDitude describes it as “extreme emotional sensitivity and pain triggered by the perception (not always the reality) of criticism and/or rejection.”


Notice the parenthetical? People with ADHD are often super self aware. We KNOW the feeling isn't in line with reality. It doesn’t help. So if you know/suspect someone is experiencing RSD don’t try to reason them out of it. It’ll probably just make them feel worse.


What does RSD feel like?


Another snippet from ADDitude: “At its worst, RSD can imitate a full, major mood disorder complete with suicidal ideation.” 


Yes, it’s that intense.


Personal Example: 

I’m planning to hang out with a new crush. They cancel on me. They have a great excuse-I get it & 100% agree they should go deal with their thing instead. We can always reschedule.


But I still FEEL it. And it feels like I got hit with a truck. And that truck was full of everyone and everything I love. And it exploded, killing everyone except me.


The resulting grief is intensely overwhelming. Sometimes I am literally incapacitated, unable to work, eat, or do anything except lay in bed and fight suicidal thoughts. All because someone cancelled plans that are easily rescheduled.


And yet, with all my experience and training, I didn’t realize it was RSD until yesterday, because I’ve always conceptualized it as disappointment, not rejection.


What Triggers RSD?


When you think about rejection, what’s the first thing that comes to mind? 


Asking someone out and they say no? Being turned down for a job? What about when someone gives you criticism (even if it’s constructive)? Or simply fails to notice something you were proud of? Someone forgetting your name or pronouns? Dismissing, downplaying, or outright gaslighting your feelings? Cancelling plans-or even just changing them? Or assumes you know you’re invited, so doesn’t ask? Not understanding an inside joke your friends or coworkers make? Even body language — a shared glance, a look, a sigh, a shrug… heck, it might even be something you IMAGINED happening.


Any and all of these — and so many more situations — can be CRIPPLING. Debilitating. No matter how big or small the thing is. No matter that you KNOW it doesn’t make sense. You know they care, they didn’t mean it, they were actually frustrated at something completely unrelated.


You know they were actually just in pain and made a weird face, or they were distracted… Doesn’t matter. We literally cannot control the fact that it happens any more than we can control the inevitable heat death of the universe. We feel it. We literally cannot control the fact that it happens any more than we can control the inevitable heat death of the universe.


Now What?


I share this story, this experience, because it is SO EASY to miss. I had it in my head that I was ‘overreacting’ to disappointment, I completely missed the fact that disappointment comes after rejection. And that simple misunderstanding has plagued me with guilt and shame for YEARS.


I wish I could say there was some kind of trigger for this realization. Some skilled question or brilliant article I could share. But it was just…random.


So, instead, I’ll leave you with these three things. 


One - Be Kind. 


To yourself (stop beating yourself up for your feelings, mistakes) as much as to others (ADHD is invisible. You don’t know who will experience this, what will cause it, or how intense it will be). 


Shame is not an effective motivator for change. What is? Compassion. Empathy. Patience.


Two -  Be Informed. 


You can’t show compassion, empathy, or patience if you don’t first understand. When someone shares an experience, a feeling, a thought, a diagnosis, and you feel tempted to say something like, “well yeah, but (it will get better / it’s not that bad / you’re making a big deal / stop being so sensitive / you don’t actually feel that way / you know it’s not true / look at the bright side, etc),” just stop. Pull out your phone and Google it.


Or better yet — just believe them. Accept that they are the best judge of their experience, and just because you don’t understand — or experience it differently — doesn’t mean what they feel is wrong, invalid, or false.


Three - Be Patient. 


It’s a part of being kind, but it’s more, too. Your friend / coworker / employee / loved one may need some extra reassurance. They may need support pulling out their coping skills, calling a crisis line, or caring for themselves.


They may not even be aware that that’s what they’re experiencing (even if they are a super awesome coach who helps people with ADHD every day). So, be patient with them. If it’s you, be patient with yourself and revisit tip #1.



I live with ADHD every day. I’m very aware of (most) things I’m doing wrong, and I also don’t want to be doing them. But a good coach, supportive friends, and the freedom to use coping skills and accommodations as needed, make life pretty okay.

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