Dealing with Rejection Sensitive Dysphoria (RSD) and ADHD
Psychiatrist William Dodson developed a term specifically applicable to people with attention-deficit/hyperactivity disorder (ADHD): rejection sensitive dysphoria (RSD). Rejection sensitive dysphoria applies to people with ADHD because ADHDers tend to be particularly sensitive. While the existence of RSD is up for debate, the emotionality of ADHDers is not. Many with the disorder agree that they are extremely sensitive to rejection, criticism, and failure.
What Is Rejection Sensitive Dysphoria?
Dodson defines rejection sensitive dysphoria as the pain felt by those with ADHD when faced with criticism or failure. More accurately, it is their perception of being rejected. People with RSD might be easily embarrassed and anxious, though their impetuosity and practice hiding their sensitivity might make it difficult to detect. They overreact to slights in all sorts of ways, sometimes having a meltdown, becoming enraged, depressed, or even suicidal.
There are also numerous rejection sensitive dysphoria symptoms that occur over the long-term. Some include:
- Some overachieve and people please to avoid criticism, ignoring their own desires and goals.
- Many create self-imposed limitations, avoiding new or challenging situations and relationships.
- A few become cruel and distant to others in order to avoid attachment and risk rejection.
These episodes of depression and anger might be brief and, unlike bipolar disorder, tend to be based on events rather than cycles (How to Deal with ADHD and Anger in Adults). Still, other disorders, such as borderline personality disorder and posttraumatic stress disorder, manifest similar sensitivity and reactivity.
Because of this, many questions about RSD remain unanswered. Does rejection sensitive dysphoria without ADHD occur?
Is it hereditary or developed? Since such a high percentage of people with ADHD report symptoms of RSD, it is likely that the phenomenon is both genetic and learned.
Noelle's Experience with Rejection Sensitive Dysphoria
A family member with ADHD and I both have similar experiences with romantic relationships: we avoid them. At least, we have a history of (attempting) to remain romantically unattached. I used to wonder how others handled so many close relationships, since being rejected was almost unbearably devastating for me. However, like many with ADHD, patiently waiting for a relationship was also never my forte, so I often felt caught between restlessness and the fear of rejection (ADD and Relationships: How Adult ADHD Affects Relationships).
One of the most difficult things about being sensitive is the guilt. I thought I should be able to control my emotions. Some have expressed concern about my emotionality, citing it as an inability to make it through life. Unfortunately, comments like this simply made me more disheartened and worried. Many who are sensitive have been told that they are weak, silly, and immature.
How to Deal with Rejection Sensitive Dysphoria
Though it seems hopeless, there a number of ways to deal with RSD:
- Deal with your emotions before a meltdown. It is helpful to try to let go of the guilt, to accept your emotions, and move away from perfectionism.
- Get the right diagnosis. Because my intense bouts of depression did not usually last as long as major depressive disorder, I previously believed I could not be treated for depression. Dodson states that appropriate medications can help.
- Go to therapy with a specialized counselor. Adult ADHD therapy can help you develop strategies to cope with strong emotions. (Although Dodson dismisses therapy.)
- Take steps to reduce overall stress. This is important even when you are doing well. I find that my RSD is more manageable when I regularly make an effort to take care of myself, physically and mentally.
These are only a few methods of dealing with RSD. Have you struggled with sensitivity? What helps and what doesn't help? Do you think RSD is a helpful term, or is it too specific to those with ADHD? Let me know in the comments.
Dodson, W., M.D. (2017, November 27). Where ADHD and Bipolar Disorder Overlap. Retrieved November 28, 2017, from AdditudeMag.com
Dodson , W., M.D., & Tuckman, A., PSY.D., MBA. (2017, August 18). Free Resource: Rein In Intense ADHD Emotions. Retrieved November 28, 2017, from AdditudeMag.com
Frank, M. A., Ph.D. (n.d.). Rejection Sensitivity, Irrational Jealousy, and Impact on Relationships. Retrieved November 28, 2017, from ExcelAtLife.com
Rejection Sensitive Dysphoria. (2017, February 13). Retrieved November 28, 2017, from DodsonADHDCenter.com
Thome, J., Haeussler, K., Liebke, L., Bohus, M., Bungert, M., & Lis, S. (2015, March 20). Rejection sensitivity and symptom severity in patients with borderline personality disorder: effects of childhood maltreatment and self-esteem. Retrieved November 28, 2017, from bpded.biomedcentral.com
Matteson, N. (2017, November 28). Dealing with Rejection Sensitive Dysphoria (RSD) and ADHD, HealthyPlace. Retrieved on 2019, July 20 from https://www.healthyplace.com/blogs/livingwithadultadhd/2017/11/adhd-and-rejection-sensitive-dysphoria