ADHD and Rejection Sensitive Dysphoria
What is now known as Rejection Sensitive Dysphoria is my area of expertise because I can confidently state that I have it. I am 80 years old. I wasn’t aware that I had ADHD. ADHD explains why my mind wandered in school and when I was reading. I failed in all of my efforts to concentrate. As a result, my grades suffered, and I was thought of as either not very smart by some teachers and other teachers who thought I was lazy because they recognized my intelligence.
I never understood that my social anxiety and avoidance had much to do with RSD. I am confident that RSD accounted for my bouts of depression. I felt so insecure that I could never understand how my wife could select me as a marriage partner and have me as a father of two children. We were married for nearly fifty years until her tragic death from Pancreatic Cancer. I realized ADHD as a mental health practitioner, but only recently learned of RSD. Learning about both conditions has been enormously helpful. That is why I state that:
“Sometimes, What you don’t Know can Hurt You.”
With that in mind, let’s learn about RSD.
Rejection-sensitive dysphoria, or RSD, is when a person feels intense emotional pain related to rejection. The word dysphoria is a strong feeling of pain or discomfort.
People with RSD experience more intense feelings of rejection than we usually consider rejection. The negative feelings that come with RSD are powerful and hard to manage. People with RSD are likely to interpret vague interactions as rejection. They find it difficult to control their feelings and thoughts of rejection.
The factor that makes this even more difficult for these individuals is that they do not know they have Rejection Sensitive Dysphoria. These people consider themselves unattractive, undesirable, unintelligent, and not worth it for anyone to have them around. If anything happens that they interpret as rejection becomes a further confirmation of their worthlessness.
An important symptom of RSD is emotional dysregulation is the inability to regulate emotions. The feelings are of being overwhelmed, uncomfortable, or even emotionally in pain.
Symptoms of rejection-sensitive dysphoria
As mentioned, the key symptom of RSD is intense emotional pain. That pain usually has to be triggered by rejection or disapproval. However, people with RSD often have difficulty describing what it feels like because it’s so intense and unlike most other forms of pain (emotional or otherwise).
People with RSD often show the following traits and behaviors:
- It’s easy for them to feel embarrassed or self-conscious.
- They show signs of low self-esteem and trouble believing in themselves.
- They have trouble containing emotions when feeling rejected, which is often noticeable in children and teenagers with this condition. Some may react with sudden anger or rage, while others may cry.
- Some people with RSD may turn their feelings inward. These individuals become severely depressed, and sometimes, it’s mistaken for sudden emotional shifts that can happen with bipolar disorder or borderline personality disorder.
- They’re often “people pleasers” and become intensely focused on avoiding the disapproval of others.
- They start projects and tasks or set goals if they think of success.
- They compensate for fear of failure or rejection by going all-out or striving for perfectionism. However, the downside is that they often experience intense anxiety and may not easily prioritize self-care or downtime.
RSD happens in people with ADHD. It may be linked to other personality and mood disorders. Still, more research is necessary regarding who experiences this issue and how common it is.
If you think you have RSD, it’s essential to see a healthcare provider to get a diagnosis of a related condition like ADHD and then to follow up with a mental health provider.
Your provider can recommend treatment options and guide you on what you can do to help yourself as you learn to manage RSD.
One thought on “ADHD and Rejection Sensitive Dysphoria”
I’ve only vaguely heard of this from a pre-lockdown friend (we’ve lost touch now) – he had recently been diagnosed with ADHD (age about 55) and was then told about RSD. Before that, I hadn’t heard of it. Reading your article makes me wonder about myself. I have a severe fear of rejection (and abandonment). I can’t remember a time when I didn’t have it. About 25 years ago, I was first diagnosed with Bipolar, and then, about ten years later, they decided it was BPD (EUPD). I went through all different mental health programmes, such as STEPPS, and was put on medication. Nothing really helped, and I kept thinking that my symptoms didn’t seem like BPD, but that’s what the psychiatrist told me then. I no longer have any classic BPD symptoms, but I am still on medication. I wonder whether I’m more likely to have RSD, although I’ve long been discharged from the mental health system and am reluctant to return as I wasn’t treated very kindly last time. I think I will do some more research on this topic and perhaps speak to my doctor about the possibilities at some point. Thanks for sharing this helpful information, Allan.