Week 9 - Rejection Sensitive Dysphoria

WEDNESDAY GROUP RECORDING: https://us02web.zoom.us/rec/share/xctVNezS3WBIepWTxl7WS7YlD6joeaa82iZI_vUOmU7w2cjcftGFuVSuA0f7qplk?startTime=1596657950000



Rejection Sensitive Dysphoria

  • RSD is on a spectrum
  • It is not exclusive to ADHD
  • Everyone with ADHD does not experience RSD
  • However, it is very common within ADHD population

“Rejection sensitive dysphoria (RSD) is extreme emotional sensitivity and pain triggered by the perception that a person has been rejected or criticized by important people in their life. It may also be triggered by a sense of falling short—failing to meet their own high standards or others’ expectations.” - William Dodson, Attitude Mag

Some Characteristics (source: Psychology Today)

  • High sensitivity about the possibility of rejection
  • Overly high standards for yourself
  • Feeling easily triggered toward guilt or shame
  • Isolating yourself in a preemptive strike not to be rejected
  • Aggressive or rageful behavior toward those who have been perceived to have slighted you
  • Frequently feeling an uncomfortable physical reaction due to "not fitting in" or being misunderstood
  • Self-esteem that is entirely dependent on what others think, and rises and falls accordingly
  • Frequent and intense ruminating after an interaction about how you did or said something wrong

The emotional response can be

(1) internalized or;

(2) externalized.

(1) Internalized:

  •  Feels like an emotional rollercoaster
  • “It can imitate a full, major mood disorder complete with suicidal ideation. The sudden change from feeling perfectly fine to feeling intensely sad that results from RSD is often misdiagnosed as rapid cycling mood disorder.”

(2) Externalized:

  • Rage and outbursts at the people responsible for causing the pain.
  • 50% of people who are assigned court mandated anger-management treatment have previously unrecognized ADHD

Coping with RSD usually takes two forms:

  1. People pleasing / hyper vigilance / over achieving 
  2. No longer trying


  • Many options, depending on severity - seek professional support if this feels debilitating for you. 
  • Increase awareness.
  • Answer the following questions:
  • Does RSD impact you?
  • If so, what characteristics most impact you?
  • Do you internalize or externalize your emotional response, or both?
  • How do you cope? Type 1 or 2 or a combo? (see coping w/ RSD above)
  • Notice throughout the week (and beyond) where this may show up in your life and observe your emotional reactions with compassion.