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What You Need To Know About Rejection Sensitive Dysphoria

Rejection Sensitive Dysphoria is a raging storm of emotions

Rejection-sensitive dysphoria is like a thunderstorm. I see it coming, dark clouds in the distance telling me to run for cover. Just like I can’t stop pouring rain, I am powerless against the flood of emotions RSD brings on.

Like overflowing waters, those emotions can spill over, ruining the things it touches in its path. Once the storm is gone as quickly as it came, we are left to deal with the aftermath.

It is no secret that those of us with ADHD suffer from a certain emotional intensity. Feeling things more deeply is par for the course. However, rejection sensitive dysphoria is something a little different than that.

What is rejection sensitive dysphoria?

Rejection sensitive dysphoria is a sensitivity to rejection that causes people with ADHD to be hypersensitive to criticism, and rejection. The challenge is, that people who struggle with rejection sensitive dysphoria can perceive criticism, or dislike where there is none.

That is where the sensitivity comes in. We are hypervigilant, and a word, gesture, or deed can be taken out of context and misinterpreted. It’s frustrating!

Don’t think that means we are pulling offenses out of thin air. According to William Dodson, the average ADHD child receives 20,000 more “negative messages” in their lifetimes, on average. That means that many of us are seeing criticism or rejection because we are much more likely to receive it in the first place.

People spend much of their time offering up what they believe to be “helpful” criticisms of people with ADHD, but they’re often cruel. Once, when I was newly diagnosed, someone who I had a rather high opinion of listened to me describe the disorder and the symptoms, and replied with ” well don’t worry, even if nobody ever wants to put up with you, you’re a smart girl.”

I can recall often in childhood when my impulsiveness and enthusiasm were made fun of. I was often told to shut up, told that I talked too much, or that the things I cared about were not important. Many ADHD children are raised to believe that they are over the top, too intense, and too much. Not only is it cruel, but it can actually cause ADHD symptoms to worsen. We become accustomed to dimming our lights so we can live among those who are too cowardly to allow their own to shine.

Meanwhile, in order to begin working on a problem, we have to know how to identify it. The symptoms of rejection sensitive dysphoria will sound familiar to you, even if you didn’t know what to call them before.

What are the symptoms of rejection sensitive dysphoria?

Once I learned what the symptoms of rejection sensitive dysphoria were, I realized I have had it for quite some time. Do any of these symptoms sound familiar to you?

  • Fear of failure
  • Avoiding trying new activities for fear of being no good at them
  • People-pleasing to avoid criticism
  • Rage when experiencing criticism or rejection
  • Extreme emotions when you experience rejection or criticism
  • Shyness
  • Isolation from people to avoid rejection
  • Intense depression or thoughts of self-harm that disappear as quickly as they came
  • Fear of disappointing the people you love or letting them down

These symptoms, in conjunction with our regular ADHD symptoms, can prove to be a true torment. Nobody wants to live a life where they spend the majority of their time angry or use their precious energy to please everyone but themselves.

How do my symptoms manifest? For as long as I can remember, I have been extremely sensitive to criticism. In an effort to avoid criticism, I have missed out on opportunities. For instance, I don’t dance because I never wanted to draw attention to myself.

There have been many times when I missed events because I didn’t feel like I looked good enough or that I would do well enough. I stopped inviting people to my home because I feared that my home isn’t clean enough. Any of those critiques result in a pain that takes my breath away.

In an instant, it feels as though every single bad thing that has been said about me is true. I feel worthless. And in that worthlessness, I feel completely unworthy.

How do you prevent/predict a rejection sensitive dysphoria trigger?

Because we live in the real world, we cannot predict a trigger unless we know we are going to be in a situation where there will be critiques. Some of the trouble spots could be a family gathering, job reviews/interviews, during arguments with friends or loved ones. During those times, there could be a chance that something will be done or said that could trigger your rejection sensitive dysphoria. If you can go in expecting these situations, you can be better prepared for the onslaught of emotions.

When I am triggered, I feel a strong sense of despair crashing over me like a wave that is going to completely wipe me off my surfboard. I feel so overwhelmingly depressed that it feels like I will not survive the onslaught. It makes me want to make rash decisions like ending relationships, moving away, changing careers, whatever will get me as far away from the trigger as possible. For example, I might say something like this:

“I just broke up with my boyfriend. That’s it, I’m never going to date again. I might as well get used to the idea of living alone for the rest of my life.”

In those moments, it feels like the end of everything. That this issue I am distressed about will never be resolved.

When you are feeling this intensity of emotions, it becomes really important for you to learn your rejection sensitive dysphoria triggers. Ask yourself these questions to find out what some areas to watch may be.

  • What makes you feel unworthy?
  • What quality do you most dislike about yourself?
  • How do you feel when you’ve “let somebody down”?
  • Are you sensitive to a critique of your appearance?
  • Are there any skills you lack that make you feel ashamed?
  • Who’s approval do you want the most?
  • How do you feel when having to spend time with someone who disapproves of you?

Think about the answers to these questions to form some ideas about how you handle rejection and criticism in general. It will help you to form a picture of what causes your rejection sensitive dysphoria symptoms to flare up.

The physical effect of rejection sensitive dysphoria(for me)

Extreme emotional sensitivity not only has an effect on our mental health but on our physical health as well. I never expected it, but that emotional pain can translate into physical pain for me as well. When I am dealing with rejection sensitivity, my back and shoulders tighten up, causing me a great deal of pain.

My heart races, and it feels like my blood pressure is going through the roof. It is a very similar sensation to that of a panic attack. In fact, I manage it much like I would the pain from a panic attack. A bit of ibuprofen, some warm compresses, and those sore muscles loosen up.


As you know by now, rejection sensitive dysphoria is a set of symptoms that can ride along with attention deficit hyperactivity disorder (although other conditions can have RSD as well, I’m not covering those here). ADHD hypersensitivity is well known, we talk about how our senses are heightened when it comes to sight, touch, smell, and sound. We don’t often speak about ADHD sensitivity when it comes to emotions and how that can affect us. Solid ADHD treatment should include a discussion about ADHD rejection sensitive dysphoria.

Because of the lack of discussion, rejection sensitive dysphoria is frequently mistaken for bipolar disorder, or borderline personality disorder, or social anxiety. One of the ways you can tell rejection sensitive dysphoria apart from these conditions is that rejection sensitive dysphoria comes quickly and intensely, and it goes away as quickly as it comes. That can cause people not to take people who suffer from these symptoms seriously and brush it off as an overreaction.

How to treat rejection sensitive dysphoria

To deal with rejection sensitive dysphoria is to understand what a mess it can make of things for you. Emotional outbursts, even when they are not happening to us personally can be distressing to us all. Rejection sensitive dysphoria can have a negative effect on our relationships with our families and friends, and leave us to isolate ourselves even further.

Rejection sensitive dysphoria can show up in other areas of our lives too. Once, during a period of unemployment, I would cry for an hour after I received a rejection notice from a job. Jobs require reviews of our performance. Receiving a negative review can absolutely trigger our rejection sensitive dysphoria, and having reactions on the job are the very thing we want to avoid at all costs.

Rejection sensitive dysphoria on the job can make people feel as though we are unstable or too emotional. We owe it to ourselves to learn everything we can to manage our rejection sensitive dysphoria. Overcoming rejection sensitivity may seem impossible, but I promise you there are ways to control it.

How do you know you have rejection sensitive dysphoria?

It is important for you to know if you have rejection dysphoria. You are not alone, and there are so many ways that you can get help. Find yourself an ADHD support group and talk it out. Sit with your therapist and work your way through things. There is a rejection sensitive dysphoria test you can take that can be extraordinarily helpful to you.

25 coping techniques for rejection sensitive dysphoria

Sometimes I get discouraged and feel like there is no method that will help me to control my rejection sensitive dysphoria. That is how frustration goes, isn’t it? We become distressed and discouraged and feel like nothing else will ever help. No matter what our emotions are telling us, it isn’t true. Here are some of the ways I have learned to self soothe when I feel rejection sensitive dysphoria coming on.

Feel free to add your own techniques in the comments. It is only through sharing of information and support that we can get to what we need.

  1. Taking a warm bath
  2. Visualization
  3. Grounding
  4. Calling a trusted friend
  5. Calling my mother
  6. Recalling times when things went well
  7. Stepping away from the problem
  8. A quick nap
  9. Escaping the house
  10. Going for a car ride
  11. Snuggling with my dogs
  12. A hug
  13. Aromatherapy
  14. An ice cream cone
  15. Mindfulness
  16. Writing
  17. Spirituality
  18. Crochet
  19. A Pinterest quest
  20. Sitting in the sunshine
  21. Affirmations
  22. Look for the beauty
  23. Map out the “worst-case scenario”
  24. Remember the words of the people who love you
  25. Anything with low stimulation

This isn’t a comprehensive list of everything you can do to help soothe yourself, but it is a start. Learning to self-soothe when rejection sensitive dysphoria strikes can take time, but it is not impossible. Give yourself the space you need to learn this skill as you have learned so many others in the time you have been learning to manage your ADHD. You got this!

Meanwhile, I’ve put together a treat for you. I created this rejection sensitive dysphoria guide to help you walk through identifying your triggers, releasing the bad feelings from those who have criticized you, and how to plan for a situation that might set your rejection sensitive dysphoria off. I hope it really helps on the way to managing it well. Click here to download your guide!

Until next time,


Read more

How To Make Rejection Sensitive Dysphoria and Dating Easier

The Ultimate ADHD Guide

5 Ways ADHD Relationships Are Remarkable

Taking ADHD Medication is a Complex Process

ADHD and House Cleaning Is a Perpetual Challenge

11 thoughts on “What You Need To Know About Rejection Sensitive Dysphoria

  1. Great post! There are so many things that I can look back on now that I have a diagnosis and go “oh wow THAT’S why I do that!” I spent a LOT of years moving from one town/state to another and part of that I think was moving on from jobs/schools before my huge number of mistakes or avoidances could catch up with me. The idea of getting fired or even just censured at work was horrible beyond anything I could imagine and I always felt like I KNEW it was coming. I had no way of coping with my sensitivity but these days I do better I think just because as I get older I have less f–ks to give. 😀 I love your list of strategy ideas though… Pinterest quests are definitely going to become my go-to. 😀

    1. I’m SO glad the post helped you and cheers to finding less f–ks to give!

    2. Hi I did the same thing moving around a lot because I felt I had to keep in front of a wave.

  2. Thank you for writing this! It’s so helpful to see RSD described through the lens of someone’s person experience and not diagnostic terms. I’m not sure whether I have RSD per se. I relate to a lot of this, but the quickly passing anger isn’t really me. I am very rejection sensitive, but that usually results in shutting down rather than lashing out. When someone is angry at me I find it hard to speak or even string thoughts together. And the self-hate and fear that comes with these episodes can last for a week or two, triggered over and over again every time I have contact the person, even if the contact is neutral or even positive.

    1. Hi Lee,

      I’m glad that you brought this up, because things can definitely work differently for others, and those experiences are important to share. Might I suggest talking with your medical professional about PTSD? What you’re describing sounds like what happens to me when my PTSD is triggered.

  3. […] if you’re looking for sage advice on how to deal with RSD, once again, Rene Brooks has a great post for you. Also, I have found it incredibly comforting to find other people with ADHD who share our […]

  4. Guanfacine, it’s a game changer for me RSD, completely gone.

  5. I have add and have always felt left out when dealing with groups of people. Due to rsd I tend to not hang out with them because I already feel like Im not wanted and this creates a self-fulfilling prophecy :/

    1. I’m so sorry that you feel unwanted. I hope that you can sit with a therapist, they can often help us work through that.

  6. […] [Read More on Rejection Sensitive Dysphoria…] […]

  7. I have just been diagnosed with ADHD. I am 39 years old and never understood why I felt so different from other people. But the biggest and most scariest thing was I didn’t understand why I would get so angry when rejected or made fun of. It was like a wave of sadness and anger I had no control over. The pain I felt was a physical one and it hurt more then I could say. I had a very traumatic childhood and lose my dad and love ones. I am dyslexic and was bullied every day of my school life. I was the kid with no dad the kid that was different. I never had any friends and was always told I was doing it wrong both at home and at school. I think this plays a massive part in my RSD. I am getting help now but I wish I had know this years ago :(. The pain and the people I lost because I didn’t understand why I felt like that. I thought I was just broken and alone even crazy. Thank you for writing this it really helped I am looking to get help now I know what it is.

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