Why So Sensitive? Understanding Rejection Sensitive Dysphoria in ADHD
Have you ever been called overly sensitive? Do little things that others might brush off feel profoundly painful to you? Do you have ADHD? If so, you may be struggling with Rejection Sensitivity Dysphoria, one of the most common and difficult aspects of life with ADHD.
What is Rejection Sensitive Dysphoria (RSD)? A Maryland ADHD Therapist explains
RSD describes an acute over-sensitivity to perceived criticism, followed by an emotionally extreme reaction. Fixating on the one suggestion for improvement in an otherwise positive performance review. Erupting in rage when gently teased. Sobbing with rejection when a friend doesn’t return a text. Endlessly analyzing a cocktail party comment, sure it was a personal attack. For people with RSD, the judgement of others feels unbearably painful and excruciatingly real, even when it is not (and it is usually not).
Emotional Dysregulation and Rejection Sensitive Dysphoria in Adults with ADHD
Emotional Dysregulation is one of the most challenging aspects of living with ADHD. And RSD is often reported as the most disruptive manifestation, especially for adults.
Those with RSD can experience even the most benign of criticisms or mistakes as as rejection and failure. They are then immediately thrown into an extreme emotional tailspin, aimed either at themselves (internalized) or at others (externalized).
When internalized, this may manifest as a deep depression, including suicidal ideation and thoughts of self-harm. An externalized reaction includes sudden and intense fits of rage at the triggering person or situation. While others might be able to brush these off quickly, RSD can lead to perseveration and an inability to ‘let it go’ and move on.
Because our understanding of the scope of ADHD is still limited, RSD is often misdiagnosed as a mood disorder or rapid cycling Bipolar Disorder. However, there are key differences:
Do I have Rejection Sensitive Dysphoria?
Signs of RSD:
Perceived judgment or criticism triggers sudden emotional outbursts
Negative self-talk
Poor self-esteem and self-perception
Withdrawal from social situations (RSD can also mirror social anxiety)
Perseveration and rumination
Defensiveness in relationships
Difficulty managing emotions and reactions
People with RSD often become people pleasers, putting others first in an effort to to avoid personal rejection. They may learn to over-compensate and over-achieve, while feeling inadequate. RSD may drive others to an avoid anything that involves risk, losing out on opportunities because their experience of failure is too acute.
Treatment for Adult ADHD Can Help
While there is no cure for RSD, therapy and ADHD medications are effective tools in reducing its negative impact. Therapy helps those struggling with RSD to recognize, process and manage their emotions. By partnering with a therapist to gain insight and coping skills, those with RSD can challenge misperceptions, change behavior, and improve their quality of life.
To start feeling more connected and supported, reach out to a therapist for adult ADHD today.
