Rejection Sensitivity
Perhaps it’s because I’m a Gen X therapist that I take every new ‘thing’ with a lot of skepticism. When I started hearing about Rejection Sensitivity Dysphoria, I brushed it off as a TikTok fad.
My complaint and skepticism were led by: how do you measure it? Doesn’t everyone feel crappy when they’re rejected? Who out there is OK with rejection? Is this an extension or part of social anxiety? I was actually making this very argument on a therapist subreddit when someone opined, “yeah, but this is more than feeling bad, it’s dysphoria.” That’s what got me thinking. I dug deep into my past clientele with ADHD, and when they really delved into the pain, embarrassment, or fear of either of those to the point it was causing them misery. Then I thought about people diagnosed with social phobia, who are overwhelmed with many competing thoughts, which lead them to be shy or quiet in social settings because they can’t decide on which thought to express aloud.
I also thought about how treatment for ADHD has reduced this type of anxiety.
Anyway, here’s some more information about RSD.
Why Does Rejection Sting So Much? Let's Talk About RSD
If you have ADHD, you’re likely familiar with the "standard" symptoms: the lost keys, the 47 open browser tabs, and the ability to focus on everything except what you actually need to do.
But there’s a "secret" symptom that many of us deal with—one that doesn't usually show up on a standard diagnostic checklist, yet feels like the heaviest part of the ADHD experience. It’s called Rejection Sensitive Dysphoria (RSD).
What Exactly is RSD?
The word "dysphoria" comes from the Greek word for "unbearable." For someone with RSD, the pain of perceived rejection isn't just a bummer—it feels like a physical punch to the gut.
Imagine you text a friend and they don’t reply for six hours.
The Neurotypical Brain: "Oh, they must be busy at work."
The RSD Brain: "They hate me. I said something weird three years ago and they finally realized I’m a weirdo and I don’t deserve friends, which is true. It’s only a matter of time until everyone figures this out, but they did first. I….HATE…MY LIFE….I HATE ME!!!!"
It’s an extreme emotional sensitivity to the idea that you’ve let someone down, failed, or been rejected—even if there’s no evidence it’s actually happening.
Why Does This Happen?
It’s not because you’re "too sensitive" or "dramatic." It’s actually wired into the ADHD brain. Because ADHD makes it harder to regulate emotions, the "emotional brakes" in the brain don't always work.
When a negative thought enters, the brain turns the volume up to 11 before you even have a chance to process the facts.
The "RSD Survival Kit"
While RSD can feel overwhelming, you aren't powerless against it. Here are a few ways to turn the volume down:
The 5-Minute Rule: When that "everyone hates me" feeling hits, wait five minutes before reacting. Most RSD flares are intense but short-lived.
Check the Facts: Ask yourself, "Do I know they’re mad, or am I guessing they’re mad?" Usually, it's the latter.
The "H.A.L.T." Method: Are you Hungry, Angry, Lonely, or Tired? RSD loves a worn-down battery.
Own the Brain: Just knowing that RSD is a "glitch" in the ADHD wiring—and not a reflection of reality—can take some of its power away.
Put the thought on trial: have you had this thought before and it turned out it was totally wrong? Is this thought making a bunch of false accusations that cannot be verified, as it has done countless times before?
You’re in Good Company
If you’ve ever felt like your world was ending because of a slightly short email from your boss, you are not alone. RSD is a grueling part of the ADHD journey, but understanding it is the first step toward managing it.
You aren't "too much." Your brain just cares a whole lot, sometimes a little too loudly.