ADHD: Rejection Sensitivity Dysphoria

How to overcome rejection sensitivity.

ADHD is often misdiagnosed or missed, especially when it comes to women. Women are identified as struggling with anxiety or depressive symptoms when in reality it is unmanaged ADHD. Symptoms are often missed or are not clearly understood in how they present–Rejection Sensitivity Dysphoria (RSD) is one of them. Though RSD is not a specific symptom outlined in the DSM for ADHD, the combined experiences of many neurodivergent people has shed light on RSD as early as the 1960s. This makes it an important aspect of treatment planning in counseling when working with an individual with ADHD.

So then, what is rejection sensitivity dysphoria?

RSD is an intense emotional reaction to perceived social rejection. It can also be an extreme reaction when a person with ADHD feels as though they have failed someone or a group. Even with this explanation, people often do not realize they are experiencing RSD. This article tries to explain what rejection sensitivity symptoms look like.

Misreading social cues as rejection.

A person struggling with RSD often misreads social cues and turns social normalities into entire narratives of rejection. For a neurotypical person, facial expressions, body language, and tone of voice are ever changing and fluid. These simple social cues are a typical part of a normal day, but to someone with RSD, a simple widening of eyes could be a sign of disapproval. A change in tone is read as annoyance. A group of people breaking up when a person struggling with RSD walks up is not just a group of people done with a conversation, but instead a group of people avoiding a conversation. Having RSD is like being on high alert, scanning everyone to categorize every social cue as evidence of approval or disapproval.

Fear of failing a relationship.

A person struggling with RSD often goes above and beyond in relationships. They are always doing small things to show their worth in the relationship by giving gifts or offering to help. They are often first to volunteer when something might be going awry. In conversations they are quick to apologize. In fact, they might often ask if they have done something to upset you. Having RSD is like having a friendship motor cranked up on high where you are always performing in relationships to show that you are dependable, helpful, and valuable in someone’s life.

You might be struggling with RSD if the following sound familiar:

• You analyze text messages and re-read text exchanges when someone doesn't text you back.

• You constantly think that people are talking negatively about you.

• You have an entire narrative of evidence of why someone might not like you.

• A tone of voice can send you into a spiral of thinking that someone does not like you or they are mad at you.

• You are extremely sensitive to perceived criticism.

• You replay conversations over and over in your head looking for evidence of misfaults.

• You want to solve people’s problems by volunteering to help and often find yourself over committed.

• You want to do something nice to make up for a perceived failure.

There is hope for those struggling with RSD!

Once you have identified it in your life, you can become more aware of how you perceive rejection and create affirmations about who you are and how you are a valuable friend. Counseling can help you increase confidence and decrease rumination and/or anxiety. Counseling can also help you reframe experiences to move you from a RSD narrative into a more realistic narrative that is accepting of others’ choices and behaviors. Another part of treatment planning might include learning boundaries in relationships.

EMDR can help rejection sensitivity!

An EMDR treatment plan for RSD would include targeting those negative feelings and beliefs associated with perceived rejection and/or failures. EMDR can also help you process past relationship struggles to decrease anxiety and rumination. If you are ready to move past a life burdened by rejection sensitivity dysphoria, contact Abiding Waters Counseling LLC today! 

This article is not to be used as diagnostic, but rather information on a possible experience. If you think you may be struggling with your mental health, please seek treatment from a professional.