What is Rejection Sensitive Dysphoria?

“Why are you crying? There’s nothing to be upset about!”
You may be used to hearing some variation of this if you have ADHD.  And if you are, don’t worry–there is  a reason for it.
If you’re a friend, teacher, coworker, or family member of someone with ADHD, and you’re wondering why they’re so damn sensitive, read on…


Difficulty handing big emotions is common to those of us with ADHD, but unfortunately, this is not a fact that is commonly known about.
Many people hear “ADHD”, and they think of a loud, hyper kid with the attention span of Dory.  They don’t think about how severely ADHD affects our emotions.
(It is a very real, and scientifically documented thing, though.  According to Dr Barkley, an expert in ADHD, “emotional dysregulation” has been considered a symptom of ADHD since the late eighteenth century, and was only removed from medical documents in very recent history, not because it was disproven–but simply for the convenience of psychologists.*
*You can hear more about that here: http://adhdlectures.com/lecture-view.php?LectureID=16)

When you combine emotional dysregulation with another ADHD tendency: impulsivity,
what you get are “meltdowns” and “overreactions” from ADHDers acting on their first instinct (often too quickly to think logically), in response to the extreme emotions.
According to the Mayo Clinic,  “The inability to control impulses can range from impatience waiting in line or driving in traffic to mood swings and outbursts of anger.”
When you offend or hurt a person with ADHD, you will very likely see them “fly off the handle” in anger, break down in tears, or simply subtly try to avoid you for an extended period of time.

You may be thinking: “But what about when they do those things for no reason at all?”
These seemingly “random” flashes of emotional behavior can seem scary from the outside, especially when you’re witnessing it in a small child with ADHD throw a violent tantrum.  However, what often seems like a “for no reason” flare-up, may actually be a response to very deep hurt your ADHD friend is feeling.  You may not think you did anything to trigger a negative emotion, so why is this happening?

Rejection Sensitive Dysphoria is why.
Many sources define Rejection Sensitive Dysphoria (aka “RSD”) as “extreme emotional sensitivity and emotional pain triggered by the perception that a person has been rejected, teased, or criticized by important people in their life…” (meaning, what the ADHDer perceives as rejection or judgement, even if they are incorrectly perceiving the offending party’s intentions) “…or a sense of failure to meet either their own high standards or others’ expectations.”  (That’s right, we can trigger RSD in ourselves, just by falling into the trap of perfectionism.)  RSD can sometimes even be intense enough to cause major depressive episodes and suicidal thoughts or actions, according to ADHD specialist Dr William Dodson.


Of course, having this dysphoria does not mean we’re delusional.  We can think logically, and sometimes we know we’re overreacting, but that ADHD impulsiveness and lack of emotional regulation just makes it so hard to stop feeling all the feelings once they start.

Amanda Morin, a special education teacher who also struggles personally with special needs (both in herself and in her children), describes Rejection Sensitive Dysphoria in a post on Understood.org:
“It’s knowing you may be overreacting to something small, but also feeling it with such emotional intensity that it hurts. I’ve heard people call it an “emotional sunburn.” The idea is that when you have a sunburn, even a light pat on the shoulder is jarringly painful.  An emotional sunburn completely disrupts your ability to self-regulate. It short-circuits your ability to produce a typical emotional response.”

For me personally, the knowledge that I am over-reacting to perceived criticism, that it is “just” RSD, gives me the added anxiety of thinking everyone around me knows I’m over-reacting, is thinking about my over-reaction, is judging me for my over-reaction…. Which, of course, causes even more RSD, because I’m again only projecting the idea of judgement.  It’s a vicious cycle.

Both the rejection (or perceived rejection) and the knowledge that we are probably over-reacting can really take a hit to an ADHDer’s self-esteem.  That drop in confidence makes us so afraid of further rejection and judgement, that it becomes increasingly difficult to try anything new, or tasks where there is a history and/or potential for failure.  Then, being afraid to try things leads to staying in our comfort zones, and doing less and less, contributing to the stereotypical image of ADHD laziness.
Dr William Dodson has some very insightful things to say about Rejection Sensitive Dysphoria’s connection to fear of failure in this article: https://www.additudemag.com/fear-of-failure-adhd-emotions/?fbclid=IwAR0QyMBjSYtFuZrrHVJgtk6t8tf8XnjsMV5sk6wXCV77SY3B-MzPmsZPsts



I know this was a bit out of character for my typical blogging  style, but because the emotional side of ADHD is so often misunderstood, I really wanted to keep my first post about Rejection Sensitive Dysphoria as educational and non-personal as possible.
I have a lot more to say on the subject, though, so stay tuned for some more personal, opinionated posts on RSD later (maybe with a little self-depreciating humor thrown in).

For this post, here are my sources, in case anyone wants to read further on the subject of RSD right now:






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