Table of ContentsView AllTable of ContentsTraitsRSD and ADHDCauses and TriggersDiagnosticsSelf-RegulationSupport and TreatmentRelationship Effects
Table of ContentsView All
View All
Table of Contents
Traits
RSD and ADHD
Causes and Triggers
Diagnostics
Self-Regulation
Support and Treatment
Relationship Effects
Everyone experiences rejection at one time or another. It’s a normal part of life. However, for people with rejection sensitive dysphoria (RSD), even mild rejection can lead to intense and overwhelming feelings of failure.
People withattention deficit hyperactivity disorder(ADHD) have an increased likelihood of experiencing RSD, but you can still experience RSD without ADHD.It’s also a trait ofautism spectrum disorder(ASD) and other mental health conditions.
Rejection Sensitive Dysphoria Traits
People with RSD experience an overwhelming, instantaneous, negative emotional reaction to even mild forms of rejection.Criticisms that other people might brush off or feel sad about for a short period feel catastrophic to a person with RSD.
People with RSD are also prone to perceivingrejection when there hasn’t been any, furthering theirdysphoria.
Examples of Defining Symptoms
Overall, someone with RSD is more likely to:
In response to rejection (or the perception of it), people with RSD might experience the following symptoms:
What Does Rejection Sensitive Dysphoria Feel Like?
A qualitative study asked people with ADHD about their symptoms, and many participants reported experiencingrejection sensitivity. This is what they had to say:
People with ADHD may be more susceptible to RSD, even though difficulty with emotional regulation isn’t included in the current diagnostic criteria for ADHD.This could be due to differences in the brains and nervous systems of people with ADHD and other forms of neurodivergence.
NeurodivergenceNeurodivergenceis when a person’s brain processes and learns differently from the social norm, or what is considered “neurotypical.”
Neurodivergence
Neurodivergenceis when a person’s brain processes and learns differently from the social norm, or what is considered “neurotypical.”
In a study of 391 children, higher ADHD symptoms were associated with higher scores on sensitivity to rejection measures. The children with greater ADHD symptoms also were less responsive to social acceptance cues.
A 2023 study of 43 young adults with ADHD was the first to look at RSD in adults with ADHD. Many of the participants, but not all, reported symptoms of RSD.
In 2024, William Dodson, the scientist who coined the term “rejection sensitivity dysphoria,” published a case series of patients with ADHD who displayed RSD to define RSD since it is not a validated diagnosis on its own.
In this case series, Dodson details the stories of four patients with RSD and the treatments they received. He reports that these patients' stories are consistent with over 300 other patients from his clinical practice and reports from numerous international psychiatrists. RSD has been understudied, and research on this topic is in its early stages. Dodson recommends further research to enhance its understanding.
Is RSD Unique to ADHD?
RSD is not unique to ADHD. It is also associated with other forms of neurodivergence, like ASD. Rejection sensitivity is believed to be a trait found in other mental health conditions, including:
It is not clear if RSD is a symptom of these mental health conditions or perhaps is a diagnosis on its own.Additional research may provide insight in the coming years.
Researchers believe that RSD develops from childhood experiences of rejection, neglect, or abuse.For example, your parents might have been highly critical or neglectful, leading you to internalize these experiences into low self-esteem or abandonment issues.
Based on their childhood experiences, an adult may be highly vigilant to criticism and react out of proportion to a perceived rejection. Rejection can come in the form of:
Do You Need a Diagnosis?
RSD is not a diagnosis on its own but rather a trait that is more common for people with certain mental health conditions, like ADHD.
RSD is an emerging area of research, and scientists are working to better define it and its possible treatments. In the future, it could be a diagnosis—or an official part of other diagnoses.
Learning about RSD and whether you might have it can give you helpful insight into your behaviors and emotions. Talking to a mental health professional, such as a psychiatrist or therapist, may help you recognize a sensitivity to rejection.
People with RSD have reported various ways to self-manage their symptoms, and better respond to rejection. Strategies include:
Professional Support and Treatment
Professional support from your healthcare team can also be highly beneficial for managing your RSD.
Consider seeing apsychiatristor licensed mental health professional to find out if an underlying condition is related to your RSD. A psychiatrist can prescribe medication if it may help your symptoms. While some psychiatrists conduct therapy, some don’t. In that case, therapy with a qualified mental health professional can help you develop tools to cope with RSD.
Since RSD is not an official diagnosis, there is no Food and Drug Administration (FDA)–approved medication specifically for it. However, research has reported off-label use of the following medications for people who display symptoms of RSD:
Therapy—specificallycognitive behavioral therapy(CBT)—andmindfulnessmay be beneficial for treating RSD. CBT is commonly used as a treatment for ADHD, and both patients and psychiatrists have reported that it can help reduce sensitivity to rejection. However, no research supports this—just anecdotal reports (based on reports and observations) from psychiatrists and patients are available.
ADHD Medications and Side Effects
Relationship Effects and Improving Social Health
Having RSD can make you extra sensitive to rejection or feel like you’re a failure. The fear of rejection can lead you to isolate yourself and potentially damage meaningful relationships.
Understanding your tendency toward RSD and triggers can help improve your relationships and general social life.
If you feel comfortable sharing about RSD with your loved ones, teachers, or supervisors, this may help them better understand your reactions and how to communicate with you. Getting professional treatment for RSD—in the form of medication or therapy—may also help you manage and rebuild relationships.
Summary
Rejection sensitivity dysphoria (RSD) is an extreme response to rejection, whether that rejection is real or perceived. It’s common among people with ADHD but is also found in people with ASD and other mental health conditions. This is a new area of research, and RSD is not an official diagnosis on its own or a part of diagnostic criteria for other conditions.
6 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ginapp CM, Greenberg NR, MacDonald-Gagnon G, Angarita GA, Bold KW, Potenza MN.“Dysregulated not deficit”: a qualitative study on symptomatology of ADHD in young adults.PLoS One. 2023;18(10):e0292721. doi:10.1371%2Fjournal.pone.0292721Dodson W, Modestino E, Ceritoglu HT, Zayed B.Rejection sensitivity dysphoria in attention-deficity/hyperactivity disorder: a case series.ACTA Scientific Neurology.2024;7(8):2582-1121. doi:10.31080/ASNE.2024.07.0762Gao S, Assink M, Cipriani A, Lin K.Associations between rejection sensitivity and mental health outcomes: a meta-analytic review.Clinical Psychology Review. 2017;57:59-74. doi:10.1016/j.cpr.2017.08.007Babinski DE, Kujawa A, Kessel EM, Arfer KB, Klein DN.Sensitivity to peer feedback in young adolescents with symptoms of ADHD: examination of neurophysiological and self-report measures.J Abnorm Child Psychol. 2019;47(4):605-617. doi:10.1007/s10802-018-0470-2Normansell KM, Wisco BE.Negative interpretation bias as a mechanism of the relationship between rejection sensitivity and depressive symptoms.Cognition and Emotion. 2017;31(5):950-962. doi: 10.1080/02699931.2016.1185395Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).Emotional regulation.
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Ginapp CM, Greenberg NR, MacDonald-Gagnon G, Angarita GA, Bold KW, Potenza MN.“Dysregulated not deficit”: a qualitative study on symptomatology of ADHD in young adults.PLoS One. 2023;18(10):e0292721. doi:10.1371%2Fjournal.pone.0292721Dodson W, Modestino E, Ceritoglu HT, Zayed B.Rejection sensitivity dysphoria in attention-deficity/hyperactivity disorder: a case series.ACTA Scientific Neurology.2024;7(8):2582-1121. doi:10.31080/ASNE.2024.07.0762Gao S, Assink M, Cipriani A, Lin K.Associations between rejection sensitivity and mental health outcomes: a meta-analytic review.Clinical Psychology Review. 2017;57:59-74. doi:10.1016/j.cpr.2017.08.007Babinski DE, Kujawa A, Kessel EM, Arfer KB, Klein DN.Sensitivity to peer feedback in young adolescents with symptoms of ADHD: examination of neurophysiological and self-report measures.J Abnorm Child Psychol. 2019;47(4):605-617. doi:10.1007/s10802-018-0470-2Normansell KM, Wisco BE.Negative interpretation bias as a mechanism of the relationship between rejection sensitivity and depressive symptoms.Cognition and Emotion. 2017;31(5):950-962. doi: 10.1080/02699931.2016.1185395Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).Emotional regulation.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Ginapp CM, Greenberg NR, MacDonald-Gagnon G, Angarita GA, Bold KW, Potenza MN.“Dysregulated not deficit”: a qualitative study on symptomatology of ADHD in young adults.PLoS One. 2023;18(10):e0292721. doi:10.1371%2Fjournal.pone.0292721Dodson W, Modestino E, Ceritoglu HT, Zayed B.Rejection sensitivity dysphoria in attention-deficity/hyperactivity disorder: a case series.ACTA Scientific Neurology.2024;7(8):2582-1121. doi:10.31080/ASNE.2024.07.0762Gao S, Assink M, Cipriani A, Lin K.Associations between rejection sensitivity and mental health outcomes: a meta-analytic review.Clinical Psychology Review. 2017;57:59-74. doi:10.1016/j.cpr.2017.08.007Babinski DE, Kujawa A, Kessel EM, Arfer KB, Klein DN.Sensitivity to peer feedback in young adolescents with symptoms of ADHD: examination of neurophysiological and self-report measures.J Abnorm Child Psychol. 2019;47(4):605-617. doi:10.1007/s10802-018-0470-2Normansell KM, Wisco BE.Negative interpretation bias as a mechanism of the relationship between rejection sensitivity and depressive symptoms.Cognition and Emotion. 2017;31(5):950-962. doi: 10.1080/02699931.2016.1185395Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).Emotional regulation.
Ginapp CM, Greenberg NR, MacDonald-Gagnon G, Angarita GA, Bold KW, Potenza MN.“Dysregulated not deficit”: a qualitative study on symptomatology of ADHD in young adults.PLoS One. 2023;18(10):e0292721. doi:10.1371%2Fjournal.pone.0292721
Dodson W, Modestino E, Ceritoglu HT, Zayed B.Rejection sensitivity dysphoria in attention-deficity/hyperactivity disorder: a case series.ACTA Scientific Neurology.2024;7(8):2582-1121. doi:10.31080/ASNE.2024.07.0762
Gao S, Assink M, Cipriani A, Lin K.Associations between rejection sensitivity and mental health outcomes: a meta-analytic review.Clinical Psychology Review. 2017;57:59-74. doi:10.1016/j.cpr.2017.08.007
Babinski DE, Kujawa A, Kessel EM, Arfer KB, Klein DN.Sensitivity to peer feedback in young adolescents with symptoms of ADHD: examination of neurophysiological and self-report measures.J Abnorm Child Psychol. 2019;47(4):605-617. doi:10.1007/s10802-018-0470-2
Normansell KM, Wisco BE.Negative interpretation bias as a mechanism of the relationship between rejection sensitivity and depressive symptoms.Cognition and Emotion. 2017;31(5):950-962. doi: 10.1080/02699931.2016.1185395
Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD).Emotional regulation.
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