Table of ContentsView AllTable of ContentsCausesSymptomsDiagnosisTreatmentCoping

Table of ContentsView All

View All

Table of Contents

Causes

Symptoms

Diagnosis

Treatment

Coping

Although not formally recognized as a disorder,rejection sensitivity dysphoria(RSD) can be defined as an overwhelming emotional reaction to real or perceived rejection or criticism that can interfere with daily life. The exact cause is unknown, but RSD tends to affect people with attention deficit hyperactivity disorder (ADHD)more often than others. RSD can cause problems at work and school and can put a strain on your relationships. It can also lead to lowself-esteem.

Read on to find out more about RSD, including symptoms, common triggers, and treatment options.

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young woman looking upset after an argument with her partner at home

Symptoms of RSD can include:

The mood changes can happen immediately and can be very disruptive. This can happen several times a day.

RSD is more than a feeling of being upset at rejection; it may even interfere with your ability to get through the day.Because of the need to avoid criticism and feelings of failure, you may become a people-pleaser or perfectionist.

As RSD is not a formal diagnosis, there are not any clearly established diagnostic criteria. In many cases, it’s categorized as a manifestation of the emotional dysregulation found in ADHD.RSD is not part of the criteria to diagnose ADHD in the United States, but emotional dysregulation is a diagnostic feature in the criteria for ADHD in the European Union.

Sometimes RSD is misdiagnosed associal anxiety disorderbecause people have a tendency to avoid social situations where they may be criticized. It can also be misdiagnosed asborderline personality disorderorrapid cycling bipolar disorderbecause of its transient and immediate nature, along with the strength of the emotional reaction.

If you have ADHD in addition to RSD, getting an accurate diagnosis and then a treatment plan can help manage symptoms and reduce the intensity of RSD.

There are ways to cope with RSD that can help you handle the painful or uncomfortable emotions that come up. The eventual goal is to learn to react thoughtfully, instead of reflexively. Coping tactics can include:

Sometimes an ADHD support group, whether in person or online, can be helpful. People who know what it’s like to be dealing with RSD can validate your feelings and experiences and share the coping techniques that have worked for them.

Summary

RSD is more than just being sensitive. The emotions are intense and sudden, and they can cause significant distress. If you believe you have RSD, talk to your healthcare provider about treatment options, including certain ADHD medications as well as stress management techniques.

A Word From Verywell

Rejection is painful for everyone, but for people living with RSD, it disrupts everyday life. The feelings that come up when you’re criticized or rejected—or you’re worried you will be—can be overwhelming and can cause problems with your relationships and at work or school. Be sure to talk with your healthcare provider about your symptoms and what you’re experiencing. There are tools to help you with your RSD, and for some people, medication can be helpful.

5 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.Lenzi F, Cortese S, Harris J, Masi G.Pharmacotherapy of emotional dysregulation in adults with ADHD: A systematic review and meta-analysis.Neuroscience & Behavioral Reviews. 2018;84:359-367. doi:10.1016/j.neubiorev.2017.08.010ADDitude.New Insights Into Rejection Sensitive Dysphoria.Hance MA, Blackhart G, Dew M.Free to be me: the relationship between the true self, rejection sensitivity, and use of online dating sites.The Journal of Social Psychology.2018;158(4):421-429. doi:10.1080/00224545.2017.1389684CHADD.Emotional Regulation and Rejection Sensitivity.CHADD.Rejection can be more painful with ADHD.

5 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.Lenzi F, Cortese S, Harris J, Masi G.Pharmacotherapy of emotional dysregulation in adults with ADHD: A systematic review and meta-analysis.Neuroscience & Behavioral Reviews. 2018;84:359-367. doi:10.1016/j.neubiorev.2017.08.010ADDitude.New Insights Into Rejection Sensitive Dysphoria.Hance MA, Blackhart G, Dew M.Free to be me: the relationship between the true self, rejection sensitivity, and use of online dating sites.The Journal of Social Psychology.2018;158(4):421-429. doi:10.1080/00224545.2017.1389684CHADD.Emotional Regulation and Rejection Sensitivity.CHADD.Rejection can be more painful with ADHD.

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.

Lenzi F, Cortese S, Harris J, Masi G.Pharmacotherapy of emotional dysregulation in adults with ADHD: A systematic review and meta-analysis.Neuroscience & Behavioral Reviews. 2018;84:359-367. doi:10.1016/j.neubiorev.2017.08.010ADDitude.New Insights Into Rejection Sensitive Dysphoria.Hance MA, Blackhart G, Dew M.Free to be me: the relationship between the true self, rejection sensitivity, and use of online dating sites.The Journal of Social Psychology.2018;158(4):421-429. doi:10.1080/00224545.2017.1389684CHADD.Emotional Regulation and Rejection Sensitivity.CHADD.Rejection can be more painful with ADHD.

Lenzi F, Cortese S, Harris J, Masi G.Pharmacotherapy of emotional dysregulation in adults with ADHD: A systematic review and meta-analysis.Neuroscience & Behavioral Reviews. 2018;84:359-367. doi:10.1016/j.neubiorev.2017.08.010

ADDitude.New Insights Into Rejection Sensitive Dysphoria.

Hance MA, Blackhart G, Dew M.Free to be me: the relationship between the true self, rejection sensitivity, and use of online dating sites.The Journal of Social Psychology.2018;158(4):421-429. doi:10.1080/00224545.2017.1389684

CHADD.Emotional Regulation and Rejection Sensitivity.

CHADD.Rejection can be more painful with ADHD.

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