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Coping with Rejection Sensitive Dysphoria: Strategies for Managing Emotional Turmoil

Updated: May 10

Rejection Sensitive Dysphoria (RSD) is an intense emotional reaction triggered by either real or perceived criticism or rejection. Many neurodivergent individuals experience this, and while some argue that it's exclusive to ADHD, others believe it can also manifest in people with autism, social anxiety, or a history of trauma. 


The term was coined by Dr. William Dodson, who described it as "a triggered, wordless emotional pain that occurs after a real or perceived loss of approval, love, or respect."

What does RSD look like?

This reaction is characterized by overwhelming feelings of depression, anxiety, or hurt, often accompanied by physical sensations such as a painful stab in the stomach. Individuals may go to great lengths to please others, neglecting their own needs, and may avoid social interactions due to fear of rejection or criticism. Moreover, RSD can lead to self-destructive behaviors like self-harm or suicidal thoughts, as well as difficulties in relationships due to self-sabotage and a sense of not being understood.

  • Overwhelming feelings of depression, anxiety, or hurt

  • Physical sensations like a painful stab in the stomach

  • Going to great lengths to please others and ignoring one's own needs

  • Avoiding social interactions due to fear of rejection or criticism

  • Engaging in self-destructive behaviors, including self-harm, suicidal thoughts, or unhealthy coping mechanisms

  • Struggling in relationships due to self-sabotage and a feeling of not being understood

Woman looking sad out of the window

What causes RSD?

RSD is particularly prevalent among neurodivergent individuals, including those with ADHD and autism, who often experience heightened emotional dysregulation. Factors triggering RSD include misinterpreting neutral responses as criticism, feeling like a failure, and past rejection experiences. Low self-esteem and overthinking social interactions can exacerbate this condition.

What can trigger RSD?

  • Misinterpreting a neutral or vague response as criticism

  • Feeling like a failure at a task

  • Actual or anticipated rejection or criticism

  • Reminders of past rejection experiences

  • Misinterpreting a single comment as a sign of being disliked

  • Misreading constructive feedback

  • Misinterpreting someone's tone of voice or facial expressions

  • Low self-esteem, relying heavily on external acceptance for self-worth

  • Overthinking social interactions

Living With RSD

Taking care of oneself is paramount for those managing RSD. Seeking support from a healthcare professional specializing in ADHD and its related conditions is crucial for diagnosis and treatment guidance.


Considerations include:

  • Medication: Incorporating medication into daily routines can alleviate RSD symptoms.

  • Therapy: Regular sessions with a therapist can aid in adapting thought processes and behaviors to mitigate RSD's impact.

  • ADHD Coaching: ADHD coaching serves as an essential treatment option, providing structured support and guidance to individuals in managing RSD symptoms. Coaches help clients develop practical strategies, enhance executive functioning skills, and cultivate resilience in coping with rejection-sensitive emotions.

  • Self-care: Managing stress is essential, as it can exacerbate RSD symptoms.

  • Self-compassion: Embracing failures and rejection as part of life's journey is key to managing RSD. Finding healthy outlets to process emotions is vital.


How to support someone with RSD

Supporting someone with RSD involves offering reassurance, actively listening to their experiences, and providing feedback sensitively. It's essential to communicate clearly and help navigate unfamiliar situations while reminding them of their worth and loved ones' support. Individuals with RSD should remember that imperfection is universal, and others are not as judgmental as they may perceive. Accepting mistakes and acknowledging that nobody is perfect are crucial steps in managing RSD and fostering self-compassion.

  • Offer extra reassurance

  • Avoid minimizing or dismissing their feelings

  • Listen and make an effort to understand their experiences

  • Provide feedback or criticism in a sensitive manner

  • Communicate clearly and explicitly

  • Help them navigate unfamiliar situations

  • Remind them that they are loved

Supporting a Child with RSD

Children with ADHD are at higher risk of RSD.

 Parents can assist by:

  • Consulting a healthcare provider for early diagnosis and intervention.

  • Understanding the neurological basis of RSD and ADHD, which affects behavior regulation.

  • Practicing patience and avoiding frequent criticism, as it can intensify RSD symptoms.

  • Fostering resilience in children, teaching them to learn from setbacks and develop coping strategies.

Reminders for individuals with RSD

  • Understand that nobody is perfect

  • Realize that people aren't judging you as harshly as you may think

  • Know that it would take much more than your mistakes for everyone to hate you

  • Remember that you are still loved, even when you make mistakes

  • Acknowledge that you wouldn't judge others as harshly as you may perceive them to judge you

  • Recognize that it's impossible to know what other people are thinking

  • Accept that no one is perfect, and it's okay to make mistakes.

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