RSD and ADHD – What is rejection sensitive dysphoria, and why does rejection hurt more than it should?
According to ADDitude, rejection-sensitive dysphoria (RSD) is when someone experiences extreme emotional sensitivity and pain that is triggered by the perception that they have been rejected or criticised. The reaction to it is often described as unbearable fear (a response to the here and now), shame and/or anxiety (worries about the future).
It can be as simple as a colleague making a comment about your work, to a friend not returning your calls. Neurominority people (and specifically ADHDers) tend to *spiral* into overthinking and catastrophising. Of course, this isn’t limited to ADHDers, and anyone can experience RSD
We see RSD affecting neurominority people far more often than neurotypical people. The reason why is not entirely known, but various trains of thought throughout this article indicate why people think it’s more prevalent in neurominorities.
Recognising these feelings are RSD-related can be the first step to unravelling and exploring *how* you can navigate these intense feelings that might be stopping you from moving forward.
NOTE: It’s important to remember (especially if you’re NOT the person experiencing RSD) that the emotional response to rejection can be so strong, it’s often described as physical, intense and highly impairing. This trigger can then lead to low moods, depression, escalation and cycling of rejection. This is why an understanding of RSD in the workplace is super important for employers so they know how they can support their teams through clear communication and feedback.
If you experience RSD, it’s good to recognise this in yourself so that when it rears its ugly head, you can take a step back, begin to lessen the overwhelm, and implement some strategies so it’s easier to overcome.
It's easier said than done, I know! Believe me, I experience it, too, so I completely understand the gut-wrenching reaction to what other people might feel to be the smallest bit of “helpful” feedback because my brain seems to be wired to hone in on the negative.
Okay – let’s dive into some reasons why we think RSD shows up for neurominorities, especially those with ADHD..
Why do neurominorities, including those who are ADHD, experience Rejection Sensitive Dysphoria?
Rejection Sensitive Dysphoria could be because of differences in the brain
We know that in ADHDers there are differences in the way the brain processes information and regulates emotions.
There’s the amygdala - the part of the brain that keeps you safe. I find it useful to remember that our brains are always working hard to keep us safe - to detect threats and protect us. Super handy in prehistoric times when we needed to be very aware of our surroundings and things like wild bears. Not so much call for it now (unless you happen to work with bears, obvs).
The prefrontal cortex - the part that’s responsible for executive function. This helps you to make plans, solve problems, and adapt to new situations. The things that neurotypicals seem to get on quite well with, while as an ADHDer you are likely to find more challenging.
One of the leading experts on ADHD, Dr. Russell Barkley, a clinical professor of psychiatry, has regularly documented (along with his peers) the difficulties with emotional regulation for ADHDers because of these differences in the brain. He’s written many books and even a fact sheet covering executive function in more detail and how that affects emotional regulation.
And it’s because of this that we think we see more of a correlation between neurodivergent people experiencing rejection sensitive dysphoria.
That intense reaction to a perceived threat (the feedback in whatever form) and the reduced ability to problem solve and think more critically about that feedback.
Rejection Sensitive Dysphoria could be because of a learned response
If you’ve ever been in therapy *high five – me too*, you’ll have probably learned that a lot of what we experience in the here and now *can* be down to learned experiences. Things that have happened in the past shape and form our behaviours and feelings. Usually in our unconscious – we don’t even realise we’re doing it – as it’s an automatic reaction. As automatic as pushing on the brake pedal in your car when you know you need to stop. You do it without even thinking about it.
We know that a lot of late-diagnosed ADHDers have spent many years being misunderstood. Given labels like lazy, forgetful, daydreamy or seen as ‘too much’. These *rejections* and perceived failures start to become the norm, and our unconscious mind will start to expect it.
Let’s take friendships for example, as a common thread with my clients.
Let’s say you have a friend who is always mega responsive when you message them. Someone you have top banter with and who’s first on your funny meme sharing list. You like them a lot and you value their friendship. One day, your friend doesn’t reply to a meme that had you snort your coffee onto the desk - you found it that funny. You start to worry you’ve upset them. The story you’re telling yourself in your head starts to spiral:
Was the meme somehow offensive? You don’t think so.
Did you do something else to annoy them? Pretty sure the answer is no
Did you forget something? That’s possible.. But what?
The mental list of scenarios goes on and on.
But the reality is that your friend simply forgot because they were busy. . But your RSD went into overdrive because of past learned experience.
RSD could be caused by one of these factors, a combination of both, or something else entirely. What we can be certain of is that it’s a common experience among ADHDers and other neurominorities.
What strategies can you implement to overcome Rejection Sensitive Dysphoria?
The Story in My Head vs. The Reality
When RSD kicks in, it often spins a narrative in your mind that feels incredibly real, even if it's not based on any facts. This is your brain trying to protect you, but sometimes it overestimates the threat.
Image of a brain under a rain cloud with a speech bubble that says ‘why does it always rain on me?’ standing on the path to a giant sun in the sky.
The key is to challenge that internal story by actively seeking out the reality of the situation. Personally, this "story in my head" exercise is the one I use most often myself. It’s almost like I have to consciously tell myself to use it, to give myself permission to acknowledge and process those feelings.
Here's how to navigate from the emotional narrative to logical steps:
1. Identify "The Story in My Head"
The first step is to recognise the narrative your RSD is creating. What's the worst-case scenario your mind is painting? What conclusions are you jumping to about someone's intentions or your own worth?
Examples:
The Story: "My boss/client didn't reply to my email straight away, so they must be really disappointed with what I’d put and are probably figuring out how to get rid of me. I'm a complete failure."
The Story: "My mate hasn't texted me back for a few hours. They're clearly annoyed with me or don't want to be my friend anymore. I must have done something wrong."
The Story: "I messed up that presentation and spoke too quickly in places. Everyone thinks I'm useless and will judge me for it. I should just avoid public speaking forever."
Write it down, even if it feels a bit silly or over-the-top. Acknowledging it is the first step towards dismantling it.
2. Look for the Facts: Reality Check
Once you've identified the story, it's time to become a detective and look for the actual evidence.
Talk to someone: Your coach (me!), a trusted friend or partner. Someone who can help you look at the facts of the situation and allow you to separate them from the stories. Once you recognise what’s real from what’s a story, you can move even further away from the rejection.
Probing questions you and your trusted person can ask:
"What evidence do you have to support the story in your head?"
"What could possibly be another (less negative) explanation for what happened?"
"When have you experienced something similar before, and what was the outcome?"
"What would you tell a friend if they were in this exact situation?"
Continuing the examples:
The Story: "My boss/client didn't reply to my email straight away, so they must be really disappointed with what I’d put and are probably figuring out how to get rid of me. I'm a complete failure
Facts/Reality Check: "They’re often busy and can take a while to reply to emails. They've praised my work in the past. There have been no indications of poor performance or them being unhappy with me. It's Friday afternoon, they might be off for the weekend."
The Story: "My mate hasn't texted me back for a few hours. They're clearly annoyed with me or don't want to be my friend anymore. I must have done something wrong."
Facts/Reality Check: "My friend works long hours. They don't always have their phone on them. We had a great time last time we hung out. They haven't expressed any anger or annoyance with me."
The Story: "I messed up that presentation and spoke too quickly in places. Everyone thinks I'm useless and will judge me for it. I should just avoid public speaking forever."
Facts/Reality Check: "I stumbled over a few words, but I recovered quickly and slowed myself down. Several people complimented my content afterwards. It's normal to feel a bit nervous. One mistake doesn't define my overall competence."
3. Move to Logical Steps
Once you've grounded yourself in the facts, you can transition from emotional reactivity to proactive, logical steps.
Based on the boss/client example: Instead of spiralling, you might decide to send a follow-up email on Monday morning if you haven't heard back, or simply trust that they will respond when they can.
Based on the friend example: You can wait for them to reply when they get a chance, or just send a casual, quick message if you need something specific from them.
Based on the presentation example: You can focus on learning from the experience, identifying areas for improvement for your next presentation, and reminding yourself that growth involves making mistakes.
Take a breather. Your nervous system is affected by this rejection or perceived threat, so start to calm and regulate it with your breath. Try a meditation app (I love Headspace) or simple box breathing - breathe in for 4, hold for 4, and out for 4, hold for 4..
Image of a square titled ‘box breathing’ each side has a pointed arrow clockwise around the square. Caption under each arrow is as follows ‘start here, breathe in for 4, hold for 4, breathe out for 4, hold for 4’
4. Journaling/Wild Writing: If a specific area of your life is deeply affected by RSD, start journaling. I'm not a big journaler myself, but I do use "wild writing" as a coping strategy. It's like free writing, but with an emphasis on untamed, unfiltered expression. You write continuously for a set period, without stopping, editing, or censoring—just let anything and everything flow onto the page.
Sometimes I notice I keep writing the same word over and over, and that can lead to unravelling other thoughts. Sometimes it’s pure nonsense. But this somewhat raw process is always incredibly powerful for uncovering and processing my emotions related to RSD.
5. Daily affirmations. Repeat self-compassionate affirmations daily or have them on a post-it or sticker on your desk as a visual reminder:
“I am enough”
“It’s okay to make mistakes”
“I accept myself unconditionally”
“My worth is not defined by other people’s opinions of me”
“I accept who I am today”
“I am a work in progress”
Sometimes, a tangible cue can be incredibly grounding. For me, a key visual reminder is "Amor fati," a Latin phrase meaning "a love of fate." This isn't about passive acceptance or resignation - it's about actively embracing everything that happens in life (the good, the bad, and the indifferent) as a necessary part of personal acceptance and growth. It's about letting go of the struggle against what is, and instead, finding a way to lean into it. I actually had "Amor fati" tattooed on my arm as a permanent, visual reminder to let go, to release the grip of control, and to find peace with the unfolding of life, especially when RSD tries to pull me into a spiral of regret or perceived failure.
If Rejection Sensitive Dysphoria is affecting your life, I can help coach you through it and build tools and resilience so that you can stop letting it hold you back in life and work. Plus, you get my coaching magic on other aspects of life or work that you might find challenging right now.
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About
I'm Victoria Tretis, and I coach neurodivergent adults, often through access to work (including ADHD, ASD and Dyslexic) who feel stuck and overwhelmed in the chaos of daily life. They want to design and achieve their version of success. (I don't believe there is one right way to accomplish this.)
I also work with line managers who want to strengthen the support they provide within neurodiverse teams.
My work is not about rich people getting richer. Instead, sessions are centred around clients wanting to better understand themselves and those around them.