Rejection Sensitive Dysphoria (RSD) is a condition often experienced by people with Attention-Deficit/Hyperactivity Disorder (ADHD) that involves an intense emotional response to perceived or actual rejection or criticism. People with RSD may react with feelings of overwhelming sadness, frustration, or anger, often disproportionate to the triggering event. RSD is not yet formally recognised as a standalone condition in diagnostic manuals, but it is increasingly acknowledged as a significant factor in the emotional and social experiences of those with ADHD (Dodson, 2020).
Understanding RSD in ADHD
While ADHD is typically associated with challenges in attention regulation, impulsivity, and hyperactivity, emotional dysregulation is also common. RSD is a form of emotional dysregulation where even minor cues of rejection, such as constructive criticism or being left out of a social event, can cause intense reactions. According to a study by Bunford et al. (2015), people with ADHD are more likely to struggle with intense emotional responses, which can make managing rejection particularly challenging.
Key Features of RSD
- Intense Emotional Reactions: People with RSD may experience emotions that feel unmanageable in response to perceived rejection, resulting in feelings of sadness, shame, or anger.
- Impact on Relationships: Due to heightened sensitivity, individuals with RSD might avoid social situations, be overly apologetic, or react defensively to feedback, which can create strain in personal and professional relationships (Asherson et al., 2019).
- Avoidance of Potential Rejection: Some individuals may avoid opportunities or situations where they fear rejection might occur, which can limit their social and professional lives.
Why RSD Is Particularly Common in ADHD
The exact cause of RSD is not fully understood, but it’s believed to be linked to the brain’s processing of emotional and social cues in those with ADHD. ADHD-related brain differences, particularly in the prefrontal cortex, contribute to impulsive and emotionally intense responses. Also, people with ADHD often grow up feeling misunderstood or criticised for behaviours stemming from their condition, which may heighten sensitivity to perceived rejection (Barkley, 2014).
Coping Strategies for RSD
- Self-Awareness and Acceptance: Recognising that RSD is a part of the ADHD experience can help reduce self-blame and promote self-compassion.
- Therapeutic Support: Cognitive behavioural therapy (CBT) and dialectical behaviour therapy (DBT) are often helpful for managing intense emotions and improving emotional regulation. Dodson (2020) notes that addressing RSD directly in therapy can help individuals with ADHD develop more resilient responses to rejection. One of the ways this works, is teaching people that while they may not be able to control events, they are able to have some control over how they interpret events, and therefore the resulting emotions.
- Medication: In some cases, ADHD medications, such as stimulants, have been reported to lessen the intensity of emotional reactions in ADHD individuals, though this varies widely from person to person (Arnsten & Rubia, 2012).
Considerations
Rejection Sensitive Dysphoria is an oft overlooked aspect of ADHD that can significantly impact emotional health and social functioning. Increased awareness and support for RSD in ADHD treatment and workplace or educational environments can improve well-being for those affected. And finally, understanding that these reactions stem from neurobiological differences, not personal failings, allows for a more compassionate approach in managing RSD.
References:
- Arnsten, A. F., & Rubia, K. (2012). “Neurobiological circuits regulating attention, cognitive control, motivation, and emotion: Disruptions in neurodevelopmental psychiatric disorders.” Journal of the American Academy of Child & Adolescent Psychiatry.
- Asherson, P., et al. (2019). “Emotional dysregulation in adults with ADHD: A consistent finding across diverse clinical samples.” European Psychiatry.
- Barkley, R. A. (2014). Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. Guilford Press.
- Bunford, N., et al. (2015). “Emotion dysregulation is a primary feature of ADHD.” Journal of Abnormal Child Psychology.
- Dodson, W. (2020). “Emotional dysregulation and ADHD: The overlooked link.” ADHD Report.