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  • Jo Richardson Au

Rejection Sensitivity Dysphoria



No one likes rejection, right? It can cause discomfort, embarrassment, hurt feelings, humiliation, anger, anxiety and depression; why would anyone like it?


But, for most of the population, rejection is a part of life and although they may experience hurt feelings at being rejected, it is not to an almost phobic and emotionally debilitating level. It’s something that stings at the time, but is relatively easy to get over.


Meet RSD; Rejection Sensitivity Dysphoria; an emotional condition that is part of Attention Deficit Hyperactivity Disorder. Not every person with ADHD will experience RSD to a heart crushing extent, but for those of us that do; here’s what living with this level of RSD is like.


The risk of being rejected is not exclusive to romantic situations. It happens in friendships, work relationships and situations, family interactions, and many more. RSD can affect all of these dramatically.


Imagine that you are so paralysed by fear of being rejected that when faced with the possibility of it happening, you could become mute, immobile, enter a fawning state where you are people pleasing or acting how you think the other person wants you to act in order for them not to reject you, avoid the person or situation entirely, or exhibit a physical reaction such as excessive sweating, nausea, shaking, headache, or a stomach upset.That the thought of making yourself emotionally vulnerable to someone is akin to entering a gun fight with a pencil.




Risking rejection is like facing your deepest fears and it doesn’t stop once the interaction has ended; even if it has ended on a positive note.


We often become plagued with a constant and relentless anxiety that tells us that you are going to suddenly realise that we aren’t good enough, that you are going to reject or abandon us, that we are wrong and that the pain of rejection is on its way.


It becomes a constant companion that can affect your emotions and physical state to a crisis point. In my personal experience, my brain tells me that, even if the other person hasn’t rejected me or it has ended very positively, that they will change their mind and that it’s only a matter of time before they see me for the screwed up and broken person that I see myself as.


It is only when we have built a strong, stable and trusting relationship that these fears diminish to a degree. But that doesn’t mean that they are gone and; especially in times of stress and uncertainty, those fears can rise up like a tsunami; ready to wash us away.

Researchers have theorised that RSD is caused by how our ADHD brains are wired, stating that because it is known that those with ADHD tend to feel things very deeply and often miss social cues, we can misinterpret criticism and rejection when there is none and, when we are rejected or criticised, we feel it exceptionally deeply and it can cause lasting mental damage.


In my opinion; and from a personal perspective, I think it has more to do with our self confidence and that, those who have RSD to a more intense degree, have suffered trauma through numerous rejections or criticisms in the past and now the mere thought of putting ourselves in a position where we could experience that trauma of being rejected again is utterly abhorrent.


When we are rejected, the pain is very real. It reinforces our worst fears about ourselves being unworthy and it can cause not only a deep depression, but actual physical pain. Often it is this level of pain that makes the prospect of making yourself vulnerable to potential rejection all the more crippling.




It’s not only rejection that RSD is connected to, even though the name only focuses on rejection. Criticism is also a huge trigger for us as, again, it reinforces the idea that we are not good enough or are unworthy.

If all of this wasn’t enough to be dealing with, RSD is also affected by ‘perceived’ rejection or criticism. We can project our fears onto the other person in the situation and see rejection and criticism that isn’t actually there, but our RSD is triggered and it can send us reeling back down the anxiety spiral.

Looking at the long-term effects of having RSD, it can make you steer clear of situations where you may have to make yourself vulnerable to either rejection or criticism; avoiding relationships and friendships because the pain you could experience is too much of a risk to take. Not taking opportunities or any risks.

There are ways that you can lessen or move through RSD when it occurs.

Talking through your anxiety or fears with a close friend, family member or therapist can help to untangle the perceived rejection from the reality of the situation. It can also help you process your own feelings about what has happened and can help to steer you through it until the RSD flare up has passed.




Talking honestly with the person that you feel has either rejected or criticised you can be incredibly helpful when dealing with RSD. It can help to see both sides and it will dispel any perceived rejection that you may have been experiencing. It also helps to understand why you are being rejected or criticised, as it is often not for the reasons that your brain is telling you.


Cognitive Behavioural Therapy is believed to help as it can help you to deal with past trauma (that could be a cause of the intensity of your RSD), how to resolve conflict, how to manage your emotions and stress during situations, and how to communicate when your feelings are hurt.


Finding a way to keep your day to day stress levels down will also help, such as through meditation, mindfulness, exercise, or any other activity that you find relaxing.


There are medications that can be used to help when you are experiencing a bad RSD flare up, such as antidepressants for any depression that you may be experiencing, but trying to build up your emotional resilience and self-esteem is a far better long-term strategy to dealing with RSD.



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