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Rejection Sensitivity Dysphoria: The Emotional Rollercoaster of ADHD

Updated: Jan 15


TL;DR: What You Need to Know About Rejection Sensitivity Dysphoria (RSD)

Rejection Sensitivity Dysphoria (RSD) is an intense emotional response to perceived criticism or rejection, commonly experienced by people with ADHD. It can show up as overwhelming sadness, anger, shame, people-pleasing, avoidance, or complete shutdown, even when no rejection was intended. These reactions aren’t “overreactions”; they are linked to differences in emotional regulation and how the ADHD brain processes social feedback. Understanding RSD, and using tools like mindfulness, self-talk therapy strategies, journaling, and strong support systems, can reduce its power and help you reclaim your voice.



Two people holding hands over a table, in a supportive way
Two people holding hands over a table, in a supportive way

Have you ever felt crushed by what seemed like a tiny comment? Maybe a glance that felt cold, a casual remark that sent your thoughts spiraling, or an unread message that left you questioning your worth? Have you ever been told you are way too sensitive? If you’re someone with ADHD, or you love someone who is, these experiences might sound all too familiar. What you’re feeling often goes by the name Rejection Sensitivity Dysphoria (RSD) , a term that captures an intense emotional reaction to perceived rejection or criticism.

This blog explores what RSD is, how it shows up in everyday life, why it feels so hard, and how we can begin to cope with it, all grounded in research where possible and rooted in lived experience.


What Is Rejection Sensitivity Dysphoria?

Rejection Sensitivity Dysphoria (RSD) refers to extreme emotional sensitivity and a deep emotional pain in response to actual or perceived rejection or criticism. The reaction can be disproportionate to the event, and it can feel like more than just “being sensitive.” It can derail your day, your relationships, or your self-esteem entirely.


While RSD is not an official psychiatric diagnosis in the DSM-5, many clinicians and researchers talk about the underlying rejection sensitivity phenomenon as part of emotional dysregulation, a core challenge for many people with ADHD. Emotional dysregulation; difficulty managing or modulating emotional responses, appears in 30–70% of adults with ADHD in research on emotion regulation difficulties. Frontiers

At the neurophysiological level, researchers have found that youth with more pronounced ADHD symptoms show enhanced brain responses to rejection feedback and reduced reactivity to positive social feedback meaning the brain pays more attention to rejection cues and less to acceptance cues. PMC


What Does RSD Feel Like? Symptoms at a Glance

RSD doesn’t look the same for everyone, but some experiences are common:

  • Intense emotional reactions to perceived rejection, sadness, shame, anger, or even numbness

  • Fear of criticism that leads to avoiding social or professional opportunities

  • Low self-esteem and self-doubt triggered by seemingly small cues

  • Social withdrawal or isolation as a protective strategy

  • Mood swings in response to perceived slights


It’s important to note that rejection sensitivity itself is a well-studied psychological trait, and people with ADHD across multiple studies, tend to show greater reactions to social feedback. PubMed


How RSD Interferes With Daily Life

RSD doesn’t stay in one part of life, it can ripple outward:


At Work

Fear of criticism may make it hard to share ideas in meetings, ask for a raise, or take risks - even when you deserve credit or recognition. This can feel like a self-fulfilling cycle of anxiety and withdrawal. This was a huge problem for me, and even though I was very successful in my corporate career, I often worked so much harder on a presentation or meeting notes, due to making sure I had every angle covered in a conversation to avoid any conflict or criticism.


In Relationships

Even well-intended comments from friends, family, or partners can feel threatening. One moment someone jokes, and the next you’re left replaying every word, searching for hidden judgment. This has been especially hard for me, and I have one memory when it took me 2 years to ask my husband to do something for me, as I was so scared he would hate me or would leave me. I remember that once I did ask, it was fine and quickly fixed, making me wonder why I had waited so long.


Social Media Fallout

Scrolling can turn into ruminating:


  • Why didn’t they like my post?

  • Are they ignoring me?

  • Did I say something wrong?


Multiple studies show that social media can amplify ADHD-related emotional dysregulation and anxiety, with problematic use associated with more ADHD symptoms and emotional distress. PubMed


A Personal Story: When I Couldn’t Speak Up

Let me share one moment that crystallizes this all too painfully for me.

There was a time I wanted to speak up and join in a group conversation with some new friends - an idea I was genuinely excited about. But as soon as I started to voice it, my mind froze and at the same time ruminated such terrible negative thoughts.


  • What if I sound silly?

  • What if someone thought less of me?

  • What if my words upset someone?

  • What if they hate me?

  • What if they don't want to be my friend anymore? (Something I have struggled with my entire life..).


So I shut down. I smiled. I said nothing. Inside, I felt like I’d just slammed a door on my own voice.

Later, I replayed every second - agonizing over how I might have been judged. I couldn’t rationalize it at the time. I just knew that pushing my thoughts out felt too risky. This wasn’t simple shyness or insecurity, it was a visceral fear of emotional pain that I couldn’t articulate, let alone confront.

That moment and many like it shaped how I have interacted socially and professionally for most of my life,not because I lacked insight, but because my emotional response was too intense to endure. I struggle still to this day, always worried about what other people think of me, driving up my anxiety, which escalates the emotional response... but thankfully not to the extent I did, since I have learnt some simple coping skills to overcome the crazy thoughts in my mind.



Coping Strategies That Help

While RSD can feel like a storm with no calm in sight, many find relief with practices that build emotional resilience and self-understanding:


Cognitive Behavioral Therapy (CBT)

Helps reframe negative thought patterns and reduce overinterpretation of rejection cues.


Mindfulness Practices

Slow, intentional breathwork and grounding exercises can create emotional distance from the immediate reaction. This has been one of the most transforming practices for me, and breathwork and mindful meditation is my go to anytime I feel rejection bubbling up.


Support Networks

Find your people.. Talking with people who get it can validate your experience and reduce the internal pressure to “perform” socially.


Journaling

I have far too many journals, and have at least 5 on the go at any one time.. (hello ADHD brain!) and I find that I write out what is bothering me, and come back to it at a later date and can then do some reflection on how I handled the situation. Capturing your internal narrative helps you separate perception from reality and track emotional patterns over time.


Professional Guidance

The emotional dysregulation that fuels RSD can be life-changing for some. Always consult a qualified clinician for personalized recommendations.


Final Thoughts

Rejection Sensitivity feels and is real, and whether or not it’s classified as an official diagnosis, its impact on everyday functioning is undeniable for many people with ADHD. Recognizing the patterns, validating your responses, and finding tools that help you navigate emotional sensitivity is a powerful step toward compassion and self-acceptance.


You are not alone. There are strategies, professionals, and communities who understand these experiences, and you deserve to feel supported, heard, and empowered.


By sharing our stories and strategies, we can cultivate a community that empowers individuals with ADHD to embrace their unique experiences and thrive despite the challenges of RSD.



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