Rejection Sensitive Dysphoria (RSD) in Attention Deficit Hyperactivity Disorder (ADHD) is widely discussed online. But separating pop psychology from a scientific understanding can be challenging. The truth is: RSD isn’t just a buzzword—it’s a well-documented trait associated with ADHD. While RSD is not a formal clinical diagnosis, it is a real and significant aspect of ADHD that affects emotional regulation and self-esteem.
Most of what is written about RSD online doesn’t go far enough to explain the science. So let’s untangle the wires connecting ADHD and an intense fear of rejection.
What is Rejection Sensitive Dysphoria?
RSD is triggered by the anticipation of rejection—even when it’s unlikely. To avoid that pain, people with ADHD often develop avoidance behaviors. The problem? Avoidance offers short-term relief but deepens the fear over time, making RSD more intense.
RSD also makes actual rejection unusually painful. Unlike typical rejection, RSD burns. That’s why it’s called “dysphoria,” a Greek word meaning unbearable. In response to this pain, people with ADHD have big reactions. This intense emotional response affects many areas of life, especially relationships. For example, RSD can cause spouses to lie—not out of deceit, but out of fear of criticism. It can fuel perfectionism, leading to late nights at work just to maintain the illusion of flawlessness.
The ADHD Brain and RSD
Why do ADHD brains experience rejection (and everything else) so intensely?
A recent study on ADHD youth supports the fact that the prefrontal cortex and the amygdala (the feeling part of the brain) have a atypical connection in ADHD people. As a result, the ADHD brain experiences emotions more intensely and then struggles to process those emotions.
Many scholars argue that RSD is so common, it should be in the diagnosis for ADHD. Alas, it remains absent because it’s hard to measure emotions in a controlled study.
But even if ADHD people have big emotions, why do they also have bigger reactions to rejection? Meaning, even if someone feels fear, why do they also text their girlfriend 100 times to make sure they didn’t upset her with their joke over dinner?
Why It’s Hard to “Stop and Think” Before Reacting
Emotional Dysregulation
At its core, RSD is caused in part by emotional regulation. In an ADHD brain, executive functions—such as planning ahead, working memory, and filtering out distractions—function differently than in a neurotypical brain. Emotional regulation is also an executive function, which means that people with ADHD not only experience emotions intensely, they also struggle to regulate them. Big feelings trigger big reactions.
In addition to emotional regulation, the ADHD brain struggles with impulse control, leading to quick and intense action (ie avoidance or overreaction). This impulsivity can strain relationships—you might cancel an interview, snap at your kids, or quit a job on a whim.
Experience Changes the Brain
Through a process called neuroplasticity, all brains change based on their experiences. It just so happens that having ADHD gives you some…umm…interesting experiences.
Kids with ADHD are criticized more because of the differences ADHD creates between them and a world built for neurotypical people. Being criticized frequently can cause ADHD kids to feel dismissed and invisible. Over time, the imprint of those experiences makes them hyper aware of others’ actions. Kids with ADHD learn to scan a room for judgement: “where is the next criticism coming from and how can I avoid it at all costs?”
RSD is Real
RSD isn’t just ordinary sensitivity to rejection, it’s a real, brain-based condition. Its impact on relationships and self-
confidence can be significant. Fortunately, holistic ADHD treatment that addresses RSD can lead to greater success in both relationships and life.
Key Takeaways
- RSD is neurological and based on the experience of having ADHD
- ADHD people struggle to regulate big emotions
- Impulses to act on big emotions occur without thinking and can impact relationships
- ADHD treatment can help minimize the impact of RSD on your life
Begin Adult ADHD Treatment in Columbus, Ohio
Looking for more individualized support? You don’t have to feel a constant fear of rejection. ADHD-focused therapy can help you manage fear and build confidence in your relationships. Our counseling practice in Columbus, Ohio has caring therapists who specialize in ADHD testing and ADHD treatment. To start your counseling journey with Focused Mind ADHD Counseling, follow these simple steps:
- Fill out the contact form to schedule a free 15-minute phone
- Meet with one of our caring therapists.
- Stop feeling an intense fear of criticism. Start finding your confidence and calm.
Other ADHD Services Offered at Focused Mind ADHD Counseling
Adult ADHD treatment is not the only service we offer at our Columbus, OH counseling practice. At
Focused Mind ADHD Counseling, we offer a variety of mental health services, including ADHD
testing. As an adult with ADHD, we know you may also benefit from anxiety treatment for ADHD,
counseling for men with ADHD, couples therapy for ADHD, or depression counseling for ADHD. You
can also view our blog for more resources and helpful info.
