What Is Rejection Sensitive Dysphoria?

Rejection Sensitive Dysphoria (RSD) is a term used to describe an intense emotional response to perceived or actual rejection. For those who experience RSD, even small criticisms or feelings of being excluded can trigger overwhelming emotional pain. This reaction is not merely a heightened sensitivity; it can feel unbearable and disproportionate to the situation at hand.

Key Characteristics of Rejection Sensitive Dysphoria

RSD is not an officially recognized medical diagnosis but is often discussed in the context of conditions like Attention-Deficit/Hyperactivity Disorder (ADHD). People with RSD may experience:

Extreme Emotional Pain: Feeling deep sadness, anger, or humiliation in response to perceived rejection.

Overreaction to Criticism: Struggling to separate constructive feedback from personal attacks.

Avoidance of Situations That May Lead to Rejection: Shying away from opportunities or relationships out of fear of failure or rejection.

Perfectionism or People-Pleasing: Trying to avoid rejection by meeting every expectation or seeking constant approval.

How Is RSD Different from General Sensitivity?

While many people dislike rejection, RSD causes a visceral, intense emotional response that can:

Feel Physical: Many describe the pain as feeling like a punch to the stomach or a blow to the chest.

Be All-Consuming: The emotional impact can dominate a person’s thoughts for hours or days.

Trigger Secondary Issues: RSD often leads to self-doubt, shame, or withdrawal from social interactions.

What Causes Rejection Sensitive Dysphoria?

The exact cause of RSD isn’t fully understood, but it’s commonly associated with:

ADHD: Individuals with ADHD are more likely to report experiencing RSD. Differences in brain wiring may make emotional regulation and sensitivity to feedback more challenging.

Early Experiences: Childhood experiences of rejection or criticism can contribute to heightened sensitivity in adulthood.

Genetics: There may be a hereditary component, as emotional hypersensitivity can run in families.

How Does RSD Affect Daily Life?

Living with RSD can be incredibly challenging. It can:

Impact relationships: People with RSD may misinterpret neutral interactions as rejection, leading to conflict or withdrawal.

Hinder career growth: Fear of criticism or failure may prevent individuals from pursuing new opportunities or sharing ideas.

Reduce quality of life: The emotional toll of RSD can contribute to anxiety, depression, or feelings of isolation.

Coping Strategies for Rejection Sensitive Dysphoria

If you experience RSD, there are ways to manage its impact:

1. Recognize and Name the Feeling

Understanding that you’re experiencing RSD can help you pause and reflect before reacting. Remind yourself that the intensity of your feelings may not match the reality of the situation.

2. Challenge Negative Thoughts

Work on identifying and reframing thoughts like "They don’t like me" or "I’m a failure." Ask yourself if there’s evidence to support these beliefs or if they stem from fear.

3. Practice Self-Compassion

Be kind to yourself when you’re feeling rejected. Acknowledge your pain without judgment and remind yourself that rejection is a natural part of life.

4. Seek Professional Support

Therapy can help you develop tools to manage RSD. Cognitive Behavioral Therapy (CBT) and mindfulness techniques are particularly effective in improving emotional regulation and self-awareness.

5. Consider ADHD Treatment

If you have ADHD, managing symptoms with therapy or medication may help reduce the intensity of RSD episodes.

Rejection Sensitive Dysphoria can feel isolating and overwhelming, but it’s important to remember that you’re not alone. By understanding RSD and seeking support, you can learn to manage its effects and build a more fulfilling, resilient life. If you suspect you’re struggling with RSD, consider reaching out to a mental health professional to explore strategies tailored to your needs.


Julie Kolzet, Ph.D.