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Understanding Rejection Sensitive Dysphoria (RSD)

Rejection Sensitive Dysphoria (RSD) is a symptom of ADHD that can be difficult to understand and manage. Despite not being a formal diagnosis, RSD is one of the most common and disruptive manifestations of emotional disregulation. It affects those with ADHD in different ways and leads to people-pleasing behaviors, anticipatory fear of embarrassment or judgment, overachieving as a coping mechanism, painful emotional reactions to criticism or rejection, and difficulty regulating emotions.

In this blog post, we'll discuss what RSD is, how it manifests itself, and treatment options for those who suffer from it.

What is Rejection Sensitive Dysphoria?

Rejection Sensitive Dysphoria (RSD) is an intense emotional reaction that occurs when someone with ADHD experiences rejection or criticism—which can range from feeling slighted by family members to failing a test at school. People with RSD may experience feelings of profound sadness, anger, anxiety, and humiliation in response to these situations. These feelings are often far more intense than the situation warrants because they are directly linked to the person's emotions rather than the actual event. [insert CBT somewhere here?]

Who Does RSD Affect?

People with ADHD are more likely to suffer from RSD than those without it. This is because people with ADHD have difficulty managing their emotions which can make certain situations feel overwhelming or out of control.

Additionally, people with ADHD may be more prone to perfectionism due to their desire for approval and acceptance from others. This heightened sensitivity can lead to increased levels of stress when faced with rejection or criticism.

How Does RSD Manifest Itself?

People who suffer from RSD will often exhibit several common behaviors such as...

  1. People-pleasing behaviors in an effort to avoid criticism or rejection

  2. Anticipatory fear of embarrassing themselves or being judged

  3. Overachieving as a way of coping

  4. Painful emotional reactions when criticized

  5. and difficulty regulating these extreme emotions afterward.

These behaviors can have long-term effects on relationships as well as academic/career performance if left unchecked.

Treatment Options for RSD

Fortunately, there are various treatments available for those who suffer from RSD. Medications such as clonidine and guanfacine have been found to help reduce anxiety levels associated with RSD by targeting the underlying neurological responses that cause it.

Psychotherapy can also be helpful in managing symptoms by teaching people how to cope with episodes of intense emotion through relaxation techniques, cognitive therapy, and mindfulness practices.

Additionally, engaging in new interests or hobbies can help distract from episodes associated with RSD and give an outlet for creative expression.

Understanding the Cause of RSD

Rejection Sensitive Dysphoria is a complex condition that affects many people living with ADHD. It’s important to understand the root cause so that you can better manage your symptoms and develop strategies for overcoming them.

With proper treatment options such as medication, psychotherapy, mindfulness practices, creative outlets, and other coping mechanisms, those suffering from Rejection Sensitive Dysphoria have hope for finding relief from their symptoms. By learning more about this condition, we can help create awareness among those affected by it, so they feel supported in finding ways to manage it successfully.


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