Rejection Sensitive Dysphoria: 10 Signs You Might Have RSD and 5 Ways to Manage It
Reading Time: 5 minutesNobody likes being rejected. Whether you’re ghosted by a romantic partner, passed over for a promotion, or left out of a friend get-together, it hurts. However, people with rejection sensitive dysphoria (RSD) experience rejection as intense emotional pain. For them, being rejected is as painful as a physical sensation of being struck or wounded.
Moreover, people with RSD may imagine that others reject them or are disappointed in them, even when that’s not the case. And because they suffer so much when they think they’ve been rejected, they may avoid dating, social interactions, or new activities that have the potential to end in failure.
Key Takeaways
- People with rejection sensitive dysphoria have intense emotional reactions to rejection, criticism, disapproval, or failure.
- RSD appears to be more common in neurodivergent people, due to their differences in brain structure and emotional regulation.
- Rejection sensitivity is similar to RSD but doesn’t usually trigger the same level of emotional pain.
- Medications, therapy, and self-care can be helpful in managing RSD.
What Is Rejection Sensitive Dysphoria?
Rejection Sensitive Dysphoria (RSD) is not listed as an official mental health diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. However, it is a real condition that can affect children, teens, and adults, and cause nearly extreme discomfort and emotional distress.
People with RSD have strong reactions to rejection, criticism, disapproval, failure, or the feeling of having disappointed others. (The word “dysphoria” comes from a Greek word meaning severe emotional pain, dissatisfaction, or discomfort.) Adding to these devastating feelings, people with RSD also feel shame about their extreme reactions. This helps explain why they have a higher risk of anxiety, depression, self-harm, and suicidal thoughts or behaviors.
The Link Between ADHD and RSD
Neurodivergent people—people with attention deficit hyperactivity disorder (ADHD) or autism spectrum disorder (ASD)—are more likely to experience rejection sensitive dysphoria. That’s because the condition seems to be linked to differences in brain structure and emotional regulation. Researchers believe that people with RSD have differences in their brain that make it difficult for them to regulate emotions, especially emotions related to perceived or actual rejection.
Specifically, the frontal lobe of the brain controls our ability to use language, develop social skills, and control our impulses and emotions. And in neurodivergent people, this area of the brain works slightly differently. As a result, they often have difficulty correctly interpreting how their words or behavior impacts others. This can trigger feelings of confusion, betrayal, and failure. And their inability to regulate these emotions makes the intense feelings even more extreme.
Furthermore, neurodivergent children may have trouble socializing with peers, sitting still in class, and obeying parents’ instructions due to their ADHD or ASD. Hence, they experience scolding and disciplining more often than other children, and are more frequently teased, bullied, and rejected by peers. Adults with ADHD also report experiencing higher levels of criticism. Over time, this can create sensitivity to rejection and negative feedback.
The Difference Between Rejection Sensitive Dysphoria and Rejection Sensitivity
Rejection sensitivity is a condition that’s very similar to RSD. It also involves extreme emotional responses to rejection, as well as emotional dysregulation. As with RSD, rejection sensitivity appears to be more common in people with ADHD. Moreover, it’s associated with mental health conditions such as major depression and other mood disorders, social anxiety disorder, borderline personality disorder, and PTSD. In addition, experiencing childhood trauma, including growing up with a highly critical or rejecting caregiver, can lead to rejection sensitivity.
Like people with RSD, people with rejection sensitivity typically feel severe anxiety about being potentially rejected. And they tend to overreact to feelings of rejection with anger or sadness that’s disproportionate to the situation. However, people with rejection sensitivity don’t usually experience the overwhelming emotional pain—the dysphoria—that comes with RSD.
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10 Signs of Rejection Sensitive Dysphoria
Here are 10 common symptoms of rejection sensitive dysphoria:
- Having strong people-pleasing tendencies
- Always expecting rejection—for example, if a boss or romantic partner wants to talk, assuming you’ll be fired or broken up with
- Low self-esteem, extreme self-doubt, and negative self-talk
- Being overcome by sudden outbursts of negative emotions like rage or extreme sadness
- Experiencing emotions as a physical sensation, as though you’ve been punched or wounded
- Difficulty controlling or managing reactions, leading to feelings of shame
- Finding relationships draining, and avoiding intimacy for fear that people won’t like you once they get to know the real you
- Shying away from trying new things or interacting socially due to the fear of disapproval or social rejection
- Trying to be perfect in order to avoid any chances of failing or disappointing others
- Perceiving others’ neutral responses as negative or rejecting
How Is Rejection Sensitive Dysphoria Treated?
Experts recommend a variety of approaches to treat RSD. Medications, including the Alpha-2 receptor agonists used for treating ADHD and stimulant medications like Adderall and Ritalin, can be helpful in enhancing emotional regulation. Monoamine oxidase inhibitors (MAOIs), a category of drugs often used to treat depression, can also reduce sensitivity to rejection.
Furthermore, psychotherapy can be life changing for people with RSD. In therapy, they gain insight into their overwhelming feelings, and learn skills for managing their responses, impulses, and emotions. And they learn social skills, like listening carefully and asking questions, that can help them avoid misinterpreting situations and other people’s responses to them. Moreover, a mental healthcare provider can help them address other mental health conditions that go hand in hand with RSD.
How to Manage Rejection Sensitivity and RSD
Whether you have RSD, rejection sensitivity, or simply a low tolerance for failure and rejection, these tips can help. Practicing these approaches will strengthen your ability to navigate moments of uncertainty and feelings of failure.
Pause before reacting
It takes time and practice, but learning to pause before reacting will help reduce the intensity of your feelings. Take a step back and see if you can reassess what you’re experiencing. Are your perceptions of what’s happening real? Could you ask questions or get more information to help you see a particular interaction or situation more clearly? Is there a coping skill you could use to help regulate your emotions in this moment?
Reduce stress in your everyday life
Anxiety and stress can make rejection sensitivity worse. See if you can find ways to lower your day-to-day stress levels. That might mean making external shifts, like changing your living situation or adjusting your schedule to create more downtime. Or it might mean using healthy coping skills, like physical activity or creative expression, to build your stress resilience.
Be compassionate with yourself
Remember that you are not alone in having feelings of failure or sadness related to rejection. Everyone experiences these feelings at some point, even people who don’t have RSD. When you’re struggling, talk to yourself as you would to a good friend. Remind yourself that no one is perfect, and that what you see as flaws in yourself are part of what make you the unique individual you are.
Regulate your nervous system
For people with RSD, experiences or fears of rejection trigger the nervous system’s stress response—the fight-or-flight reaction. Find ways to turn off the stress response and tap into the relaxation response. Slow, conscious breathing and other mindfulness exercises, like yoga and meditation, have a powerful calming effect on the nervous system.
Embrace your sensitivity
Reframe your RSD or rejection sensitivity as a superpower. You have the ability to feel things deeply and experience profound emotions. Your heightened sensitivity can make you an amazing friend, partner, or colleague. Being sensitive can give you insight into what others are feeling, and therefore strengthen your empathy.
Treatment at Newport Institute for Ages 18–35
At Newport Institute, we guide young adults to build resilience, learn healthy coping skills, and form authentic connections with self and others. Through individual and group therapy, clients uncover and process trauma and rejection from their past, and learn they are not alone in their experiences. We also incorporate a family component to support young adults in strengthening their relationships with the people who matter most to them.
Contact Newport Institute today to learn more about our approach to young adult treatment and our locations around the country.
Frequently Asked Questions
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