Dec 12, 2024
Rejection hurts. Science has shown that social rejection—perceived or real—lights up pain receptors in the brain, meaning that rejection actually hurts. But while most people will experience social rejection and feel the uncomfortable hum of pain, some find it excruciating.
Rejection Sensitive Dysphoria (RSD) is a set of symptoms causing severe emotional pain in response to perceived or real social rejection, criticism, or failure. It impacts many people with ADHD and Autism but can be found on its own as well.
This article will go over what RSD is and how to cope with it.
What is Rejection Sensitive Dysphoria?
Rejection Sensitive Dysphoria is not recognized in the DSM (the diagnostic handbook for therapists and psychiatrists), so it cannot be officially diagnosed. People with RSD experience extreme emotional reactions to perceived or real social rejection. On the outside, they may look overly sensitive, socially anxious, or like a perfectionist.
In truth, people with RSD are struggling with an emotional and mental health problem that is still being explored and researched. Here’s what we know about it.
Rejection Sensitive Dysphoria Symptoms
Although there is no set list of Rejection Sensitive Dysphoria symptoms, most people experience these signs.
When confronted with perceived or real social rejection, people with RSD will experience:
- Intense emotional responses
- Physical pain, often described as a sharp stabbing pain in their chest or gut
- Obsessive rumination after a rejection
It’s worth noting that “rejection” can mean a lot of different things, including criticism, dislike, annoyance, failure, dismissal, or being ignored, just to name a few.
RSD is not contained in these moments of social rejection or criticism. Research has shown that people with RSD will behave in ways that seek to minimize the amount of negative feedback they get from peers, often resulting in behaviors such as:
- Fear of Rejection: There can be a persistent fear of rejection that affects various aspects of life, causing significant distress and impacting relationships, work, and social interactions.
- Sensitivity to Criticism: Individuals may have an extreme sensitivity to criticism, leading to feelings of worthlessness, shame, or the need to constantly seek reassurance.
- Rapid Emotional Shifts: Mood swings and rapid emotional shifts in response to perceived rejection or failure can be prevalent, leading to a rollercoaster of emotions.
- Negative Self-Image: There may be a consistent negative self-image, with individuals internalizing perceived rejection and criticism, which can erode self-esteem and confidence.
Remember that RSD affects a wide range of people and you may experience these symptoms differently.
Rejection Sensitive Dysphoria and ADHD
RSD has a very strong connection to ADHD, with some professionals saying RSD is a symptom of ADHD. It’s not known exactly why having ADHD increases your risk for RSD, but one theory is that the central nervous system has a significant role in both. Also, people with ADHD may find themselves outside the norm of social interactions more often than not, increasing their risk of encountering social rejection and developing a more extreme reaction to it.
Is it RSD or Social Anxiety?
Social anxiety and Rejection Sensitive Dysphoria share a lot of similarities, but they differ in one key aspect: Social anxiety has a comfort zone, whereas RSD does not. With social anxiety, there will be some situations in which you are more anxious than others, and anxiety-provoking situations can be helped by bringing a trusted friend or family member with you.
RSD is different in that all rejection is painful, and rejection by a trusted or loved peer is even more so. Also, it is not the social aspect that is frightening but the rejection part.
Treatment for Rejection Sensitive Dysphoria
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For many people, treatment for RSD involves seeking an ADHD diagnosis and subsequent treatment. If ADHD is the root cause of your RSD, this is the best way to treat the symptoms. (Learn about treatments for ADHD here.)
Counseling, or talk therapy, is a primary treatment for both RSD and ADHD. A therapist can help you develop coping skills, address negative thought patterns, and stop harmful behaviors.
Medication is also a possibility for people with severe RSD or RSD with ADHD. Stimulants or antianxiety medications could be a possibility for you. Talk to a therapist about being referred to a psychiatrist for medication management.
Finally, there are a number of coping skills you can learn to mitigate the worst of RSD. Often, these skills will help develop emotional regulation through exposure therapy: getting you used to rejection while managing your emotions. Over time, your brain will learn that rejection is not the painful thing it thought it was.
Coping skills for RSD include:
- Self-Compassion: Practice being kind and understanding towards yourself, recognizing that everyone experiences rejection at some point. Treat yourself with the same compassion you would offer a friend in a similar situation.
- Mindfulness Techniques: Engage in mindfulness practices such as deep breathing, body scans, or meditation to help stay present in the moment and prevent intense emotional reactions to perceived rejection.
- Positive Self-Talk: Challenge negative self-beliefs and practice positive affirmations. Remind yourself of your strengths, accomplishments, and worth, even in the face of perceived rejection.
- Setting Boundaries: Establish clear boundaries in your relationships to protect your emotional well-being. Communicate your needs assertively and learn when it's okay to say no to requests that may trigger feelings of rejection.
- Seek Support: Reach out to trusted friends, family members, or a therapist for support and guidance. Sharing your feelings with someone who listens without judgment can help alleviate the intensity of rejection sensitivity.
- Engage in Activities You Enjoy: Participate in activities that bring you joy, whether it's a hobby, exercise, nature walks, or creative outlets. Engaging in positive experiences can boost your mood and self-esteem.
- Practice Emotional Regulation: Learn techniques for managing overwhelming emotions, such as journaling, grounding exercises, or progressive muscle relaxation, to calm your mind and body during moments of heightened sensitivity.
Coping skills are tools to help you navigate challenging moments with resilience and self-compassion. Each small step you take towards self-care and emotional well-being is a valuable investment in your journey towards living your brightest life. Reach out for support, explore coping strategies, and remember that healing and growth are within your reach.
If you would like to seek therapy for Rejection Sensitive Dysphoria, contact Lifebulb Counseling & Therapy. We have online therapists located near you and little to no wait times. We also accept most major insurances. Contact our team to be scheduled with a therapist near you, or browse our therapist directory to find someone that fits your needs.
