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Rejection Sensitive Dysphoria: A Tell-All Guide

Do you have ADHD? Have you heard about rejection-sensitive dysphoria? Characterized by a strong emotional response and a fear of certain situations, rejection sensitive dysphoria is a symptom of mental illness that is strongly associated with attention deficit hypersensitivity disorder.

So, in this article, we’ll cover all you need to know about rejection sensitivity, and how it may affect your day-to-day life!

What is RSD or Rejection Sensitive Dysphoria

If you’ve been diagnosed with attention-deficit hyperactivity disorder ADHD, then you’ve probably experienced episodes of rejection sensitive dysphoria. Well, rejection-sensitive dysphoria is a form of mental illness, where a person may experience severe emotional sensitivity and emotional pain.

Generally, this means that people with ADHD will perceive a situation negatively, when in reality the situation may not aim to cause them emotional pain. Let’s look at an example; if a person with rejection-sensitive dysphoria was to receive a delayed “text message response” from a person they are fond of, then that person with RSD may experience symptoms such as anxiety and low-self esteem.

Rejection Definition

By definition, rejection denotes to the action where a person’s ideas, concepts, behavior, etc may be refused or dismissed for a given reason. Generally, rejection can come in the form of social rejection or emotional rejection. This may result in a person developing severe anxiety in a specific situation, loss of self-esteem, and a feeling of hopelessness.

Dysphoria Definition

In general, the term dysphoria comes from the Greek word, dysphoros, which translates to hard to bear. Therefore, dysphoria simply can be defined as a feeling or state of mind that’s hard to bear, or uneasy.

Rejection Sensitivity and Relationships

In 1996, a study discovered that rejection sensitivity can play a major role when it comes to peoples intimate relationship. The study discovered that people with rejection sensitivity experience:

  • insecurity in their intimate relationships
  • satisfaction problems

For example, do you know a person who may be quite emotionally dependent on their partner? Or a person who fears that their partner may leave them? These are all examples of a rejection sensitive person as they have a fear of their partner leaving them.

Now, do you know of a person who seems unhappy in their relationship? Perhaps it’s not their partner’s fault, but rather how the rejection sensitive individual perceives their relationship to be. This example demonstrates that rejection sensitive individuals may experience general dissatisfaction and unhappiness in their intimate relationships.

Rejection Sensitivity and Relationships—It Affects Men and Women Differently!

Men with rejection sensitivity generally tend to be very controlling of their intimate relationships. Men with rejection sensitivity may get more or easily jealous of situations that may compromise their relationship with their partner. It’s been suggested that mean who demonstrate reactive, controlling, and jealous behaviors are at risk of potentially emotionally abusing their partners.

In contrast, women with rejection sensitivity may behave quite differently from men, when in an intimate relationship. In general, women tend to remain a lot more hostile and negative when in a relationship. For example, a woman who feels as though she is not receiving sufficient attention may tend to verbally abuse her partner, or deny them sexual satisfaction.


Attention Deficit Hyperactivity Disorder aka ADHD is defined as the mental and brain disorder that affects a persons brain activity. ADHD is most commonly associated with:

  • Inattention
  • Hyperactivity
  • Impulsivity

Generally, adult ADHD may present itself a lot differently, than a child with ADHD. For example, children with ADHD may experience increased hyperactivity and an inability to focus. Whereas, an adult may experience more rejection sensitivity and hyperactivity-impulsivity.

ADHD is a form of brain development disorder. This is because people with ADHD generally tend to have a less developed caudate nucleus, putamen, nucleus accumbens, pallidum, thalamus, amygdala, and the hippocampus.  Now if we look at each of these parts of the brain, we would be able to see, how they contribute to our emotions, thoughts, and day-to-day lives.

For example, the amygdala is the part of the brain that is responsible for functions such as memory, emotions, and decision making. An adult with ADHD would then have a much smaller amygdala, thus resulting in their inability to focus, and their rejection sensitivity.

Is Rejection Sensitive Dysphoria the Same As Social Phobia?

Social Phobia is also more commonly known as social anxiety disorder. Social Phobia refers to the idea that people may have a fear of either being placed in a social situation or a fear of being the center of attention.

This form of mental illness generally denotes to the idea that a person may experience overwhelming feelings, anxiety, increased heart rate, and muscle tension as a result of being placed in a social situation. As such, a person with social anxiety disorder may develop symptoms similar to rejection sensitivity. This includes depressive thoughts, low self-esteem, and sensitivity to criticism.

When we look at rejection sensitive people, then there’s no doubt that both mental illnesses look the same! However, the causes of social phobia are generally associated with genetics, past social and cultural experiences. Similarly, the causes of ADHD are often associated with underdevelopment of the brain. Rejection sensitivity is similar in the sense that it becomes one of the underlying symptoms of both social phobia and ADHD

Is Hysteroid Dysphoria a Type of Rejection Sensitivity?

According to the American Journal of Psychiatry, hysteroid dysphoria is a form of chronic mental illness that causes a person to experience episodes of depression as a result of a specific type of stress. As opposed to it being a specific type of rejection sensitivity, hysteroid dysphoria is a subtype of atypical depression that includes rejection sensitivity as a symptom.

RSD Symptoms

Understanding the symptoms of rejection-sensitive dysphoria can be quite complex. This is because RSD is actually a type of symptom for patients with ADHD. However, in general, a person with ADHD and rejection sensitivity may experience the following symptoms:

  • setting high standards for oneself
  • strong emotional reaction
  • Shyness
  • depression or depression thoughts
  • fear of failure
  • rage towards the situation or person that causes them discomfort
  • loss of self-esteem
  • seeking for self-approval from family, friends, and/or partners
  • A feeling of hopelessness
  • The person may criticize themselves a lot

How To Treat RSD or Rejection Sensitive Dysphoria

Because rejection-sensitive dysphoria is associated with ADHD, your mental health professional may consider treating the ADHD first. Originally, the conventional method of treatment for rejection sensitivity was psychotherapy. Over time this treatment has shown some efficacy.  Today, however, your mental health professional may also recommend medications such as a combination of alpha agonists guanfacine and clonidine—or, monoamine oxidase inhibitors (MAOIs).

 4 Facts About Rejection Sensitive Dysphoria

  1. Rejection sensitivity is a difficult concept to understand. Some forms of rejection sensitivity suggest that people may feel their emotions (depression, fear, etc) prior to the stressful situation occurring. As a result, they may find or perceive the situation in a negative manner.
  2. ADHD is often misdiagnosed as either bipolar disorder or Asperger’s syndrome.
  3. Over the last few years, there’s been a lot of debate suggesting that people with ADHD are more at risk of developing mental illnesses such as Alzheimer’s disease. However, this is still a topic that’s currently being studied.
  4. Cognitive-behavioral therapy has become one of the common treatment for people suffering from ADHD. Cognitive-behavioral therapy is a type of therapy that focuses on thoughts, behaviors, and emotions.

Rejection Sensitive Dysphoria and You

Rejection sensitive dysphoria is a symptom that is most commonly associated with ADHD in adults and children. This form of mental illness often presents as intensive emotional feelings, fears, and outbursts of depression as a result of potential underdevelopment. While there is no cure, rejection sensitivity and ADHD can be controlled through treatment with medication.







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