Don’t Take It Personally – A Guide to Rejection Sensitive Dysphoria in Children and Adults

upset adhd couple arguing. woman is arguing at man who has rejection sensitive dysphoria

Last Updated on

May 3rd, 2024 11:34 am

Did you know that with Rejection Sensitivity Dysphoria children and adults don’t get an official diagnosis? Yet this form of emotional dysregulation is widely recognised amongst professionals and the wider community as a mental health condition characterized by an extreme reaction and feelings of rejection, negative self-talk and emotional sensitivity.

People with Rejection Sensitive Dysphoria, as it’s also known, often have a fear of rejection and find it difficult to take part in social activities and can experience a great deal of social anxiety and distress when interacting with others.

What is Rejection Sensitive Dysphoria?

Rejection Sensitive Dysphoria (RSD) is an emotional dysregulation condition where a person feels intense emotional responses against them. This can include anger, sadness, hopelessness, and feelings of failure. These intense feelings of emotional pain often lead people with RSD to manifest a social phobia from within, avoiding situations for fear of someone acting against their intentions.

Because the fear of conflict is so great, people with RSD adopt the people pleaser role to minimize the possibility of rejection. Further, it is often comorbid with other mental health disorders, medical conditions, and mood disorders like Bipolar Disorder, Social Anxiety Disorder or Borderline Personality Disorder. But it is often overlooked or misdiagnosed because the symptoms are not as severe.

What Are the Symptoms of Rejection Sensitive Dysphoria?

The core symptoms of Rejection Sensitive Dysphoria in neurodivergent people can vary depending on the person, but often include a fear of actual rejection, feeling inferior to others, and a fear of social interaction. People with RSD may also have difficulty trusting others and may feel that they are not good enough, especially in romantic relationships.

RSD also manifests itself within neurodevelopmental conditions as dysregulation in Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD) where a chemical imbalance in the brain combined with personal trauma solidifies a hypersensitivity to criticism. This is further exacerbated by the autistic struggles to read facial expressions, with such misinterpretations leading to an inner confusion and frustration with the situation.

Further symptoms of rejection sensitivity can be difficult to find. They may include obsessively thinking about negative experiences, or perceiving constructive criticism as negative feedback or social rejection. Individuals with these intense emotions often show depressive symptoms, and have low self-esteem based on how they feel others relate to them and a sense that they’re not liked by others. Social rejection, withdrawal and overwhelming emotional outbursts are also common in those with this condition.

Symptoms of RSD are often brief and triggered by emotional experiences. A trigger is usually a specific event, such as an argument or fight that causes painful memories to resurface, often historic emotional or physical abuse that results in Posttraumatic Stress Disorder (PTSD).

RSD is a complex condition, especially when combined with other disorders such as Attention Deficit Hyperactivity Disorder, Social Anxiety Disorder, or Borderline Personality Disorder, so it can be difficult to identify which symptoms are present.

angry older couple in bed

RSD can take over your love life if communication needs aren’t met

What Causes Rejection Sensitivity?

The cause of RSD in neurodivergent people can be traced back to childhood trauma like abuse, emotional neglect, abandonment, or bullying that occurred during the developmental years leading up to puberty. Rejection Sensitive Dysphoria in children and adults alike may also be triggered by feelings of inadequacy stemming from Body Dysmorphia and self-esteem issues that emerge during adolescence, causing Social Anxiety Disorder later in life.

First, it is important to seek professional help from a therapist or counselor who can offer guidance and support. You can also work on building up your self-esteem and coping skills, which will help you deal with any depressive symptoms or physical pain you may experience. Finally, try to surround yourself with positive people who will make you feel good about yourself.

girl shocked in pink blouse

People with RSD are mislabeled as “easily offended”, when in reality, that’s far from the truth

How Is Rejection Sensitive Dysphoria Diagnosed?

There is no single diagnostic test for RSD. Healthcare providers with clinical experience will likely ask about your symptoms and family history. They may also use a variety of other diagnostic tests and tools with clinical recognition such as the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), or the International Statistical Classification of Diseases and Related Health Problems (ICD-11).

But this is to diagnose other conditions such as Attention Deficit Hyperactivity Disorder, that may encompass elements of RSD within them, not RSD itself.

How Is Rejection Sensitive Dysphoria Treated?

Rejection Sensitive Dysphoria is treated with a combination of therapies such as talk therapy, medication, and self-care. Often, medication for adult ADHD results in fewer symptoms of RSD, since the two are so heavily interwined. Monoamine Oxidase Inhibitors (MAIO) have also been proven to ease emotional regulation issues in people with ADHD.

For others, talking therapy helps with understanding and manage their emotions, while medication that lowers blood pressure can help to regulate moods. Self-care can involve things like exercise and relaxation techniques to relieve depressive symptoms.

Another approach is Cognitive Behavioral Therapy (CBT). This type of therapy helps people to change the way they think and behave. CBT is often a combination of Cognitive Behavioral Therapy and problem-solving skills to cope with difficult situations. It helps people learn how to be their own therapist by teaching them coping skills and changing their behavior.

Exposure therapy is another approach that has been shown to be as effective or more effective than other forms of psychological treatment for people with Rejection Sensitive Dysphoria. Exposure therapy involves gradually exposing yourself to the things that you are afraid of. This allows you to face your fears and learn that they are not as bad as you thought they were.

How Can People With Rejection Sensitive Dysphoria Cope With Their Condition?

There is no one-size-fits-all answer to this question, as the experiences of Rejection Sensitive Dysphoria vary from person to person. However, some tips on how to cope with the condition include:

– Seeking support from friends and family members.

– Joining a support group or online forum.

– Seek out a mental health professional or counselor who can help you manage negative emotions.

– Practising self-care is vital for alleviating symptoms of RSD, especially for anyone with a depressive disorder.

Rejection Sensitive Dysphoria Can Have its Strengths

It’s hard to think, but Rejection Sensitive Dysphoria can be seen as a sign of empathy, despite what facial reactions may show.

The emotional reactions to rejection are beneficial in that, as you’re sensitive to the thoughts of others, you care about not only the world but how others perceive your actions.

This can, with the right support and guidance, bring the very best out of you as you learn to grow and develop over time.

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Rob Butler
30-Something Millennial with ADHD and suspected Autistic and Dyspraxic. Thought leader behind this website. Big visions of a better future for everyone, but forgets where he is half the time.Loves Rugby, his kids, and anything silly. Hates U2 and Marmite.

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