Rejection Sensitive Dysphoria

For people with ADHD, this term means a lot. It provides an explanation for the many times they’ve found themselves reacting to any form of rejection, big or small with an immense amount of emotional pain and turmoil. 

For people without ADHD, this may be one of those symptoms that is lesser known or they didn’t know it had a name and research attached to it. Yet 99% of people with ADHD have it.

Currently, the majority of my clients are female and each and every one of them experience this symptom quite intensely. Sentences like “constantly longing for approval” or “wanting to please everyone so they like me” are not uncommon. 

Rejection Sensitive Dysphoria (RSD) is when someone feels extreme emotional pain from rejection, criticism, or even the possibility of disappointing others. It’s not just being a little upset—it can feel overwhelming, like a deep, intense sadness, embarrassment, or even anger.

People with ADHD often experience RSD because their brains are wired to be extra sensitive to feedback. Even small things, like a friend canceling plans or a boss giving constructive criticism (I wrote a blog about performance reviews for people with ADHD here), can feel like a huge personal failure. This isn’t because they’re overreacting, it’s just how their nervous system processes emotions.

RSD can make ADHDers avoid situations where they might be judged, push themselves too hard to be "perfect," or react strongly to perceived rejection. The key word being “perceived” as they pick apart the detail of said rejection in the tone, the body language or the eye contact. It all plays a part in them believing you are not happy with them.

But the good news is, once you understand it, you can develop strategies to manage it like self-compassion, therapy, coaching or even some ADHD medications that help regulate emotions.