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Fear of Rejection? Dealing with Rejection Sensitive Dysphoria & ADHD

Written by Klarity Editorial Team

Published: Mar 2, 2022

Medically Reviewed by Dr. Zoe Russell

Table of contents

It’s no secret—no one enjoys rejection. However, it’s no secret that it’s often a part of life. Some people are able to process it as a learning experience and move on, but for those with ADHD, it’s often not that simple. This neurotype often exhibits fear of rejection that’s so strong it completely takes over how they act—including avoiding certain situations or being unable to navigate conflict. This can have a serious impact on a person’s life and can prevent them from realizing their potential.

This fear of rejection is known as rejection sensitive dysphoria (RSD). The guide below defines what RSD is, who is most likely to experience it, and provides information for how to manage it more effectively. With this information, you can learn to work through moments of intense rejection sensitivity and experience less daily stress and anxiety.

If you’re ready to confront your RSD and reduce its impact on your daily life, Klarity can help. We’ll connect you with a licensed mental healthcare professional who will help you work toward managing your RSD symptoms and enhancing your overall well-being. You don’t even have to leave the comfort of home—just schedule your appointment and log in to the portal at the appropriate time.

Schedule an appointment today to get started.

Noticing symptoms and suspect you have a mental health condition? Find fast, affordable care from a provider on Klarity today.

What Is Rejection Sensitive Dysphoria?

Rejection Sensitive Dysphoria is defined as a person’s severe emotional sensitivity to perceived rejection or criticism. These feelings can also be triggered by a sense of personal failure, and the perception that a person hasn’t lived up to their own unrealistically high expectations. In most cases, no actual rejection or serious failure has occurred, but a person’s reaction will nevertheless be extreme.

What Are the Signs of RSD?

Not everyone will experience Rejection Sensitive Dysphoria in the same way, but there are a few key characteristics that can help an individual identify the condition.

Low Self-Esteem

When someone is in constant fear of rejection, it can have a significant impact on their self-esteem and how they approach every day. Individuals with Rejection Sensitive Dysphoria might always think the worst of themselves because they feel like they’ll always fail. This persistent lack of self-esteem can be extremely intrusive, and cause a person to miss out on many attainable goals in life.

Avoids Social Situations

Social interaction plays a significant role in Rejection Sensitive Dysphoria, as individuals with the condition will often be extremely concerned about how they are perceived by others. In many cases, a person may avoid social interaction altogether for fear that they may be publicly or privately criticized. While this may accomplish the goal of avoiding rejection, it also prevents a person from overcoming their fear and they come to believe that isolation is the only solution.

Sets Unrealistic Standards

One of the primary sources for the fear associated with Rejection Sensitive Dysphoria is the unreasonably high standard that an individual has set for themselves. While these standards can vary for everyone, they are often above and beyond expectations that other people might have and that are realistic. When these standards aren’t met, a person will often feel great shame in their perceived failure. Instead of reevaluating their standards, they will often self-criticize to the point of inability to achieve even less.

Easily Embarrassed

The emotional sensitivity found in those with RSD can also cause people to become disproportionately embarrassed very easily. Whether a person is being lightly teased, or they’ve done something slightly clumsy in public, it can feel like a catastrophe. In most situations the person has no reason to be so embarrassed, and other people likely didn’t notice what happened at all.

Irrational Anger

While some people with Rejection Sensitive Dysphoria will react to situations with great sadness or embarrassment, there are others that may respond with unreasonable anger. This anger can be expressed both outwardly and inwardly depending on the situation, with some people deeply chastising themselves for a perceived failure. It’s normal for someone to be their harshest critic, but RSD can make that judgment unfair and unnecessary.

Anger stemming from frustration can also be a symptom of ADHD, so the two conditions together create a perfect storm that impacts every part of life.

Seeks Approval

Rejection Sensitive Dysphoria can make every task or social interaction feel like a desperate quest for validation, with even the slightest shortcoming being seen as a tremendous defeat. When an individual with RSD doesn’t get what they believe is the necessary amount of approval from a peer, they may also continue to pursue that approval in a way that is intrusive to both their own life and the lives of others. Not only can this ultimately lead to several unhealthy relationships, it takes away any chance for personal growth and independence.

What Does Rejection Sensitive Dysphoria Feel Like?

Rejection Sensitive Dysphoria can manifest itself in many unique ways, but one of the primary characteristics is a persistent feeling of anxiety. When a person is particularly worried about rejection or failure, they may experience shortness of breath, increased heart rate, and intense feelings of dread. This persistent stress can also make an individual feel regularly fatigued, or like they are physically sore due to general muscle tension.

How Does Rejection Sensitive Dysphoria Affect Daily Life?

The symptoms of RSD can find their way into nearly every aspect of daily life. The fear of social rejection or embarrassment can make maintaining regular relationships very difficult, and it can also affect a person’s connection to work. An individual may decline a job offer, for example, because they feel as if they aren’t deserving or that they will not be able to meet their own perceived standards. A person suffering from RSD may also fear judgment from new superiors or colleagues.

Individuals with Rejection Sensitive Dysphoria may also experience intrusive thoughts that influence a sort of self-fulfilling prophecy. If a person spends so much time worrying about the negative outcome of a situation, then it will be bound to happen because they never took the time to consider how something could turn out differently.

Rejection Sensitive Dysphoria and ADHD

ADHD is characterized by a number of symptoms, one of them being extreme sensitivity to what other people say or think about them. This can turn into Rejection Sensitive Dysphoria in some cases, as those with ADHD can’t avoid becoming distracted from the bigger picture and place too much focus on failure. RSD can be difficult to manage alongside ADHD, as the disorder already puts a strain on a person’s ability to focus on what’s most important. 

Many of the common ADHD symptoms can dovetail with Rejection Sensitive Dysphoria, which makes each condition more difficult to cope with. For example, many people with ADHD struggle with procrastination. RSD can amplify procrastination, as the ADHD sufferer may find themselves stalled with the need for self-imposed perfectionism. If they can’t achieve perfection, they can’t avoid a possible rejection, so they don’t do anything at all.

Causes of Rejection Sensitive Dysphoria

The source of Rejection Sensitive Dysphoria isn’t always clear, but some doctors believe that genetics may be responsible for the condition. When it comes to ADHD, the disorder makes the nervous system much more sensitive to outward stimuli, making it difficult for a person to balance their emotional reaction to perceived rejection or failure. 

RSD can also be made worse by trauma—a person may pathologically focus on a specific event or slight failure which causes them to be afraid to try something new.

One of ADHD’s common symptoms is the prevalence of intrusive thoughts. RSD creates more intrusive thoughts that keep a person from fully concentrating and fully participating in work or life.

How Do I Get Over RSD?

Rejection Sensitive Dysphoria may seem like an insurmountable beast, but there are ways that an individual can get over their constant fear of rejection. While attempting to overcome RSD may turn out to be its own source of anxiety, putting in the proper work is the only way to live a life free from fear and trepidation.

How to Cope with Rejection Sensitive Dysphoria

Understand and Accept What You Do Well

When it comes to Rejection Sensitive Dysphoria, it can be very easy to get caught up in personal failures and shortcomings. One of the best ways to combat this is to build an understanding of what you regularly do well so that you have a point of reference for personal success. It may seem like a small adjustment, but focusing on the positives in life can make for a massive change in perspective.

Build Healthy Relationships

In order to enjoy a healthy, successful relationship, both partners need to be on equal footing. If one suffers from Rejection Sensitive Dysphoria  it creates an imbalance, with the other partner often having to constantly reassure and mediate. Add other symptoms of ADHD and keeping a relationship alive is an extreme challenge. 

The effects of RSD can be mitigated by paying attention to the basics of a relationship: taking the time to understand your shortcomings while being completely honest with your partner. Maintaining relationships can be difficult, but if you work on yours it can help you feel more confident in the face of rejection. Having someone to turn to provides validation that you’re alright. That maybe you experienced rejection, but that rejection doesn’t define you.

Cultivate both your romantic relationships and your friendships. People who are close to you, who know the real you, can help you diffuse the intense feeling of rejection that comes with RSD.  

Remember – It’s Not Personal

Rejection happens whether we like it or not, but it’s important to understand that rejection is not a comprehensive reflection of your worth as a person. If you’ve been rejected, it usually has more to do with the other party than it has anything to do with anything you’ve done. Even though it can be difficult not to, here’s no need to take it personally. Just because you’ve been rejected once doesn’t mean you’ll be rejected in everything you do.

Rejection Sensitive Dysphoria creates an artificial situation in which rejection seems far more personal than it really is. Developing an understanding that it’s not personal can help diffuse the feeling of rejection and make it far more manageable.

Practice Mindfulness

It can be easy to get caught up in the moment when you’re experiencing RSD, but practicing mindfulness and taking a more objective approach to things can be greatly beneficial. Whether it’s through meditation or a shift in perspective, staying present and keeping order over your emotions can prevent fears of rejection from consuming your life.

Mindfulness can also provide deep insight into your thought patterns, and when you understand how you think it can be easier to interrupt feelings of reaction before they consume you.

Treatment for Rejection Sensitive Dysphoria

If you find that your RSD is particularly invasive in everyday life, there are treatment options to help better manage your emotions and overall mental state. Medications like Intuniv and Kapvay, while usually used to lower blood pressure, have also been shown to help with RSD symptoms. Monoamine oxidase inhibitors like Parnate are also a viable option, as they have been shown to help with the impulsive behaviors and emotional symptoms associated with ADHD. Your doctor can help you find an effective course of treatment for your RSD.

Therapy and general stress management can also be effective tools to help manage Rejection Sensitive Dysphoria. A therapist familiar with ADHD and RSD can help you learn how to better control your emotions and give you the necessary tools to handle rejection in a more positive way. Simple self-care, like getting the proper amount of sleep or exercise, can also help relieve the stress that is commonplace with the condition.

If You Have Rejection Sensitive Dysphoria and ADHD, Klarity Can Help

If you’re dealing with the challenges of rejection sensitive dysphoria (RSD) alongside your ADHD, you’re not alone—the certified professionals on Klarity are here to help. They can guide you through receiving an appropriate diagnosis, discuss treatment options, and offer the care you need to effectively manage both conditions.

Additionally, you can access this care without ever leaving your home. Schedule your free evaluation via our telehealth portal, attend all appointments online, and have digital prescriptions sent directly to your pharmacy. At Klarity, our goal is to help you access the care you need from anywhere. Schedule an appointment today.

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