Each person’s experience with ADHD is unique. While many people associate ADHD with difficulty paying attention and restlessness, it can manifest in various ways. ADHD may be hindering you in ways you’re not aware of, such as through Rejection Sensitive Dysphoria (RSD).
What is RSD?
Rejection-sensitive dysphoria (RSD) is not a formal diagnosis, but rather one of the most common and disruptive manifestations of emotional dysregulation — a common but under-researched and oft-misunderstood symptom of ADHD, particularly in adults. RSD is a brain-based symptom that is likely an innate feature of ADHD. The experience of RSD can be painful and even traumatic. RSD is characterized by intense mood shifts triggered by a distinct episode, typically one of the following:
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- Rejection (the real or perceived withdrawal of love, approval, or respect)
- Criticism, no matter how constructive
- Persistent self-criticism or negative self-talk prompted by a real or perceived failure.
–http://www.additudemagazine.com
“The excruciating pain of RSD is often beyond description. Patients describe the intensity of RSD as “awful,” “terrible,” “catastrophic,” or “devastating,” but they cannot verbalize the quality of the emotional experience.”
-William Dodson M.D.
What Does RSD Look Like?
As a person with RSD, you may display many of the following behaviors:
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- Abrupt emotional outbursts in response to real or perceived criticism or rejection
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- Avoidance of social situations
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- Negative self-talk and thoughts of self-harm
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- Avoidance of social situations where you may fail or be criticized (making it difficult to differentiate from Social Anxiety Disorder)
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- Low self-esteem and negative self-perception
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- Consistent negative self-talk leading to self-sabotage
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- Continual rumination (the act of repeatedly thinking about negative past events or problems, causing overthinking and intrusive thoughts).
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- Fixation (being unable to stop thinking about something or someone, or an unusually strong interest in something or someone)
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- Difficulties in relationships, particularly feeling constantly under attack and responding defensively.
What could this mean for you?
As a person with RSD you may be less likely to:
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- Seek help
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- Be able to say “no”
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- Work successfully in a group
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- Be your authentic self
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- Take advantage of opportunities
You may be more likely to:
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- Become dependent on drugs/alcohol
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- Either over or under-socialize
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- Seek reassurance and acceptance in ways that are harmful to yourself or others
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- Give up when you struggle
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- View yourself as unlovable or unworthy
RSD and Me
I have contended with RSD my entire life. Since I had a later-in-life diagnosis, I didn’t know why I was the way I was. You would think being a special educator for 25 years, at the time, might have clued me in on my diagnosis! I guess you can’t always see in yourself what you can in others. Like many people I know, I couldn’t help but feel if I had known, if I had had the information, I could have made better choices in my life. I made many, many choices based on my need to please others rather than myself, I sought validation from others rather than being able to validate myself. I was convinced that nobody really liked me or that my professors thought I was an idiot. None of which was true, but with RSD your brain plays tricks on you.
As I have learned more about how my ADHD and RSD affect me, I have become more confident, more able to make good decisions for myself and my family, and most importantly, able to love myself and all my imperfections. I am honest with my friends and family and tell them about my ADHD and RSD. I don’t fight it, I identify it and try to face it head-on. Does it always work? Hell no! But it does much of the time which makes the other times more bearable.
What Can You Do?
Recognizing your RSD is just the beginning. Here are five ways to remove roadblocks and better manage it.
Don’t Assume Rejection: Before assuming rejection, stop! take a moment to evaluate the situation and consider alternative explanations. Understand that our RSD’s explanation is not the only one.
Explore Your Strengths: We all possess strengths. Consider asking your friends, parents, or professors to identify your strengths and write them down. Read them regularly and make a conscious effort to recognize when you use these strengths. Start paying attention to the things you do well.
Use Positive Affirmations and Mantras: Creating positive affirmations can help combat negative thoughts caused by Rejection Sensitive Dysphoria. Try phrases like “I am worthy” and “I am lovable.”
Get Distracted: If you find yourself ruminating, try to be intentional in distracting yourself. Spending time with others can help take your mind off the situation. If possible avoid going it alone, it is harder to distract ourselves when we are by ourselves.
Know Your Supports: Build a support network of trustworthy people. Talk to them about RSD and ask for their help. ADHD Life Coaching could be a great support to consider!
Knowing how important it is to have a good understanding of RSD and how it can impact your life, especially during college, is the first step to accepting your RSD and not allowing it to control your choices or rule your life.
