• Sydni Rubio-Weiss

Rejection Sensitive Dysphoria (RSD)

Updated: Feb 9

RSD is a symptom of ADHD that is often overlooked. It's a form of severe emotional dysregulation that is very specific to the ADHD and ASD (Autism Spectrum Disorder) communities. Read on to find out what it is, where it comes from, what it's like for those who have it, and how to manage it.

What is Rejection Sensitive Dysphoria?

Before I get into RSD, I wanted to address its cousin: Emotional Dysregulation (ED). Emotional Dysregulation is defined as having an impulsive or extreme emotional response to something and being unable to regulate those emotions. People with ED become extremely (and perhaps, "irrationally") angry and sad about things that would cause a less intense reaction in a neurotypical. Emotional Dysregulation can be experienced by anybody, but you are more likely to experience ED if you have:


- Autism Spectrum Disorder (ASD)

- Bipolar Disorder

- Borderline Personality Disorder (BPD)

- Post-Traumatic Stress Disorder (PTSD)


“People with RSD become very acutely aware of everything we're doing and saying in front of other people."

While Rejection Sensitive Dysphoria is an extreme emotional response to things, much like ED, it is also classified as being extremely emotionally sensitive to the possibility of things like:

- Rejection

- Disagreement

- Criticism

- Judgement

- Disappointing others or yourself

What does RSD feel like for those that have it?

We fear the idea of social interactions because we fear the above list. We are afraid that our coworkers, classmates, or group members are going to reject us, make fun of us behind our backs, or that we're going to say something stupid and embarrass ourselves. We're afraid of what other people's perceptions are of us and we react to it way too intensely. We have a similar feeling to that of social anxiety when it comes to the idea of having to engage in a social interaction. When we're actually present at the social interaction, these feelings are amplified and we become very acutely aware of everything we're doing and saying.

PEOPLE ARE NOT JUDGING EVERYTHING YOU SAY AND DO - but, that's easier to say than it is to accept when you have RSD. We're worried about our appearance, about how often we speak, about how we're standing, and about that joke we told that didn't get any laughs. We will lie awake every night until 1 am for 4 years thinking about that joke while the rest of the world moves on.

Why do we develop RSD and where does it come from?

You may have guessed this, but RSD develops in our childhood. By the age of 12, children with ADHD hear 20,000 more negative or critical messages than their peers without ADHD do [1]. These messages come from an adult in a place of authority, and some examples of these messages include things like:

- Why are you so messy all the time?

- Sit still and be quiet for once.

- Stop interrupting! You're being rude.

- You're so lazy!

- Your room looks a tornado went through it.