My Mental Health Series

My Mental Health: Rejection Sensitive Dysphoria

I really wish I was less of a thinking man and more of a fool not afraid of rejection.

Billy Joel

I’ve been avoiding the post about Rejection Sensitive Dysphoria. I knew the first time I ever heard the words that it was going to hit home with me. I’ve always been a sensitive person. Rejection came at me hard and strong as a child; even at home. After the last several months spent learning about ADHD, OCD, and C-PTSD, I don’t think I was ready for any more new information about my brain or my behavior.

Here, we are though and that is exactly what I’m going to talk about in this post. I was finally ready to learn more about Rejection Sensitive Dysphoria and what it means for me. While rejection, criticism, and failure are a fundamental part of the human experience, they can be harder to process for people with Rejection Sensitive Dysphoria.

What Is Rejection Sensitive Dysphoria?

brown brain

Rejection Sensitive Dysphoria (RSD) is extreme emotional sensitivity to criticism, rejection, and failure. The circumstances don’t even have to be real; RSD makes us perceive criticism and rejection where there are none. It causes severe emotional pain and can result in outbursts of rage, lashing out, or even withdrawing completely. Rejection, criticism, and failure are all universal life experiences that every human feels, but the emotional reaction is more severe in someone who has RSD

RSD often comes out of nowhere; one minute you’re in a good mood and the next you are sad and angry. The emotions are intense and can make you feel out of control. Because of the rapid shift in moods, Rejection Sensitive Dysphoria can sometimes be mistaken for a rapid cycling personality disorder, sometimes with suicidal ideation. Because RSD can be triggered by a perceived slight, it can result in anticipating rejection causing the person experiencing RSD to withdraw from social situations. It can also result in misreading constructive criticism or healthy rejection.

People with Rejection Sensitive Dysphoria often become people pleasers to avoid any and all conflict or criticism/rejection. This sometimes results in presenting a false version of yourself to people; sometimes even many different versions dependent upon who you are around and trying to please at the time. I speak from experience when I say that this type of inauthentic life will wear you down and exacerbate your disorders.

Rejection Sensitive Dysphoria often causes people to withdraw socially. This causes them to miss out on a life that was meant to be lived. They will often forgo dating, stay at an unfulfilling or unhealthy job due to fear of applying for anything new or be afraid to speak up in social or public settings.

Rejection Sensitive Dysphoria is not an official diagnosis. There are many theories about what causes Rejection Sensitive Dysphoria. It can be caused by rejection or neglect early in life. I was essentially rejected by the parents who raised me at every turn, starting at a very young age. They often withheld love and interest in me as a form of punishment. I believe strongly that my RSD started there. It can also occur in kids who were teased or bullied. Some believe that it is caused by genetics.

Symptoms Of Rejection Sensitive Dysphoria

Symptoms of Rejections Sensitive Dysphoria can include:

  • Low self-esteem
  • Avoidance of social situation
  • Fear of failure
  • High expectations of self
  • Emotional outbursts after being hurt or rejected
  • Feelings of hopelessness
  • Approval seeking
  • Anger/aggression when feeling uncomfortable
  • Anxiety
  • Feeling like a failure
  • Fear of disappointing loved ones
  • Shame, humiliation, and embarrassment that you can’t seem to let go of

There seem to be 2 categories, high anger RSD and high anxiety RSD. With high anger, we might have sudden outbursts of anger, an urge to lash out or get revenge or engage in aggressive behavior. With high anxiety, we tend to avoid situations that have a possibility, perceived or otherwise, of rejection or criticism, rumination, and turning pain inward…causing depression.

Because people with ADHD struggle with emotional regulation, impulse control, and they feel things more intensely they are more likely to suffer from Rejection Sensitive Dysphoria. They also hear more criticism and correction than most people so they can become even more sensitive than the average person.

Rejection Sensitive Dysphoria and Me

people covering face and mouth of helpless woman

I’m still learning about the ways the Rejection Sensitive Dysphoria affects me. I know for sure that I have high anxiety RSD. I’ve never been one to have outbursts or tantrums. I tend to turn my anger and distress inward, which is not ideal. Not only do I often avoid social situations, but I will actively avoid people that I am close with if I know they will voice disapproval when I talk to them. It often leads me to be dishonest with the people that I love to avoid criticism.

I ruminate and think obsessively about perceived slights and actual bad interactions can sometimes take over my entire brain; unable to think of anything else besides what happened. When I stop internalizing and I’ve finally had enough, I tend to cut relationships off at the knees. I will walk away and never look back, with no explanation.

I’ve worked hard to better handle constructive criticism. My first reaction to it (again, internally) is to automatically feel offended. I have to fight that back so that I can take the ideas and the notes that people are giving me and better myself and my work. This is especially true in my work environment, where my issues have been exacerbated due to workplace trauma.

I have become a people pleaser as I’ve moved through life and I will do almost anything to avoid confrontation. When faced with confrontation, I shake and sweat; I sometimes even dissociate completely. I generally don’t lash out, but I will run from the conflict in any way that I can. I’ve gotten better at standing up for myself over the last couple of years, but Rejection Sensitive Dysphoria will likely always have me running from a fight.

Despite my struggles with Rejection Sensitive Dysphoria, I’m working hard to not take things personally. I have always been the type of person who hates when someone doesn’t like me. I’ve made huge life decisions based solely on what other people will think about me and I’m getting more and more comfortable with the idea that not everyone is going to like me. No matter how good I am or how hard I try, I’m just not for some people.

Learning about my disorders has helped in this aspect too. I feel more deserving of clear boundaries. I have forgiven myself for so much, which makes me love myself more. Rejection Sensitive Dysphoria has kicked my ass more times than I can count, but I’m not down for good. Through medication and therapy, I will find ways to even out the balance and live a fuller, healthier life.

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ADHD Beans

Still depressed, anxious, and traumatized. Still an ADHDer. Still kicking ass and taking names when it comes to busting stigma. Changing hearts and minds, one post at a time.

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  1. Thanks for this. I can see myself in almost every part you’ve added here. I might be a member of the RSD club as well.

  2. Oliver says:

    This is one of the best pieces on RSD I have read – thank you. It has unlocked a torrent of feeling in me, so writing it must have been a rollercoaster – perhaps cathartic too?. The part on cutting people off is interesting – I have done this. But reading this I realised I have also cut locations off in the same way. I struggle to go back to places I used to live or go to school as I associate them with the negative experiences of rejection anxiety.

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