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Rejection Sensitivity Dysphoria and ADHD

Let’s talk about Rejection Sensitivity  Dysphoria (RSD). Wow, was I glad to discover this was a ‘thing’ – if I’m honest. I’ve spent most of my life being told I was overly sensitive and needed to ‘calm down’.

Have you ever been accused of being ‘too sensitive’, or had people comment that you overreact? Do you find yourself feeling easily hurt or upset by what someone else has said or done?  Then this blog is for you! 

For those of us who experience rejection sensitivity dysphoria, it can feel like we’re on a constant rollercoaster of emotions. The smallest of things that feel like criticism or rejection can escalate very quickly in our minds, sending us into a spin.

In work situations, I felt like a failure, inadequate, and as if I was about to be found out as a big fat fraud, at any given minute. It triggered behaviours in me like prolific people pleaser, over-delivering, and taking on too much (hello overwhelm, anxiety, and burnout). In my personal life, it led to me feeling hurt, rejected, angry, and everything in between. I felt like a terrible human being and not worthy of friendship or love – hello again to prolific people pleasing and trying to be all of the things to all of the people!

Learning about rejection sensitivity dysphoria (RSD) has been an incredible catalyst for managing it. They do say knowledge is power!

What is Rejection Sensitivity Dysphoria?

Rejection Sensitivity Dysphoria (RSD) is a powerful emotional response to perceived rejection or criticism. If you follow any ADHD’ers on social media, you’ll likely have heard them talking about it. RSD amplifies feelings of discomfort, distress, and inadequacy in the face of real or imagined social dismissals.

There’s something important to note here – this is about perceived rejection or criticism, and this will be different for each of us.  This can lead to some additional challenges when the person you believe has rejected or criticised you, didn’t mean to, or is oblivious to the way you have interpreted the act or comment. 

The perceived criticism or rejection can be the smallest of comments or reactions, and it can trigger RSD, catastrophising something that a neurotypical is likely to dismiss without a second thought.

Neurologically, ADHD often presents with irregularities in emotion regulation and dopamine pathways, heightening sensitivity to potential social threats or disappointments. This can have a profound impact on our lives, and can cause constant anxiety about social interactions, avoidance of situations where rejection might occur, and an internalised narrative of not being ‘good enough’, all of which can overshadow our potential and self-worth.

Some ADHD’ers with rejection sensitivity dysphoria (hi, me), often replay situations or conversations over and over again in their heads, wondering how we could have been so stupid, or creating elaborate stories about what others think of us. It’s painful and it’s exhausting. 

Let’s have a look at the science, it helps to give a little more insight into what’s going on and therefore enables us to consider some ways to manage it – and even harness it as a superpower. I’m not joking, you can turn your rejection sensitivity dysphoria into a positive! 

The Science Behind Rejection Sensitivity Dysphoria

An Evolutionary Perspective

 Before we dig into the science of rejection sensitivity dysphoria, let’s go back in time. From an evolutionary standpoint, being attuned to social rejection was crucial. Our ancestors relied on social groups for survival. Being ostracised or rejected from the group could mean death. Therefore, the brain developed a heightened sensitivity to potential social threats. In the modern world, this evolutionary trait translates to a fear of rejection—even when our survival isn’t at stake.

But why might those with ADHD experience this at more intense levels? The answer might lie in the evolutionary role of ADHD itself. Some theories suggest that individuals with ADHD traits served as the “hunters” or “explorers” of ancient communities. Their impulsivity, hyperactivity and heightened alertness to the environment (including social cues) would have been assets. However, in today’s structured society, these same traits can sometimes feel more like liabilities, especially when paired with the brain’s heightened sensitivity to rejection.

What do you think about this theory? This makes sense to me because in all honesty, I don’t believe that autism and ADHD just came out of nowhere, I believe that neurodiversity has always existed, but it’s been so misunderstood, in society’s rush to label everything and everyone.

What’s going on inside the brain?

The brain is a complex organ, continually processing a myriad of emotions, actions, and reactions. But when it comes to ADHD and RSD, specific regions and pathways play pivotal roles. Understanding this helped me to understand my own experiences with rejection sensitivity dysphoria, and to go on to create some coping strategies.

The Amygdala’s Alarm System: Situated deep within the brain’s temporal lobe, the amygdala acts as an emotional alarm system. When confronted with potential threats (like rejection), it can trigger a cascade of reactions. In those of us with ADHD, this “alarm” can be more sensitive, sounding off with increased intensity.

Prefrontal Cortex and Regulation: The prefrontal cortex, responsible for cognitive behaviours like decision-making and emotion regulation, often function differently in those of us with ADHD. An underactive prefrontal cortex may struggle to regulate the heightened emotional responses from the amygdala, leading to the intense feelings characteristic of RSD.

Dopamine, Reward, and Rejection: Dopamine gets a lot of attention, as I am sure you’re aware! It’s a neurotransmitter linked to pleasure, reward, and motivation, and plays a notable role in ADHD and RSD. People with ADHD often have irregular dopamine regulation. This dysregulation can amplify feelings of rejection since the anticipated reward (acceptance) isn’t achieved, causing a more profound sense of loss.


When I learned about rejection sensitivity dysphoria, on this basis, I was able to first think what an epic hunter-gatherer I would have been (maybe I was born in the wrong era!?) But I was also able to understand the reactions in my brain and therefore my body – having this awareness helped me to notice my responses and process them differently. Let’s explore some of the ways you can do that too.

The Benefits of Rejection Sensitivity Dysphoria

Rejection Sensitivity Dysphoria (RSD) isn’t all bad, you’ll be pleased to know!  The heightened emotional sensitivity that comes with RSD, when understood and harnessed correctly, can be a unique strength. 

Let’s have a look at some of the positives of rejection sensitivity dysphoria, so you can start to spot where it really your superpower!

Empathy Amplified: RSD makes you acutely aware of emotions, not just in yourself, but in others too. This enables a deep level of empathy, a powerful tool in building genuine relationships, whether personal or professional. It’s like having an emotional radar; you pick up on feelings that might go unnoticed by others. Have you ever noticed that you pick up other people’s emotions quickly, or that you can be affected by someone else’s emotions? I can walk into a room feeling one thing, and within seconds that emotion changes – particularly if I sense sadness or anger.

Creativity Supercharged: The emotional depth of RSD means you experience the world in vivid colours, with intense feelings. This can act as fuel for creativity. Whether it’s art, writing, or innovation in business, your unique perspective can lead to original, out-of-the-box ideas. 

Deep Connections: On the flip side of being more vulnerable to feeling hurt, is that this same vulnerability can lead to deep, authentic connections. When you allow yourself to be seen, truly seen, by others, you open the door to relationships built on trust and mutual understanding. 

These are three pretty great examples of where rejection sensitivity is a bonus! I’d love to hear how your RSD is a positive in your life. Please feel free to comment on the post, email me directly, or join our Facebook Group (button below). I’m sure your story of positivity will serve as inspiration for others, too. 

How To Manage RSD

For many entrepreneurs and leaders, feedback and criticism come with the territory. But when you have rejection sensitivity dysphoria, even the most well-intentioned critique can feel like a gut punch. This sums up my entire corporate life, where I felt like a constant failure and even the smallest perceived criticism would send me into an anxious spiral. On the plus side, it made me a highly supportive Leader, and I was acutely aware of what I said to my team, and how. 

How can you, as a neurodiverse professional, manage and even thrive amid the feedback-filled waters of the business world? Here’s some ideas that might work for you: 

  • Reframe the Feedback: Instead of viewing criticism as a personal attack, see it as valuable data. Critiques often spotlight areas of potential growth. By detaching emotion from feedback and viewing it analytically, you’re better positioned to use it constructively.
  • Seek Clarification: If a piece of feedback stings, seek clarity. Sometimes, what’s perceived as criticism might simply be a suggestion or a misunderstood point. Engaging in a conversation can demystify the intent behind the feedback.
  • Be open and honest: If direct criticism tends to derail you, consider sharing this with a trusted colleague or mentor to filter feedback. They may be able to help you reframe the feedback or word it in a way that feels more comfortable for you. 
  • Focus on the Big Picture: In the grand scheme of things, one piece of negative feedback is just a blip. Regularly remind yourself of your achievements, goals, and the bigger vision. When you’re grounded in your purpose, minor setbacks or criticisms become easier to navigate.
  • Practice Self-compassion: Recognise that everyone, no matter how seasoned, faces criticism. Instead of berating yourself, practice self-compassion. Understand that it’s okay to be hurt, but it’s essential to pick yourself up, learn, and move forward.
  • Harness Support Systems: Share your feelings with a trusted friend, family member, or therapist. Sometimes, voicing your concerns and feelings helps in detangling them and seeing them in a fresh light.
  • Celebrate Wins: Make it a point to celebrate your successes, no matter how small. By regularly focusing on the positive, you create a counterbalance to any negativity that might come your way.

It's not all bad!

While rejection sensitivity dysphoria can undoubtedly present challenges, understanding its positive facets can help shift how we view it, and therefore how we experience it.  It’s not about downplaying the struggles but about celebrating the often-overlooked strengths and opportunities that lie within this heightened emotional sensitivity. By embracing both the challenges and the potential of RSD, you can harness your sensitivity as a unique superpower!

And remember, that all feedback and criticism is just another person’s opinion or thoughts. It doesn’t mean it’s right, or that you have to agree with it. Often people offer up their unsolicited feedback and it can be a projection of something that is going on for them.  My first thought these days, when I am on the receiving end of someone’s criticism and negative feedback is that they might be having a bad day or dealing with a tough situation. Or, they are criticising me because they are projecting their own fears or beliefs onto me. It really helps me to take the sting out of the situation. 

I hope you’ve enjoyed my blog on rejection sensitivity dysphoria.  I know from experience how challenging RSD can be, but it can absolutely be one of your strengths too. Until next time, stay bold, stay brave, and keep shining your beautiful, unique light.

I’d love to see you over in our Facebook Community if you’re not already there. Click on the button below to join our supportive group for female entrepreneurs and leaders (or those committed to showing up fully in their lives!). We are UK based, but you’re welcome to join if you’re not UK based. Nikki x

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