RSD, or Rejection Sensitive Dysphoria, is a set of traits that are often associated with ADHD. RSD is characterized by extreme emotional response ( often felt in the body) to perceived or real rejection or criticism.
Adhd people may be more prone to experiencing RSD due to their heightened sensitivity and difficulty regulating emotions.
RSD isn’t in the DSM yet, but many experts advocate for it to be on the criteria for ADHD. If you have RSD, you feel intensely hurt, shamed, and angry when blamed or rejected. If you have RSD, and as an ADHD woman, you may also experience this severe, intense, painful reaction when you:
Imagine yourself being criticized or rejected
Believe that these situations might be occurring ( even if they aren’t)
If you fear that they might happen.
Three symptoms of RSD when you have ADHD are Ruminating, Self Blame, and Somatization.
One symptom of RSD in ADHD women is rumination, which is the tendency to repeatedly think about and dwell on negative thoughts and emotions associated with an episode as if you are stuck in a loop. This can magnify the experience and make you feel terrible.
If you find yourself blaming and criticizing yourself for something that happened where you feel you were criticized over and over, you might be experiencing RSD.
Somatization is also a common symptom of RSD in ADHD women. Somatization refers to the physical manifestation of emotional distress, where the individual may experience physical symptoms such as headaches, stomachaches, or muscle tension as a result of the intense emotional reactions associated with RSD. RSD episodes are traumatic.
The only research to date exploring RSD suggests that RSD is higher in women than men (Ginapp et al., 2023).
Anectodal studies have consistently suggested very high rates of RSD in adhd people.
It consists of the tendency to:
Feeling Left Out Socially
Receiving Critical Feedback at Work
In a professional setting, receiving critical feedback can be particularly challenging for someone with RSD. Constructive criticism, meant to foster growth and improvement, can be misinterpreted as outright rejection or a sign of personal inadequacy. The emotional response can be swift and intense; it very quickly ignites, leading to feelings of shame, anger, or anxiety. Individuals with RSD might find it exceptionally difficult to separate their self-worth from their professional performance, making workplace interactions that involve feedback or evaluation highly stressful and potentially triggering.
Bill Dodson describes RSD as part of the emotional regulation syndrome of ADHD and is genetic. However, a well-known statistic often cited by ADHD researchers is that by the age of 12, most kids with ADHD have heard 2000 more negative messages than those without ADHD. It’s difficult to tease out the impact of this kind of environmental criticism on ADHD.
Rejection Sensitivity Dysphoria has also been identified in people who have social anxiety disorder and bipolar disorder.
Yes, RSD can often be misdiagnosed as anxiety, depression, or even borderline personality disorder or bipolar disorder in adhd women. The symptoms of RSD, such as intense fear of rejection, sensitivity to criticism, and emotional outbursts, can overlap with mood disorders. This misdiagnosis can happen because RSD is a relatively new construct and isn’t widely recognized. A clinician who doesn’t specialize in adhd could make this mistake.
ADHD women must be aware of the possibility of misdiagnosis and advocate for themselves when seeking mental health support. If you suspect that your symptoms may be due to RSD rather than anxiety or depression, it is important to discuss this with a knowledgeable healthcare professional who understands the nuances of ADHD and RSD.
RSD (Rejection Sensitive Dysphoria) can have a significant impact on academic performance and work productivity in individuals with ADHD.
Fear of rejection can cause you to avoid any task or challenge that you might fail at work and school. This can result in underachievement and a sense of personal failure, adding to their emotional distress.
.Shame, which is the feeling that you are bad and unworthy, can lead to spirals where you shut down completely and cannot focus.
Moreover, the constant fear of rejection and the anticipation of negative feedback or thoughts that you might have failed can create a heightened sense of anxiety and stress, making your day-to-day uncomfortable. This can even lead to chronic stress and even physical illness!
Here are some things you can do in a handy image file!
Medications such as clonidine and MAO inhibitors can help; guanfacine is also sometimes used and has been linked with symptom improvements. Ask and communicate with your doctor.
Yes, RSD symptoms in individuals with ADHD can indeed vary in severity and intensity over time.
For women with ADHD, RSD symptoms can fluctuate depending on various factors such as stress levels, hormonal changes, and overall emotional well-being.
RSD can be managed and improved.
When a group of rare adders without RSD was asked why they didn’t have RSD, they thought one of the key differences was the support system(Ginapp et al., 2023).
Learning how to Surround yourself with people who accept you just as you are is a tremendous help. Women with ADHD can sometimes choose partners who shame them because it is familiar. They may be with people ( friends and partners) who criticize them, and it will exacerbate their RsD. This is the worst kind of relationship you can pick.
Pick people who love and embrace you for who you are. Pick a cheerleader who is in your corner and supports you. Have people in your life who continuously validate that you are lovable exactly how you are. The messages need to be constant.
If you like this information, you can download a fact sheet here at the link below/
References for RSD and ADHD
Medical information obtained from this website is not intended as a substitute for professional care. If you have or suspect you have a problem, you should consult a healthcare provider.
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