7 Signs You Might Have Rejection Sensitivity Dysphoria

How to recognize rejection sensitivity dysphoria, a lesser-known ADHD symptom.

Key points

Rejection sensitivity dysphoria (RSD) is a lesser-known symptom of ADHD.
RSD symptoms, alongside other key diagnostic criteria, can help clinicians diagnose ADHD.
Many people with ADHD find it helpful to know about RSD so they can build self-knowledge and seek support.

Rejection sensitivity dysphoria (RSD) is an experience that many people with ADHD report, but it can be overlooked by clinicians. The emotional regulation experiences of people with ADHD are becoming increasingly well-recognized (Brown, 2020). Dr. William Dodson is a well-known doctor who has raised awareness widely about ADHD and the commonly overlooked experience of rejection sensitivity dysphoria. Dr. Dodson describes the experience of ADHD as an intense reaction to the feeling or experience of being rejected or criticized (Mutti-Driscoll, 2024).

Even if others are not around, some people with ADHD can experience RSD when they fail to live up to their high expectations of what they felt they should be able to accomplish in that time period. This experience of rejection is often extreme for people with ADHD, leading to a feeling of physical pain for some. To avoid this terrible feeling, many people with ADHD become perfectionists and people-pleasers (Mutti-Driscoll, 2024).

I have rarely met an individual with ADHD who did not relate to this experience of RSD throughout my five years of coaching people with ADHD.

Here are some signs that you may have RSD:

You react intensely to negative feedback (even very subtle feedback, like someone’s tone).
You have a hard time taking suggestions from others, even when they are constructive.
You are defensive when you feel criticized.
You have been told you are “too sensitive” frequently.
When people try to help you, you think they are suggesting you cannot handle important parts of your life.
You set high standards for yourself so that you can avoid giving people reasons to criticize you.
You have a hard time saying no to others or striving to please them at all costs so that others will not think ill of you.

If you relate to many of the above statements, then you might look into rejection sensitivity dysphoria and whether, in combination with other criteria for ADHD, including hyperactivity, impulsivity, and inattention, you might meet the criteria for ADHD. For those individuals who have sought a diagnosis and been “on the edge,” overlooked features of ADHD, such as RSD, might tease out some other aspects of ADHD that might help tip the scales one way or another.

Even individuals who do not pursue an ADHD diagnosis or who already have one but do not know about RSD find it helpful to know that they are not alone in responding how they do to rejection. If you experience rejection sensitivity dysphoria, you may want to find support from a therapist or coach who can help you develop increased self-awareness and emotional regulation skills so that you can reflect on the effect that RSD has on your life and get help in managing its impact on your self-esteem and your relationships.

References

Brown, T.E. (2014). Smart but stuck: emotions in teens and adults with ADHD. Jossey-Bass, Inc.

Mutti-Driscoll, C.J. (2024). The ADHD workbook for teen girls: Understand your neurodivergent brain, make the most of your strengths, and build confidence to thrive. New Harbinger, Inc.