How to deal with Rejection Sensitive Dysphoria
A little known but widely felt impact of ADHD is a serious hyper-sensitivity to rejection. When I told a previous colleague about this, they looked at me like I was speaking gobbledegook. I get it – ‘Rejection Sensitive Dysphoria’ (RSD) sounds like your ultimate ‘snowflake’ medical condition, the need for positive feedback at all times out of fear we might not be able to handle any negative feedback.
However, people with ADHD are by no means snowflakes. The average ADHD-er will have suffered a lifetime of being considered inadequate, repeated failures, feeling ‘different’, beating themselves up, and uncontrollable emotional mood swings. RSD is the symptom that has only been linked to ADHD, rather than any other condition, because it’s:
a ‘reaction’ to something (as in, not chemically-induced)
not typically long-lasting (as in, we’ll probably awkwardly feel fine in a few hours)
incredibly extreme – to the point that a person might feel suicidal. This is very dangerous in the moment, and very upsetting to deal with later on, when we feel okay again.
I think of it like having a toddler take over my brain, an emotional panic attack. Your brain becomes ‘flooded’ with emotions so paralysing that you might not be able to think rationally. This can often come from completely imaginary scenarios, such as someone replying late to our message, or being called in for a surprise meeting at work.
RSD can lead to people pleasing and anxiety, in a desperate attempt to try and avoid feeling rejection (which nearly always backfires). It can lead to depression, in an attempt to avoid any potential scenarios where we could be rejected. It can lead to perfectionism and overworking, where we set impossible standards for ourselves to meet, moving the goal posts when we do.
Ultimately, it can result in self-sabotaging – impulsive, emotionally-charged decisions that trap us in a cycle of regret, self-blame, and loneliness. We might quit jobs, end relationships, and cause arguments for seemingly no reason, not understanding our own behaviour. We can gas-light ourselves into seeing rejection that doesn’t exist, resulting from a core lack of trust in others to like us for who we are.
This is especially obvious in romantic relationships. Our partners may be bewildered at our overreactions to small things, such as them being late, or not ‘interested’ enough in us. They might be confused as to why their assurances of how much they like us are never enough, or why they have to keep trying to prove it. They might not understand why we think we are so difficult to love, and eventually, believe what we say – a self-fulfilling prophecy.
Our anticipation of rejection can sadly lead us to self-sabotage relationships with people who care about us, resulting in the feeling that love is ‘conditional’. The cruel irony is when we reject others in the hope of protecting ourselves, such as cutting out a friend in the ill-conceived hope of the other person showing they care.
Having ADHD and RSD is incredibly lonely. It means you’re struggling with all the symptoms of ADHD in a vacuum of loneliness, where you may believe that nobody truly cares about you. The symptoms bounce off each other – not being able to complete things due to insecurity of previous failures and an inability to ask for help, exacerbated by perceived loneliness and rejecting everyone as a result. It’s very dangerous to experience the extreme mood-swings in the moment, which can feel scarily intense, and may be why 4 in 10 women with ADHD have attempted suicide.
Treating RSD
It’s very difficult to treat RSD because it hits so quickly, and the emotions can overwhelm a person so suddenly that they can find themselves experiencing it at the same time as everybody else. However, it is NOT impossible – this is the main thing I coach people on now!
1) Understand your ADHD
I wrote ‘ADHD: an A to Z’ to help people overcome challenges related to their ADHD without requiring medication, or a diagnosis (as these can take 7 years on the NHS!). By treating some of the symptoms we experience, we can start building up trust in ourselves to feel as though we’re capable of having a stable life, so we don’t perceive potential rejection as a life-ruining concept in and of itself. There’s also certain types of medication which can help with RSD, which I’d recommend talking to your doctor about.
2) Recognise your RSD
I only started overcoming my RSD when I learned it was a proven medical condition. This cut off the part of my cycle where I started catastrophizing about how terrible I was and convincing myself I needed to be sectioned for these extreme mood swings. Once we recognise RSD, we can label the experience of it, removing ourselves from it. It’s something that happens to you, it’s not who you are.
Try to identify situations where this is likely to happen (e.g when dating), and have a list of things that make you feel calm, happy and secure (e.g reading a book), that can distract you from your feelings. When you’re feeling overwhelmed, try to do one of these activities as soon as possible. Remind yourself that this will pass, and you can simply ride the wave out. Try to leave any triggering situations as soon as possible to calm down, and be as kind to yourself as you can.
3) Build up your self-compassion
Ultimately, the key to dealing with rejection is to build up your self-esteem so that it’s not reliant on the acceptance of other people, just yourself. This comes from having self-esteem, and compassion for ourselves – I’ve seriously had months where I’d have to write myself love letters or lists of things that proved I was a capable human being every morning.
4) Talk to people you trust about it
It can help to discuss this with other people, even if you don’t have an ADHD diagnosis. Knowing that it exists and other people experience the same thing proves you are not alone. Although I wouldn’t recommend insisting on only positive comments from now on, you can explain to people how you would best react to certain types of feedback and criticism. You don’t even need to call it RSD - you can just explain how you operate best in response to feedback (such our texting style!).
For example, I know that I deal very well with negative feedback when I can understand it, and when I have time to process it – so having it written down is always very helpful! It’s also good to explain to people in your life how brilliantly you respond to positive feedback!
5) Reframe your thoughts
This is by far the most helpful thing I’ve done to treat my RSD. I’ve literally trained myself to do this now so that it’s automatic whenever I begin to feel the overwhelm of rejection:
What is the thought that’s bothering you?
Can you prove this to be 100% true? What proof do you have?
What is believing this thought doing to you? How is it making you behave and think?
What is the opposite of this thought? Can you find proof for this being true instead?
By training ourselves to trust other people to like us for us, and for this to be our automatic thought rather than searching for the reasons people wouldn’t like us, we can overcome RSD. This involves being aware of our tendencies to perceive rejection, and actively combatting any worries, reminding ourselves that we are liked and accepted for who we are. Typically, people feel the same way about you as you do about them!
Our brains are constantly making up stories but realising that we have the power to pick what thoughts we believe is genuinely life changing. We just have to choose to do so.
Having RSD does not mean there is anything wrong with you. It means that you feel things on a deeper level than most people, and as a result, tend to be more compassionate. Understanding the stress and emotions that your body can experience in one go means that you tend to be good at understanding the stress of other people, as it arises in small manageable chunks! Remember to be kind to yourself, no matter what. You are deserving of love and the people around you will love you unconditionally, even if it doesn’t always feel that way