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ADHD Rejection Sensitive Dysphoria: Symptoms, Causes & Treatments

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Delve into the complex world of ADHD and Rejection Sensitive Dysphoria (RSD), learn about: symptoms, causes and treatments.

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adhd rejection sensitive dysphoria

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that affects millions of people worldwide. It’s characterized by symptoms such as inattention, hyperactivity, and impulsivity, which can have a significant impact on daily life. However, ADHD isn’t just about attention and behavior; it can also manifest emotionally. One of the emotional aspects often associated with ADHD is Rejection Sensitive Dysphoria (RSD), a complex and often misunderstood phenomenon. In this article, we will delve into the intricacies of ADHD and explore the concept of RSD, shedding light on how they intersect and influence each other.

Understanding ADHD

ADHD is a neurodevelopmental disorder that affects both children and adults. The core symptoms of ADHD include:

a. Inattention: Difficulty sustaining attention, being forgetful in daily activities, and struggling to complete tasks.

b. Hyperactivity: Excessive fidgeting, restlessness, and impulsivity, leading to difficulty staying still and waiting one’s turn.

c. Impulsivity: Acting without thinking, interrupting others, and making hasty decisions.

Prevalence of ADHD

ADHD is a common condition, with an estimated prevalence of around 5% of children and 2.5% of adults. However, these numbers may vary by region and demographic factors.



Comorbidity is common in individuals with ADHD, meaning they often have one or more additional psychiatric or neurodevelopmental conditions. One notable comorbidity is Autism Spectrum Disorder (ASD), where individuals may experience overlapping symptoms of inattention and hyperactivity (AUDHD). This can complicate the diagnostic process and treatment planning.

adhd autism comorbidity


Borderline Personality Disorder (BPD) is sometimes comorbid with ADHD, as individuals may struggle with emotional dysregulation and impulsivity common to both conditions.

adhd, rsd and bpd


People with ADHD may also experience comorbidity with Complex Post-Traumatic Stress Disorder (CPTSD). CPTSD often arises from prolonged exposure to trauma, such as childhood abuse or neglect.

comorbidity of adhd, rejection sensitive dysphoria and cptsd

Other comorbidities can include mood disorders, anxiety, and substance use disorders. Recognizing and addressing these comorbid conditions is essential for providing comprehensive care and support to individuals with ADHD.

ADHD’s Impact on Daily Life

ADHD can have a profound impact on various aspects of an individual’s life. This includes academic and occupational difficulties, strained relationships, and issues with self-esteem and self-worth and ADHD can even lead to cognitive difficulties in old age.

adhd medication
adults with adhd at higher risk of dementia

The Complex Nature of ADHD Emotions

Emotional Dysregulation in ADHD

While ADHD is primarily associated with cognitive and behavioral symptoms, individuals with ADHD often struggle with emotional regulation. This emotional dysregulation can manifest in various ways, including impulsivity in emotional responses, irritability, and mood swings.

Emotional Intensity

ADHD is often accompanied by heightened emotional responses, both positive and negative. People with ADHD may experience joy more intensely but can also be more prone to frustration, anger, and sadness.

The Role of Rejection Sensitive Dysphoria

One specific emotional challenge frequently associated with ADHD is Rejection Sensitive Dysphoria (RSD). RSD is a term coined by Dr. William Dodson, referring to the intense emotional reactions individuals with ADHD may experience when they perceive rejection or criticism. It’s important to note that RSD is not a formal psychiatric diagnosis but rather a concept that many people with ADHD identify with.

Demystifying Rejection Sensitive Dysphoria (RSD)

What is RSD?

RSD is characterized by an extreme emotional response to real or perceived criticism, rejection, or failure. It can manifest as overwhelming feelings of shame, humiliation, and worthlessness. These emotions can be so intense that they can lead to avoidance of social situations and self-sabotage.

Common Triggers

Common triggers for RSD may include:

  • Rejection from friends, family, or romantic partners.
  • Criticism at work or school.
  • Perceived judgment or disapproval from others.
  • Fear of letting people down or making mistakes.

The Vicious Cycle

RSD can create a vicious cycle in which individuals with ADHD may anticipate rejection and, as a result, become hyper-vigilant in social situations. This heightened sensitivity can make them more prone to misinterpreting others’ intentions, leading to further emotional turmoil.

The Intersection of ADHD and RSD

ADHD and Emotional Dysregulation

The emotional dysregulation seen in ADHD can exacerbate RSD. The inability to control impulsive emotional reactions can intensify the emotional pain associated with perceived rejection or criticism.

A Complex Relationship

While RSD is not exclusive to individuals with ADHD, it appears to be more prevalent among them. The relationship between ADHD and RSD is complex, with ADHD potentially increasing the risk of experiencing RSD due to its emotional dysregulation component.

Coping Mechanisms

Individuals with ADHD may develop coping mechanisms to deal with RSD, such as avoidance of situations that could trigger emotional distress or seeking constant reassurance from loved ones.

Coping with ADHD and Rejection Sensitive Dysphoria

Seeking Professional Help

If you suspect you have ADHD and struggle with RSD, it’s essential to seek professional help. A healthcare provider can conduct a comprehensive evaluation, offer a formal diagnosis, and recommend appropriate treatment options.


Medication, such as stimulants or non-stimulants, can be prescribed to manage the core symptoms of ADHD, which may help improve emotional regulation. However, medication may not directly address RSD.


Therapeutic approaches, such as Socratic Questioning and the use of Cognitive Behavioral Therapy (CBT), can be beneficial for managing the emotional aspects of ADHD and RSD. CBT can help individuals recognize and challenge negative thought patterns and develop healthier emotional responses.

adhd rejection sensitive dysphoria treatment with cbt

Supportive Strategies

Supportive strategies that focus on time management, organization, and stress reduction can also help individuals with ADHD better cope with RSD. Implementing structure in daily life can reduce the likelihood of experiencing situations that trigger emotional distress.


Learning to accept oneself and embrace individual differences is a crucial aspect of coping with ADHD and RSD. Self-compassion can be a powerful tool in managing emotional challenges.

Educating Others About ADHD Rejection Sensitive Dysphoria

Raising Awareness

Raising awareness about ADHD and Rejection Sensitive Dysphoria is essential for both individuals living with these conditions and their friends, family, and colleagues. By promoting understanding and empathy, we can create a more supportive environment for those affected.

Promoting Inclusivity

Creating a culture of inclusivity where neurodiversity is celebrated can help individuals with ADHD and RSD feel more accepted and understood in various social and professional settings.


ADHD and Rejection Sensitive Dysphoria are complex and interconnected phenomena that can profoundly impact an individual’s life. While ADHD is primarily known for its cognitive and behavioral symptoms, the emotional aspect should not be overlooked. Rejection Sensitive Dysphoria, in particular, can create substantial emotional distress and contribute to difficulties in social interactions and self-esteem.

Understanding the intricate relationship between ADHD and RSD is a crucial step toward providing appropriate support and intervention. By seeking professional help, employing coping strategies, and promoting awareness, we can foster a more empathetic and inclusive society where individuals with ADHD and RSD can thrive and reach their full potential.

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