What is Rejection Sensitive Dysphoria?
Rejection Sensitive Dysphoria (RSD) is not a medical diagnosis, but a way of describing certain symptoms associated with ADHD. RSD is an overwhelming emotional sensation that a person may experience in response to an actual or perceived rejection or criticism. It is a serious condition that can result in low mood and self-esteem.
Rejection sensitive dysphoria isn't exclusively associated with attention deficit hyperactivity disorder (ADHD) or any other condition, however, it's often considered a type of emotional dysregulation (ED) commonly seen among people living with ADHD. Nearly 1 in 3 people with ADHD say RSD is the hardest part of living with ADHD.
People with RSD have a strong emotional reaction to negative judgments, exclusion, or criticism from others that it sends them into a mental tailspin, leading to rumination and uncomfortable feelings that prevent moving on to anything else. When negative judgements or criticism has occurred, or has been perceived to have occurred, people with RSD can like a deep sense of failure, disproportionate to what has actually occurred. This may cause rage or long-term shame and low self-esteem.
People with RSD often exaggerate how people feel against them, sometimes feeling people are against them or dislike them, which can add to social isolation and self-esteem. Some people with RSD may overcompensate and bend over backward, or people please, in a desperate attempt to keep themselves in others' good graces. Other people may see those with RSD as overly perfectionistic, over-sensitive, or overly reactive to even the mildest types of criticism.
What are Signs of Rejection Sensitive Dysphoria?
Becoming easily embarrassed
Getting very angry or having an emotional outburst when you feel like someone has hurt or rejected you
Setting high standards for yourself which are very difficult (or nearly impossible) to meet
Suffering from low self-esteem
Feeling anxious, especially in social settings
Staying away from social situations and withdrawing from people
Feeling like a failure because you have not lived up to other people's expectations
Some of these symptoms common with RSD are common to other mental health conditions and because of this reason, sometimes RSD can be incorrectly diagnosed. RSD is commonly misdiagnosed as Bipolar Disorder, Borderline Personality Disorder, Depression, Autism Spectrum Disorder or Social Anxiety Disorder.
Do I Have Rejection Sensitive Dysphoria?
RSD is cluster of symptoms that can cause great impairment and distress. It is not as of yet, however, an official disorder listed in the Diagnostic and Statistical Manual of Disorders (DSM-5). So it is not a condition with its own official code label, but instead is a constellation of symptoms that are often (though not always) associated with other conditions. Since it is not a mental health condition in the DSM-5, there are not a set of empirically quantifiable criteria to determine whether you "officially" meet a diagnosis for RSD. But you may have a strong suspicion if you recognize yourself in several of the characteristics below:
High sensitivity about the possibility of rejection
Self-esteem that is entirely dependent on what others think, and rises and falls accordingly
Overly high standards for yourself
Feeling easily triggered toward guilt or shame
Isolating yourself in a preemptive strike not to be rejected
Aggressive behavior toward those who have been perceived to have slighted you
Frequently feeling an uncomfortable physical reaction due to "not fitting in" or being misunderstood
Frequent and intense ruminating after an interaction about how you did or said something wrong