08/18/2025
Understanding Rejection Sensitive Dysphoria (RSD)
What it is:
Rejection Sensitive Dysphoria (RSD) describes the intense emotional pain, shame, or fear of rejection that occurs in response to perceived criticism, failure, or abandonment. The reaction can feel immediate and overwhelming, often out of proportion to the actual event. While not a formal diagnosis, RSD is widely recognized in mental health practice, especially in relation to ADHD and trauma.
Where it comes from and why it happens:
• Neurological roots: Brain regions involved in emotion regulation (like the amygdala and prefrontal cortex) can become hyper-reactive to social cues, making even subtle criticism feel like a threat.
• Trauma: Early experiences of neglect, abuse, or invalidation sensitize the nervous system to anticipate rejection. This creates a lasting, heightened alertness to disapproval.
• ADHD and neurodivergence: Research shows that 70–99% of individuals with ADHD report significant symptoms of RSD. The same neurological differences that affect attention also intensify emotional reactivity.
• Trauma prevalence: Among trauma survivors and those with CPTSD, rejection sensitivity is extremely common—often reported at nearly double the rate of the general population. This is because repeated interpersonal wounds prime the brain and body to expect rejection.
Coping skills and supports:
• Pause and ground (3-3-3 method): Name three things you can see, three things you can hear, and three things you can feel in your body. This helps bring awareness back to the present before reacting.
• Reality-check thoughts: Ask yourself: Am I interpreting or assuming rejection, or do I have evidence? What else might be true?
• Self-compassion: Remind yourself that sensitivity to rejection is a nervous system response, not a personal weakness.
• Communicate needs: Share your triggers with trusted people who can clarify intent and offer reassurance.
• Therapeutic strategies: Approaches like CBT, DBT, EMDR, and polyvagal-informed tools can help retrain the brain and calm the nervous system.
• Boundaries & structure: Reduce exposure to highly critical environments and build supportive, validating spaces.
Key reminders:
Experiencing RSD does not mean you are broken or “too sensitive.” It reflects how your brain and body learned to protect you from pain. With awareness, compassion, and effective tools, you can retrain these responses, strengthen resilience, and cultivate healthier self-trust and relationships.
~Laurie Cook, LCSW