What Is Rejection Sensitive Dysphoria?

By Robert Porter|Updated July 12, 2022
CheckedMedically Reviewed By Dr. Natalie Feinblatt, PsyD

Do you feel like you're very sensitive about what other people are saying about you? Many people feel very concerned about whether people are saying things about them or if others are shunning them. Sometimes these fears might even be irrational, but you can't help but feel them anyway. In this situation, you might be wondering whether you have rejection-sensitive dysphoria (RSD).

What Is RSD?

Are You Experiencing Rejection Sensitivity - Or Something Else?
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While not an official psychiatric diagnosis in the DSM-5, RSD is a condition that some people with attention deficit hyperactivity disorder (ADHD) will develop. People who have RSD are more sensitive to rejection than other people. In fact, people with RSD often spend a lot of time worrying about what others are thinking about them. These individuals will become more upset than usual when they're criticized or if someone speaks to them harshly. Many people with RSD might even be prone to taking things wrong and feeling shunned even if that wasn't someone's intention during a conversation.

You can think of RSD as a type of extreme emotional sensitivity. This is a very common symptom that people with ADHD might have to deal with. It should be noted that RSD episodes can be triggered by someone feeling like they have been rejected in some way. This isn't always the reality of the situation, but the feelings of rejection are very real. It is said that up to 99% of adults and teens living with ADHD are more sensitive to rejection.

Understanding The Signs Of RSD

Understanding the signs of RSD is one of the best ways to tell if you might have a problem with this condition. It should be noted that some of these signs can mirror symptoms that are associated with certain mental health conditions. For this reason, it's very important to get a proper diagnosis. If you have emotional problems or any issue making life more difficult, then it's worthwhile to speak about things with a physician, psychiatrist, or psychologist.

One of the most common signs that someone has RSD is that they will become easily embarrassed. A situation that might not seem that embarrassing on the surface could cause a person with RSD to feel extreme embarrassment. A simple joke or something else of that nature could wind up hurting the ego of someone who is dealing with RSD. Many people who have RSD also have very low self-esteem.

It's common for people who have RSD to have angry or emotional outbursts, too. This will occur when they feel that someone has rejected them or hurt them in some way. The emotions will come bubbling to the surface and will manifest through this outburst. Not all people with RSD will experience this symptom, but many people do.

Those suffering from RSD also experience social anxiety. Many people feel so anxious in social situations that they will start to avoid settings where they feel they're in danger of being embarrassed or hurt emotionally. You might notice someone with RSD withdrawing from the people that they love. They might choose to start spending more time alone and could even have problems maintaining a healthy relationship.

It's even possible that someone with RSD might feel like they're a failure. Those with this condition often set very high standards for themselves that they cannot truly meet. This can lead to feelings of failure and thinking that they have let other people down even when that isn't the truth of the matter. In extreme situations, people with RSD might even have thoughts about hurting themselves or suicide.

Similar Mental Health Conditions

As mentioned above, many mental health conditions have symptoms that mirror those of RSD. It's possible that you might not have RSD at all and that you could be dealing with another issue. If the signs above seem to relate to your situation, then you still might not be able to be sure that RSD is what you're dealing with. Remember that RSD is something that people who suffer from ADHD deal with, so you'll also be diagnosed with that if RSD is truly the problem.

You could also be dealing with conditions such as bipolar disorder, depression, social anxiety, social phobias, borderline personality disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder, or another type of mental health condition. Your doctor is going to be able to assess your situation to determine what is going on. Once they have evaluated you, it'll be possible to develop the best way to treat you.

What Causes RSD?

You might be curious about what causes RSD. At present, RSD may have a genetic component. RSD symptoms can then become worse when people are exposed to emotionally traumatic events. Stress also seems to have a big impact on RSD and emotional outbursts. When people are more stressed out, they will be more likely than usual to have RSD issues.

As for what causes an RSD outburst or episode, it can be anything that a person finds to be criticizing or rejecting somehow. Sometimes people with RSD will perceive that they're being criticized or rejected even when they aren't. They're more emotional and sensitive than usual, and this can lead to misunderstandings.

How Is RSD Treated?

Several treatments have been known to help RSD. Two specific types of medicine can make a difference and help you to manage RSD symptoms. Many patients are prescribed Guanfacine and clonidine to lower their blood pressure. This also helps to manage RSD symptoms.

Another medication that helps out is tranylcypromine, which is a monoamine oxidase inhibitor. This drug is designed to treat the impulsive behaviors and emotional symptoms experienced by people living with ADHD. These medications can be useful, and many people do wind up feeling better after taking them. It can potentially make the RSD symptoms less intense, and some experience fewer emotional outbursts when taking the medications.

What types of treatments will be right for you will depend on your doctor's recommendations. Understand that managing your stress levels will also be very important. People have more problems with emotional issues when they're dealing with high levels of stress. For this reason, you need to take extra care to ensure that you're eating right and taking care of yourself. An increased amount of attention paid to your self-care routines might make a big difference in your life.

You could try to start meditating as a healthy way to manage your stress levels. This might help you to avoid having negative thoughts that can lead to emotional outbursts, too. It's also important to do simple things such as eat right and try to get enough sleep. Try to get some exercise when you can, since you're going to have an easier time resting when your body is tired out. These suggestions might seem like common sense to some people, but they really can make a difference in your life when you're dealing with RSD.

How To Manage A Relationship Successfully When You Have RSD

Managing a relationship successfully when you have RSD might be more difficult than usual. This doesn't mean that you can't be happy with your partner. It's just going to take some effort to overcome your feelings and remain comfortable in the relationship. Trying to be open with your partner about your feelings will be helpful. If your partner can understand what is going on, they should help set your mind at ease when you're going through a difficult time.

Having a very supportive partner can certainly make a difference. If your romantic partner understands your situation, you should navigate certain relationship pitfalls more successfully. Your partner might be able to reassure you when you're feeling shunned or rejected simply due to the RSD. You don't have to face this issue alone either. Going to therapy might help you to feel much better.

Therapy isn't something that is seen as a cure for RSD. After all, the emotional outbursts that are associated with RSD generally happen suddenly and without warning. Even so, a therapist is going to be able to help out in many ways. For example, they can work with you to help you learn how to handle your emotions. A skilled therapist can help people with RSD learn how to channel their emotions positively, making it easier to deal with RSD over time.

Therapists can also work with you and your partner together. You can learn the best communication techniques to empower your relationship. They can also address any concerns you might have to keep your relationship going in the right direction. Having a therapist to talk to can make a big difference for people who have RSD issues. You shouldn't hesitate to reach out if you want to make sure that your relationship stays strong.

Online Therapy Is Available

Are You Experiencing Rejection Sensitivity - Or Something Else?

You should also know that online therapy is an option for you. If you want to get therapy as a couple but don't have the time to attend traditional therapy, then the online options are going to work out fantastically. Online couples counseling is available, which can help you overcome issues that are holding you back. The best part of online therapy is that it is designed to be as convenient as possible.

When you can rely on online therapists, it makes it easy to feel secure. You'll be able to reach out at any time, and you'll never have to worry about things such as regular office hours. If you need assistance, then you'll be able to make contact right away. It's a discreet form of therapy, and you'll be matched with licensed therapists who care about helping you. Sign up for online therapy today if you'd like to get some help with RSD issues and manage your relationship successfully.

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