Rejection-Sensitive Dysphoria: When Rejection Hits You Harder With ADHD

Growing up, I was labeled a “sensitive” child. Criticism or perceived criticism was met with tears. I looked forward to my report cards as a kid. Finally, a written document that showed I was succeeding! This thought process followed me into my teen years. I had an outlet as a staff writer for my high school newspaper as well as being a member of the drama club. Early on, my writing set me apart from others (or in the very least I was the best of the bad writers). It was a way to communicate my thoughts and feelings without the inevitable discomfort I felt speaking face to face. No facial expressions, body language, or tone of voice to analyze — simply words on paper. In the drama club, I was someone else. You aren’t criticizing me; you criticizing the character. In relationships, romantic or platonic, I was in a spiral if/when they ended. Over the years and transitioning into adulthood, I developed coping mechanisms, primarily avoidance. You can’t criticize or reject me if my hat isn’t in the ring.

I abhorred this part of my personality. I wanted to get over a breakup by eating ice cream by the pint and yelling at bad rom-coms. Instead, I’d autopilot through my days and unsuccessfully attempt to dodge each intrusive thought: restaurants, theaters, parks, all the places my former partner and I went to were salt in a wound that it took months and even years to heal.

Compliments baffled me. “Your hair looks nice like that!” I’d give the requisite thank you, but in my mind, “Did my hair look bad yesterday?” Meetings for performance reviews during jobs were nail-biters, no matter how well they went. I’d upload photographs from recent sessions and I could have dozens of compliments, but I’d isolate that one comment from a stranger on the internet and hang onto it like a toxic security blanket.

During an annual wellness exam about 10 years ago, my doctor asked if I’d ever been screened for ADHD (attention-deficit/hyperactivity disorder). Despite having bipolar disorder and generalized anxiety disorder, it had never crossed my mind, only bringing forth images of kids running around classrooms defiantly ignoring a teacher’s instructions. Nonetheless, I answered her questions and by the end of it, she was discussing medication options if I wanted to go that route. I began a stimulant medication shortly thereafter. Wow! It reminded me of the first time I got glasses. From fuzzy shapes and colors to a view as clear as HD (or cable, if you’re as old as me). My job performance improved. I was able to complete not one, but two college degrees. I was able to sit down and write a letter, an essay, an article, and simply be able to just focus. I made lifestyle modifications such as implementing organizational skills and abiding by a schedule. Time marched on and my quality of life improved. However, no matter how many miles I ran, how many smoothies I drank, or how much I journaled, helped to alleviate that painfully internalized and overly analytical brain bug.

Fast forward to a new decade and a pandemic. As I stirred restlessly at home helping my child during virtual learning, I fell into the rabbit hole of doom scrolling. Not to be confused with doom boxes, which could be an article all its own. Video shorts transitioned from retired grandmas dancing to Britney Spears to the topic of ADHD. Each anecdotal video was a person’s experience with the disorder. Each “Put a finger down…” clip left me with no fingers. Suddenly, like a ray of sunshine accompanied by a chorus of harps, there was a clip about rejection-sensitivity dysphoria. Saywhatnow?

In individuals with neurodivergent characteristics, such as ADHD, we may have issues with emotional dysregulation. Our brains process emotions differently which can cause our reactions to be much different from that of a more neurotypical person. As part of that process, rejection-sensitivity dysphoria (RSD) amplifies feelings of criticism, rejection, or disapproval. People struggling with rejection-sensitive dysphoria can be or feel:

• Highly self-conscious
• Easily embarrassed
• Feelings of low self-worth
• Difficulty managing emotions which can lead to outbursts, especially in kids
• Depression or anxiety
• Mask their insecurities by being a perfectionist or avoiding new challenges, each used to avoid the intense pain of rejection or criticism
• Described as overly sensitive by others
• Self-criticism

Rejection-sensitivity dysphoria is a newer term and isn’t an official diagnosis, but the intense pain of emotions is nothing new and is very real to those of us who have struggled with it for years. I read as much information as I could find. I found online communities. I even found people I’d been friends with for years that, after I mentioned my moment of self-discovery, the lightbulb, the dots that connected, told me of eerily similar emotions and experiences. I felt more validated and much less isolated.

It all made sense now. Yes, I’d loved and lost, but gone were my feelings of shame and self-loathing. I’d had career highs and lows, yet I could let go of that seed of dread that I wasn’t good enough or smart enough. I could finally let go of so many “if only…” thoughts that swirled round and round in my mind.

It isn’t a Hollywood montage. We didn’t open with a blank expression, disassociating from a breakup text, with image after image showing various states of emotional anguish, slow pan of the camera as the antihero hears that the pain has a name, and a final segue to a voiceover wrapping it neatly with a bow and a happy ending. It hasn’t been an easy or quick process. I take medicine for my ADHD and am in talk therapy. I make more time for self-care and am learning to give myself grace. It has helped immensely and I look forward to making more progress.

Now, this is my path towards healing. Yours will be different and only you can decide what makes the most sense for yourself and your needs.

Please know that you matter, you are worthy, you are valued, and you are needed. Imperial or metric, no unit of measurement can calculate how much you should or should not feel. There is validation and vindication that the serpentine has a name and I can unburden my shoulders.