What Is Rejection Sensitive Dysphoria?

ADHD is sometimes viewed as just forgetting things and having a short attention span, but for some, it’s a serious neurological disorder that affects a lot more than just executive function. What a lot of people don’t know is the significant emotional toll it takes on the person that has it, the extent of which can lead to severe depression and anxiety, and even suicidal thoughts.

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• Is ADHD Overdiagnosed?
• How to Study With ADHD
• What is ADHD?

Rejection sensitive dysphoria is something that commonly occurs when ADHD and anxiety combine, and it’s an extreme emotional sensitivity and pain which is triggered by the perception (not necessarily the reality) that a person has been rejected, teased or criticized by important people in their life. Rejection sensitive dysphoria may also be triggered by a sense of failing to meet either their own high standards, or others’ expectations.

People with rejection sensitive dysphoria often seek approval and validation from family, friends, and/or partners because we have low self-esteem. We are also our own harshest critics and set ridiculously high standard for ourselves, so when we feel we have failed to meet our own expectations, we rely on other people to confirm our worth.

We can experience sudden and intense bouts of depression and/or rage when we feel that we’ve been hurt, rejected or criticized and feel ashamed at the lack of control we have over our emotions. Sometimes, our emotions can manifest as an unpleasant physical sensation.

Because we have such an intense fear of failure, we would rather not try something at all or really play it down in case we’re unsuccessful, than bear the shame of building a plane that didn’t fly, so to speak. We are also easily embarrassed, so we avoid trying new things like meeting people and frequently pass up good opportunities, simply because we’re scared of potential rejection and criticism. We are reluctant to get involved in close friendships or relationships because we worry that they won’t like us, and feel anxious in social situations.

When we do get involved with others, though, we are extreme “people pleasers,” going above and beyond to get, and stay, on someone’s good side. However, we constantly feel under pressure to live up to other people’s expectations of us, and trying to please everyone at once is impossible and is therefore yet another thing that makes us feel like failures.

In the workplace, we generally assume the worst, worried that we’ll be fired every time our boss calls us into their office, so we dedicate more time than necessary to a project or become perfectionistic to make sure our work has no mistakes, so as to avoid reproach. One of the reasons that procrastination and avoiding starting a project is so common in people with ADHD is that we’re afraid we’ll fail.

Sometimes I feel like I’ve spent my entire life with people being mad at me for things that are just beyond my control. It’s really hard to take in stride. At the end of the day, I have enough confidence to keep my chin up, but that confidence is hard won, and in the moment it can be incredibly difficult to access. So when you feel like your loved one with ADHD doesn’t care or isn’t making an effort, believe me, we are. We may seem laid back and absent-minded on the surface, but inside we can be an anxious ball of frazzled nerves, always on edge and always trying our best not to let anyone down, even if it may not seem that way. Please be gentle with us even if we are angry or frustrated, because rejection sensitive dysphoria can manifest as anger as well as anxiety. Just letting us know that we are enough can give us the confidence we need to navigate life with this disorder.