What is Rejection Sensitivity Dysphoria

People with ADHD feel things more. It’s in the way our brains are wired. Part of the difference is that our limbic system, hypothalamus, and amygdala are structured differently, and paired with our impulsivity, it can cause us to have emotional dysregulation reactions. One of the most prevalent presentations of this is Rejection Sensitivity Dysphoria, also known as Rejection Sensitivity.

Bald man with beard sadly looking at the camera.

Many people think of RSD as angry outbursts, but it can present in different ways depending on how our ADHD affects us, as well as what type of trauma we have dealt with in our lives. Sometimes it is depression, where we retreat into ourselves, shutting everyone out. Sometimes it’s panic attacks or manic episodes. However it presents itself, it is detrimental to the relationships that we have in our lives.


In simple terms, when we deal with triggers, such as rejection, criticism, or whatever negativity we’ve perceived directed at us, our limbic system experiences the emotions, and signals our amygdala, and we have to deal with our Fight/Flight/Fright/Fear/Fix reflex, based on what memory/triggers our hypothalamus pulls from any strong emotional memories we have.


Men, or masculine identified people, and those with hyperactive presentation, often deal with aggressive responses such as Fight or Fix. People with inattentive presentations tend to have Flight and Fright responses.


Neurotypical people have a trigger that sends a signal when this happens from the prefrontal cortex, a Logic Response that says,


“Wait a minute, let’s think about this.”

With ADHD, that trigger is not working as well or is non-existent, and so many of us react without thinking when we are feeling criticized or overwhelmed by our feelings.


That’s why working with a psychiatrist is so important, so that we can figure out what comorbidities we deal with along with our ADHD. Many who have emotional dysregulation react well to guanfacine, clonidine, or lamictal. These medications help us balance our emotional responses and give us time to process before having outbursts. It’s important to talk to your psychiatrist about these options and see if they think they, or other treatments can help.


Therapy is also important; we have to learn about our emotions, our triggers, how to cope with them, and how to process our emotions healthily. We have to figure out how to use our creativity to channel our stress and frustrations so that they do not build up and overwhelm us. They can also help work to help exercise the Logic stop to help prevent the Emotional Dysregulation, or at least let us walk away when we realize we are being triggered. Groups like the Men’s ADHD Support Group can also provide a lot of support as well.


It’s also important to build a support system around ourselves. Now that we are learning how our ADHD and comorbidities affect us, we have to learn about the accommodations that we need, not just in our workplace but also in our relationships. We have to communicate the support that we need from our spouses, our parents, our friends, and our peers. We need to learn to set up boundaries to protect ourselves from triggering events. Therefore, educating ourselves on how ADHD affects us is important.


Rejection Sensitivity can affect people with ADHD in many ways, but it is still our responsibility to learn from the mistakes that we make and to move forward and heal. If you need help learning how ADHD affects you, schedule a session today and let’s talk about how.






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