Defining Rejection Sensitive Dysphoria (RSD) as It Relates to ADHD.

Although it does not have an official set of symptoms and is not a medical diagnosis, rejection sensitive dysphoria (RSD) is an emotional response characterized by an extreme sensitivity to perceived or actual rejection, criticism, or failure. This condition often coexists with Attention Deficit Hyperactivity Disorder (ADHD). RSD can manifest in various ways, such as feelings of shame, humiliation, and overwhelming sadness. Individuals with RSD may experience these intense emotions even in response to minor perceived slights or rejection. It is important to understand RSD as a distinct experience, separate from the core symptoms of ADHD, to provide appropriate support and treatment.

Not all individuals with ADHD experience RSD, and not all individuals with RSD have ADHD. However, research suggests that there is a higher prevalence of RSD among individuals with ADHD compared to the general population.

Symptoms and characteristics of RSD

People with rejection sensitive dysphoria may exhibit several symptoms and characteristics that are unique to this condition. These include hypersensitivity to rejection, which can lead to an avoidance of social interactions or situations where they may feel vulnerable to rejection. They may also have a strong desire for approval and validation from others and a fear of disappointing or letting others down. Additionally, individuals with RSD may be prone to experiencing rapid mood swings, going from feeling intense joy to deep despair in a short period.

The connection between RSD and ADHD

Rejection sensitive dysphoria often coexists with ADHD, and the two conditions can influence and exacerbate each other. ADHD is a neurodevelopmental disorder characterized by difficulties with attention, impulsivity, and hyperactivity. People with ADHD may already struggle with self-esteem and maintaining relationships due to their symptoms. The presence of RSD can intensify these challenges, as individuals may react more strongly to perceived rejection or criticism, leading to increased emotional distress and difficulty coping.

How RSD affects individuals with ADHD

For individuals with ADHD, rejection sensitive dysphoria can significantly impact their daily lives. The fear of rejection or failure can make it difficult for them to take risks and engage in new experiences. This can limit their personal and professional growth, as they may avoid opportunities that carry a perceived risk of rejection. RSD can also affect interpersonal relationships, as individuals may become defensive or withdraw when they feel rejected or criticized, leading to strained interactions and potential misunderstandings.

Coping strategies for managing RSD

While rejection sensitive dysphoria can be challenging to manage, there are strategies that individuals with ADHD can employ to cope with its impact. Developing self-awareness and recognizing the patterns of RSD can help individuals identify triggers and understand their emotional responses. Seeking support from therapists or support groups can provide a safe space to explore and process these emotions. Building a strong support network of understanding friends and family members can also help individuals feel validated and accepted.

Treatment options for RSD

Treatment for rejection sensitive dysphoria often involves a combination of therapy and medication. Cognitive-behavioral therapy (CBT) can help individuals with ADHD and RSD develop coping mechanisms and challenge negative thought patterns. Medications such as antidepressants or mood stabilizers may be prescribed to manage the emotional symptoms of RSD. Guanfacine (Intuniv) and Clonidine (Kapvay) are two medications your doctor may consider. Individuals should work closely with healthcare professionals to determine the most effective treatment plan for their specific needs and what follow-up is necessary.

Support and resources for individuals with RSD and ADHD

There are numerous support and resources available for individuals with rejection sensitive dysphoria and ADHD. Support groups, both online and in-person, provide a community where individuals can share their experiences, gain support, and learn from others facing similar challenges. Educational resources, such as books and websites, offer valuable information and strategies for managing RSD and ADHD. Seeking guidance from mental health professionals, such as psychologists or psychiatrists, can also provide personalized support and guidance.

RSD in children and adolescents with ADHD

Rejection sensitive dysphoria can also affect children and adolescents with ADHD. It is crucial for parents, caregivers, and educators to be aware of the potential impact of RSD on these individuals. Creating a supportive and understanding environment is essential in helping children and adolescents manage their emotional responses to rejection or criticism. Open communication, validation of their feelings, and providing them with tools for self-regulation can make a significant difference in their well-being and overall development.


Rejection sensitive dysphoria is a significant aspect of the ADHD experience, characterized by extreme sensitivity to perceived or actual rejection, criticism, or failure. Understanding and acknowledging RSD as a separate condition can help individuals with ADHD receive the appropriate support and treatment. By employing coping strategies, seeking treatment options, and accessing support and resources, individuals with RSD and ADHD can navigate the challenges associated with rejection sensitivity and lead fulfilling lives.


Harold Robert Meyer The ADD Resource Center our e-list: at for information and research regarding ADHD with innovative tips, tricks, strategies, and techniques to make ADHD life easier for you and those around you. Reproduction, retransmission, or copying is prohibited without explicit permission.

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