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ADHD and RSD

Text "ADHD & RSD" in bold white and orange on a blue and pink abstract background.

If you’ve ever felt like one slightly weird look, a delayed text, or a throwaway comment could send your brain into a meltdown… Hi. Welcome. You may be familiar with the emotional rollercoaster often described as Rejection Sensitive Dysphoria (RSD).


It’s a term many ADHDers resonate with deeply, and for good reason. Let’s break it down!



What Is RSD? (And No, You're Not “Too Sensitive”)


Rejection Sensitive Dysphoria (RSD) refers to intense emotional pain triggered by the perception, real or imagined, of rejection, criticism, or disapproval.

People who relate to RSD often describe:

  • Intense shame or sudden emotional collapse

  • Feeling crushed by small criticisms (feedback? performance review? hard pass.)

  • Replaying conversations and “confirming” that yes, everyone secretly hates them (spoiler: they don’t)

  • Struggling to bounce back after conflict or even a hint of interpersonal tension


It’s not dramatic, attention-seeking, or overreacting. It’s a real neurobiological sensitivity tied to how ADHD brains process threat, safety, and connection.



But RSD isn't in the DSM?


RRSD is not a formal diagnosis and it does not appear in the DSM-5-TR (the big guide clinicians use to label conditions, not for defining your lived experience!). But that doesn’t make the experience any less valid.


For many people with ADHD, RSD gives language to something they've felt their whole lives but couldn’t name.


People with ADHD often experience:

  • Higher rates of criticism

  • Invalidation or misunderstanding

  • Executive functioning differences, including emotional regulation challenges

  • Struggles interpreting social nuances


So while RSD is not exclusive to ADHD, and can also show up in many other experiences including trauma , anxiety, and across the wider neurodivergent community, many ADHDers recognise themselves instantly in the description.



What the Research Tells Us About ADHD and RSD


Emotional Dysregulation and ADHD

  • Adults with ADHD experience significantly higher emotional dysregulation, with emotions that may come on quickly, feel more intense and shift faster (Beheshti et al., 2020).

  • Young people with ADHD experience more intense emotional responses and are more reactive to stress and frustration than their neurotypical peers. (Graziano & Alexis, 2016).


Rejection Sensitivity and Anxiety

  • In children with ADHD, social challenges and rejection sensitivity amplify anxiety symptoms. (Alacha & Bufferd, 2025).


What Can Influence Rejection Sensitivity

  • When ADHDers found it difficult to savour positive moments (that is, fully experience and hold positive feelings), rejection sensitivity was stronger. But for people who were able to savour the good moments, RSD was not significant. (Müller et al., 2024).

  • The link between rejection sensitivity and ADHD becomes weaker once depression, anxiety, and difficulties with emotion regulation are taken into account. This suggests that these emotional factors play a significant role in how strongly RSD is experienced. (Sterecka and Oręziak, 2025).


RSD is Not Universal

  • Research also shows that RSD is not universal. Not every ADHDer experiences it, and the lived experience of rejection sensitivity can vary widely across gender, race and culture (Ginapp et al., 2023).


However, it is important to recognise that much of the current research draws from a limited demographic group, and therefore does not reflect the full diversity of people who experience ADHD, including those who have not had access to diagnosis or who come from underrepresented cultural, racial or socioeconomic backgrounds.


We hope that future research will include a wider range of voices and lived experiences so our understanding of rejection sensitivity becomes more accurate, inclusive and reflective of the real people it affects.



What Can You Do When RSD Hits?


  • Name it in the moment: “I’m experiencing rejection sensitivity right now” helps separate feeling from fact.

  • Check the story your brain is telling you: Ask yourself:

    • “What else could be true?”

    • “Did I take this personally when it might not be about me?”

    • “Do I need clarity rather than guessing?”

  • Practise savouring: Build the skill of staying with positive experiences a little longer. Research shows this can make a real difference. Try creating a “good moments” photo album or journaling small wins.

  • Talking with people who feel safe, grounded, and validating.



What Can We as Clinicians Do?

Because RSD cannot be cured by “just don’t take it personally” - if only it were that simple!


  • As clinicians, one of the most important things we can offer is validation. The emotional intensity is real, and so is the pain. When someone has spent years being told they are “too sensitive,” having their experience taken seriously can be deeply healing.

  • Clinicians can support clients to build emotional regulation skills, not by shutting emotions down, but by understanding them.

  • Another central element is creating space to explore feelings of shame and the personal stories that have built up over time.

  • And of course, all of this work happens through a Neurodiversity Affirming lens, because why would we ever choose anything else?



How We Support You at Very Helpful Chats


At VHC, our psychologists and occupational therapists understand the emotional world of ADHD, including rejection sensitivity. Whether you are seeking therapy for emotional regulation, support with ADHD, or a space to explore your experiences safely, we are here to help.


RSD is real, valid and deeply felt — and you do not have to navigate it alone. With the right support, understanding and tools, it is entirely possible to move through the world with less fear of rejection and more trust in yourself.


If you are curious about therapy or want support tailored to your neurodivergent brain, you can learn more about our services at veryhelpfulchats.com.au.


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References

Alacha, H. F., & Bufferd, S. J. (2025). Peer Functioning and Anxiety Risk in Children With Elevated Attention-Deficit/Hyperactivity Disorder Symptoms. Journal of Emotional & Behavioral Disorders, 33(4), 204–221. https://doi.org/10.1177/10634266251363946


Beheshti, A., Chavanon, M.-L., & Christiansen, H. (2020). Emotion dysregulation in adults with attention deficit hyperactivity disorder: a meta-analysis. BMC Psychiatry, 20(1), 120. https://doi.org/10.1186/s12888-020-2442-7

Ginapp, C. M., Greenberg, N. R., MacDonald-Gagnon, G., Angarita, G. A., Bold, K. W., & Potenza, M. N. (2023). “Dysregulated not deficit”: A qualitative study on symptomatology of ADHD in young adults. PLoS ONE, 18(10), 1–20. https://doi.org/10.1371/journal.pone.0292721


Graziano, P. A., & Garcia, A. (2016). Attention-deficit hyperactivity disorder and children’s emotion dysregulation: A meta-analysis. Clinical Psychology Review, 46, 106–123. https://doi.org/10.1016/j.cpr.2016.04.011


Sterecka, K., & Oręziak, H. (2025). Rejection Sensitive Dysphoria in ADHD: Myth or Reality? Assessing Its Validity and Underlying Psychological Mechanisms. International Journal of Psychophysiology, 213, N.PAG. https://doi.org/10.1016/j.ijpsycho.2025.112663


Vanessa Müller, David Mellor, & Bettina F. Pikó. (2024). Associations between ADHD Symptoms and Rejection Sensitivity in College Students: Exploring a Path Model with Indicators of Mental Well-Being. Learning Disabilities Research & Practice, 39(4), 223–236. https://doi.org/10.1177/09388982241271511


 
 
 

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