In October 2016, William W, Dodson wrote an article for CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder) in which he detailed the ‘extreme emotional sensitivity and emotional pain’ triggered by being rejected or perceiving rejection. He called it ‘Rejection Sensitive Dysphoria’.
In his original article he describes that there are three major mood problems in ADHD. Shame and Guilt, Over-reaction, and Rejection Sensitive Dysphoria. He claims that Rejection Sensitivity is the only one of these mood problems that’s exclusive to ADHD.
6 years after the original article, what do we know now?
What is Rejection Sensitive Dysphoria?
“Rejection Sensitive Dysphoria is a triggered, wordless emotional pain that occurs after a real or perceived loss of approval, love, or respect.
RSD is an extreme emotional sensitivity and emotional pain triggered by the perception or imagination by the person with ADHD that they have:
- been rejected
- been teased
- been criticised
- disappointed important people in their lives
- withdrawn their own approval of themselves when they failed to attain their own standards or goals”
– William W. Dodson
Rejection Sensitive Dysphoria is a symptom of ADHD not listed in the DSM-5 and is considered as a form of emotional dysregulation. It is extremely common (around 95% of ADHDers experience it) in both children and adults with ADHD, but as there is still very little research it is unclear whether it is a trait exclusive to people with ADHD.
Additude Magazine said: “One-third of my adult patients report that RSD was the most impairing aspect of their personal experience of ADHD, in part because they never found any effective ways to manage or cope with the pain.”
What are some common symptoms of RSD?
- Difficulties maintaining relationships
- Sudden and often extreme emotional outbursts
- Withdrawing from social situations
- Isolating yourself
- Negative self-talk
- low self-esteem
- High levels of anxiety
- Rumination and perseveration
- Sudden emotional outbursts following real or perceived criticism or rejection
What triggers RSD?
- Perceived Rejection
- Actual Rejection
- Being Teased
- Being/feeling criticised
- Feeling as you’ve let someone down
- When something doesn’t go to plan
What causes RSD?
Currently, we don’t really know why RSD occurs or how it develops. However, current research suggests that there could be a genetic link. In addition to this, some researchers suggest RSD is related to a different brain structure and chemistry in the ADHD brain.