Rejection Sensitive Dysphoria (RSD) is an extreme emotional reaction to real or perceived rejection, criticism, or failure. Unlike the occasional disappointment most people feel, RSD triggers intense emotional pain that can feel overwhelming, sometimes likened to physical pain or deep anguish.
Key points about RSD:
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Intensity of reaction: Even minor criticism or perceived slights can provoke feelings of shame, worthlessness, or panic that are far stronger than typical emotional responses.
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Avoidance behaviors: People with RSD may avoid situations where they fear rejection, such as new projects, social interactions, or romantic pursuits, to escape the intense emotional distress.
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Mental health impact: These reactions can worsen anxiety, depression, and self-esteem issues. Over time, they may lead to social withdrawal or difficulty pursuing goals.
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Connection with ADHD: RSD is commonly associated with ADHD. Many people with ADHD experience heightened emotional sensitivity, which can amplify the pain of perceived rejection.
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Internal experience: Those with RSD often describe it as a “demon in your mind” or constant negative self-talk, making it difficult to separate their self-worth from others’ opinions or imagined criticisms.
In short, RSD isn’t just feeling hurt it’s an overpowering, almost physical emotional reaction that can deeply influence how someone lives and interacts with the world.
If you want, I can also break down how it differs from normal sensitivity or low self-esteem, because many people confuse the terms. Do you want me to do that?
losely associated with ADHD and can also occur alongside mood and personality disorders. This connection means that people with RSD may experience extreme emotional responses to rejection or criticism, sometimes so intense that it increases the risk of self harm or suicidal thoughts, according to the Cleveland Clinic.
Paris described the experience vividly:
This highlights two important points about RSD:
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The intensity of the emotions is disproportionate to the situation even minor criticism can feel devastating.
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Awareness and understanding help learning to recognize when RSD is driving these feelings can help someone separate their perceptions from reality and manage the emotional impact.
In short, RSD is a deeply felt emotional sensitivity to rejection that can profoundly affect daily life, but understanding it is a key step toward coping.
People with RSD struggle to regulate their emotions (Kathrin Ziegler/Getty Images)
Symptoms of RSD
While intense emotional pain is the core symptom, other signs may include:
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Heightened embarrassment or self-consciousness small social missteps can feel devastating.
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Low self-esteem difficulty trusting one’s abilities or worth.
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Emotional dysregulation may react with sudden anger, rage, or crying when feeling rejected.
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Turning inward some experience severe depression or internalized self-blame.
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People-pleasing tendencies obsessive efforts to avoid disapproval from others.
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Avoidance behaviors postponing projects, tasks, or goals due to fear of failure.
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Perfectionism leading to intense anxiety and stress.
RSD and ADHD
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RSD is often considered part of emotional dysregulation in people with ADHD.
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ADHD can already cause mood swings, impulsivity, and intense reactions.
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With RSD, neutral comments or mild criticism may be perceived as rejection, causing misunderstandings and heightened distress.
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This combination can make everyday social and work situations feel overwhelming.
Managing RSD
Management often involves a combination of therapy, self-care, and sometimes medication:
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Talking therapies Cognitive Behavioral Therapy (CBT) or other approaches to help reframe negative thoughts.
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Medication If RSD is linked to ADHD or another condition, appropriate medication may help with emotional regulation.
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Stress reduction and self-compassion Regular downtime, mindfulness, and being kind to yourself can reduce intensity.
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Assessment by specialists Proper evaluation ensures the correct support and treatment.
A Positive Perspective
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