Rejection-sensitive dysphoria is ADHD’s dark secret.
It lurks in pretty much everyone with ADHD (99% according to WebMD), unknown and unspoken. Some people who have talked about it describe it as the worst part of ADHD.
Rejection-sensitive dysphoria, or RSD as it’s known for short, is the over-reaction to real or perceived rejection. It means that whenever someone is horrible to you – be it someone you love saying something hurtful in an argument, or a Twitter troll baiting you for kicks – you react in a way that most people would find disproportionate. Even extreme.
But why do we react like this? Because it hurts.
And no-one really knows why.
People with ADHD often get told they’re “too sensitive”. That they “blow up too easily”. They’re always over-reacting. That they’re getting upset over nothing.
All this is true. To a normal person. But what our neurotypical friends don’t realise is that we are reacting like that because it reflects how we feel. And we can’t control how we feel.
Saying that we’re too sensitive, or that we’re over-reacting isn’t helpful. It doesn’t take away how we feel. It doesn’t make it better. All it does is show us that normal people don’t understand. They have no idea of the depth of our feelings when something happens that – to them – seems relatively minor. It can feel like the world has ended.
There’s no treatment for RSD, only coping. Coping is difficult but doable. It mitigates the worst of the pain, rather than taking it away, but it’s better than nothing.
I’ve spent a long time developing strategies to cope with my rejection-sensitive dysphoria. Some are a bit weird, but they do work. I’m sharing them here in the hope that you might find them useful too.
1. RSD coping strategy: distraction
One of the symptoms of rejection-sensitive dysphoria is rumination. You will go over and over what happened. Then you’ll start thinking about what you should have said, what you could have done differently, what might happen next, and so on. You might wonder what drove the person to speak to you that way, or to do that to you. Was it your fault? Are you to blame for the bad things that happen to you?
Thinking through an issue is helpful, but rumination doesn’t do that. It takes your brain down dead-end streets. It doesn’t help you process what happened, or bring up any useful insights. It just goes over the same stuff, both real and imagined.
So distraction can be your first line of defence in coping with RSD. It just stops you from ruminating, and you can take some time to process the experience when you’re not quite so wound up.
My favourite form of distraction is one that relies on other people. If I try a book, or TV, or work, there’s nothing to stop my mind wandering back to the situation I’m ruminating on. But if I have to listen to one of my kids explaining the layout of their latest “base”, or I’m having a meeting with a colleague to develop a new project, I have to focus. I have to concentrate on the task at hand and it shoves everything else out of my mind. It will come back, of course it does, but it really helps me to shelve the problem until I’m in a place where I can cope with it.
2. RSD coping strategy: getting perspective
I know, I know.
You’re fully aware that other people have it worse than you. You’re getting upset because someone you like didn’t text you back, but you’ve just walked past a homeless person. Or you’re gutted because you got “told off” at work, but your mate’s mum is in hospital. Knowing all this doesn’t automatically make you feel better. In fact, it can make you feel worse, because you feel like you shouldn’t be upset over something relatively minor. You can feel guilty.
But gaining perspective, if you can process it properly, can help you see things a bit more clearly. And if you practice, it starts taking away the sting of rejection.
Let me explain.
Say someone was horrible to you on Twitter. Your RSD kicks in, you want to cry, or shout, or delete your account, or be horrible back. But if you take a pause, you can reflect on where your position as a victim of trolling is in the general scheme of things.
So, some people (hello inoffensive white men) have never experienced it. They’re below you on the scale. Some people have had a ton of it. In fact, anyone who pops their head above the parapet will have had it – especially if they’re trying to make the world a better place, and doubly especially if they’re a minority (hi black trans climate change activists!). All of them are above you on the scale.
So you’re probably somewhere near the bottom of the scale. That’s just where you are. That’s your position right now.
Looking at it this way can take the emotion out of the situation. You’re just imagining yourself on a scale and you’re fortunate that you’re not at the top end. But this approach can also help redirect your thoughts. Most neurodivergent people are quite caring, and you can use this trait to help others. So many of us will stand up for others before ourselves, so if you see anyone else getting trolled (and you will), you can use your experience to support them. Send them a public message or a DM. Say you’re sorry for what happened. Say you understand. And say you’re here for them.
You’ve distracted yourself from rumination, gained some perspective, taken out some of the emotion and supported others – all in one go. Result.
3. RSD coping strategy: role models
Leading on from gaining perspective is using role models to help you cope with rejection-sensitive dysphoria.
Seeing how much “better” people cope can sometimes be disheartening for those of us who don’t feel like we cope with anything very well, but I actually find it helpful. Looking at people who’ve gone through terrible experiences, who’ve done wonderful things, and just keep going!
I wish I could take their resilience, like it was a bowl of jelly, and gobble it all up.
I can’t of course, but I can look at what they’ve done – things I think I could never do – and see what I can learn from that. I don’t know why, but my default role models are American civil rights leaders. My favourite is John Lewis. Whenever I’m feeling weak or fragile or like I want to crawl into a hole and never come out, I look at his Wikipedia page. I read about how the police beat him for riding a bus with white people – even when it was legal. I look at his career – how he started as a teenager and carried on working right up until he died – never giving up, despite everything that happened to him.
John Lewis is one of those people I put on a pedestal. I will never achieve what he did and I can never be like him. I just don’t have it in me. But instead of being disheartened, I try to learn from him. I try to understand that you can get up again and keep going even after the 10th or 100th time someone’s been completely awful to you.
I know it’s within the realm of possibility.
4. RSD coping strategy: mindfulness
Sometimes I get so upset, that the other stuff doesn’t work. I can’t distract myself, or send supportive messages to people on Twitter, or read about American history because I’m too all over the place. I’m too emotional and chaotic.
If that happens, I will do some mindfulness.
If you’re one of my regular readers (hello to both of you), you will know that I found mindfulness incredibly helpful during and after my recovery from depression. I tried through apps and books but with my ADHD, I could never stick with it, until I did a real life course. You sit in an actual room with an actual teacher and do both learning and practice (she does it online now obvs).
Mindfulness taught me a lot of things, but the single most helpful thing I got from the courses was to sit with my feelings. I was so used to pushing them away, or squashing them, or denying them, that I never learnt to sit and just feel. Even the sad stuff.
The big thing about actually allowing yourself to experience feelings is that it makes the bad ones go away quicker. This surprised me. I thought if I let myself feel the bad stuff, it would drag on for ages and I would feel terrible. But the reverse is true. If you really experience your feelings – identify how you feel, name what you’re feeling (if you can) and acknowledge that it really doesn’t feel very good – you tend to find that they start to dissipate quite quickly.
Mindfulness isn’t for everyone. Some people find it ineffective and some actually find it makes things worse. As with everything to do with your mental health and neurodiversity, give it a try and ditch it if it’s not right for you. If you’ve experienced trauma and/or you have PTSD, you must exercise extreme caution when approaching mindfulness.
5. RSD coping strategy: courage
I was once paddling a canoe around a bay in Vietnam with an old French man and his wife. I told the man that I was backpacking solo around the world and he told me I have “grand courage”. I don’t feel that I have “grand courage” or even “petit courage” but who am I to argue with an old French man in a canoe?
Courage is something that very few of us feel we have a great deal of, but the good thing is, we can develop it. Every time we do something brave, we add a little tiny bit of confidence to our mental picture of ourselves. Every time we challenge ourselves and do the thing we were afraid of, we can say “Yeah. I did that.”
What does this have to with rejection-sensitive dysphoria? Well, too many of us with RSD start avoiding situations where we might get hurt. This is a thing that normal people do as well of course – just look at the number of people who’ve quit social media because of trolling, or criticism.
We feel thin-skinned. We’re told we’re over-sensitive. That we shouldn’t let a few sad losers tapping out insults on a keyboard get to us. And that makes us feel like we’re not resilient.
The thing is, resilience is something that can be developed. Like confidence. Or courage.
The more we try to face our fears, deal with the negativity and carry on doing what we do, the better we get at it. We can gradually add bits to our invisible suit of armour so we’re able to deflect the arrows of criticism when they’re fired at us.
That’s not to say we’ll all turn into a metaphorical tank, of course. If you’re a lovely human who’s sensitive to other’s needs, the flip side of that is that you’re always going to be a bit more vulnerable to the bad stuff. But you can learn to deal with it, as you develop courage, and with support.
Which brings me onto my final coping strategy…
6. RSD coping strategy: support
This, for me, is the most valuable and important of my coping strategies.
It’s one I’ve only developed recently, after therapy. I had to learn to be vulnerable, and to reach out to others when I needed support.
When I am experiencing rejection sensitive dysphoria, I talk to someone about it. About what’s happened and how I’m feeling. Who I talk to depends on where I am and who is around. I might talk to a close friend or understanding colleague – I’ll usually pick someone who I can rely on to calm me down. Or I might call a friend with ADHD and/or autism, because I know they’ll understand without it needing to be explained.
It’s made a huge difference. I feel like I’m not on my own any more. I’ve got people who will listen to me without judgement. People who can help me with all the other stuff, like distraction, and getting perspective, and helping me back on my feet so I have the courage to try again.
What if there’s no-one like this in your life? Well, you’ve got 3 options, and you can do all of them.
The first is to call a helpline. Yes, yes, I know, those are only for people who are suicidal or have other “real” problems. But RSD is a real problem and can lead to suicidal feelings (yes, I know). If something’s upsetting you, you can and should reach out to the support services which have been set up just for people like you. The Samaritans is the obvious choice, but you can also contact others, like mental health support services.
The second is to share your experience and feelings in an online peer support group. These exist on Facebook and they’re private so your other friends on Facebook can’t see what you’re posting. Peer support groups vary enormously in how they’re run, the vibe, and the kind of support you get but loads of people find them a lifeline. Just being able to share your experience and have others share that they’ve had similar, and they understand how you’re feeling. And that they’re there to support you.
The third option is more long-term. You need to develop a support network. Find those friends who listen without judgement, who understand how you feel, and can offer helpful advice (if that’s what you need). If you don’t know where to start, have a look at groups that interest you on Meetup. Join some of these and attend events (some of them will suck by the way, and you’ll leave feeling worse, but stick with it and you’ll eventually find your tribe). Think about some of your hobbies or interests that you had ages ago that you’ve abandoned – what might you like to get into again? I personally have found joining a group that’s focused around a particular activity (sports, arts, gaming etc) are better for making new friends than ones that are unstructured networking. There are still plenty of these which exist online.
One final tip: to build your support network, you have to be the person that other people need. You have to be the one to listen without judgement, to take the time to understand others and to let them know you’re here for them. You need to be a good friend to have good friends. In being a good friend, you’ll start to develop confidence which can lead to that resilience we talked about earlier, as well as developing supportive, nurturing relationships. Like with so many of these strategies, doing something in one area has positive effects in another.
Rejection-sensitive dysphoria is horrible. It leads to defensive behaviour, avoiding situations, and feeling like a sack of rubbish. It can even damage relationships.
But while you can’t make it go away, you can use the above coping strategies to manage it and mitigate the consequences.
You can use them to develop a safety net to make sure the effects don’t last too long, and that you’ve got help to get you through it.
You can ensure that rejection-sensitive dysphoria won’t take over your life.
It doesn’t have to.
You can call the Samaritans on 116 123.
After sharing this on Twitter, I received feedback from @AspieOrphan. She said that mindfulness and suggestions of developing resilience are not useful or appropriate for those who have suffered trauma (I added the last sentence in the mindfulness section above as a result of her comments). She also sent me this article on RSD and complex trauma, which I found incredibly interesting and I hope you do too.