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Why Does Neurodiversity Create Rejection Sensitive Dysphoria

For people who are neurodivergent, rejection sensitive dysphoria (RSD) can mean extreme emotional sensitivity and emotional turmoil.  Some professionals say it can even imitate bipolar disorder with suicidal ideation.  

Is Rejection Sensitive Dysphoria a New Diagnosis?

Rejection Sensitive Dysphoria is usually misunderstood as rapid cycling bipolar disorder.  RSD is extreme sensitivity and pain triggered by the perception that a person has been rejected or criticized by important people in their life.  People with ADHD or ADD often times have diffiuclty regulating their emotions and their response to being rejected, criticized or fail are much more severe than for the neurotypical individuals.  RSD is a

Externalizing the criitcism looks like an explosive anger toward the perceived person who is causing the pain.  Therefore, people may see those with RSD as overly perfectionistic, over-sensitive, or overly reactive to even the mildest types of criticism.  

RSD is not a mental health condition in the DSM-5, so therefore has no set of empirically quantifiable criteria for and official diagnosis.  RSD is a new label that is only starting to be researched in depth. 

Moreover, RS can mimick Social Anxiety Disorder but the person may not be as anxious before an interaction (like someone with Social Anxiety Disorder will be) but instead will have an extreme reaction if they felt it went badly afterward.  People with RSD feel shame, guilt, sadness, or even rage about what they perceive as a rejection, rather than debilitating nervousness that comes before an interaction even happens with Social Anxiety Disorder.

People with ADHD or ADD cope with this emotional dysregulation in many ways:

1. They become obsesed with pleasing others and go out of their way to make sure people are happy with them.

2. These people give up doing things that are anxiety-provoking and end up feeling stuck professionally and socially.  

3. Some people become overachievers because they are constantly working to be the best at what they do and strive for idealized perfection.  

5 Ways to overcome and heal RSD

1. Work with a therapist to heal the part of you who gets triggered by criticism.

2. With your eyes open or closed identify where in your body you are holding the fear of criticism.

3. Pay attention to the sensations in your body that are caused by this fear of criticism. 

4. Use the breath or touch to relax the muscles around the part of the body that is triggered by the fear.

5. Name the qualities of the bodily sensations such as: my chest feels tight, cool and heavy.

6. Practice self-compassion toward the triggered part.

Have a question for Dr. Pound to answer in upcoming blogs?  Let me know.

Go to my website at to learn more about my services


Gretchen Pound, Ph.D.

Owner and Founder of Healthier Life Therapy

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