What Is Rejection Sensitive Dysphoria (RSD)?

Some people are more sensitive than others. For example, some people may become more concerned than others about whether people are saying negative things about them. Sometimes, these fears might be irrational, but they can be persistent. In this situation, you might be wondering whether you have rejection-sensitive dysphoria (RSD), or are simply sensitive to criticism.

What is RSD?

While not an official psychiatric diagnosis in the DSM-5, RSD is a condition that some people with attention deficit hyperactivity disorder (ADHD) may develop. People who have RSD are more sensitive to rejection than other people. In fact, these individuals often spend a lot of time worrying about what others are thinking about them. They may become more upset than usual when they're criticized, or if someone speaks to them harshly. Many people with RSD might be prone to misinterpreting a situation and feeling shunned, even when that wasn't someone's intention.

You might consider RSD a type of extreme emotional sensitivity. This is a common symptom that people with ADHD might experience. It should be noted that RSD episodes can be triggered by someone feeling like they have been rejected in some way. This isn't always the reality of the situation, but the feelings of rejection are still real.

Understanding the signs of RSD

Understanding the signs of RSD may be one of the first steps to identifying the condition. It should be noted that some of these signs can mirror symptoms associated with certain mental health conditions. For this reason, it's important to get a proper diagnosis. If you are experiencing emotional problems that are making life more difficult, it could be worthwhile to speak with a physician, psychiatrist, or therapist.

One of the most common signs that someone has RSD is that they may become easily embarrassed. A situation that might not seem that embarrassing to others could cause a person with RSD to feel extreme humiliation. A simple joke, for example, could end up striking a nerve for someone experiencing RSD. Many people who have RSD also have very low self-esteem.

It's common for people who have RSD to have angry or emotional outbursts, too. This symptom may arise when they feel that someone has rejected them or hurt them in some way. The emotions can come bubbling to the surface and might manifest in an outburst. Not all people with RSD will experience this symptom, but many do.

Those experiencing RSD may also experience social anxiety. Many people feel so anxious in social situations that they will start to avoid settings where they feel they're in danger of being embarrassed or hurt emotionally. You might notice someone with RSD withdrawing from the people they love, for example. They might choose to start spending more time alone and could even have problems maintaining a healthy relationship.

It's possible that someone with RSD might feel like they're a failure, too. Those with this condition often set high standards for themselves that might not be attainable. This can lead to feelings of failure and fears of disappointing others.

Similar mental health conditions

Many mental health conditions may have symptoms that mirror those of RSD. It's also possible that you might not have RSD at all and that you could be dealing with another issue instead. If the signs above seem to relate to your situation, you may still need a diagnosis from a mental health professional to confirm your suspicions. 

Other conditions that may have overlapping symptoms include bipolar disorder, depression, social anxiety, social phobias, borderline personality disorder, post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder, for example. 

What causes RSD?

You might be curious about what causes RSD. At present, researchers hypothesize that RSD may have a genetic component. RSD symptoms can then become worse when people are exposed to emotionally traumatic events. Stress also seems to have a significant impact on RSD and emotional outbursts. 

If you are experiencing trauma, support is available. Please see our Get Help Now page for more resources.

As for what triggers an RSD outburst or episode, it can be anything that a person finds to be critical or disapproving.  Sometimes, people with RSD will perceive that they're being criticized or rejected even when they aren't. They can be more emotional and sensitive than others, and this can lead to misunderstandings.

How is RSD treated?

Several treatments have been known to help RSD. For example, there are specific types of medication that may be prescribed to help you manage RSD symptoms. Managing your stress levels may also be important. High levels of stress can exacerbate the condition. For this reason, you may need to take extra care to ensure that you're eating right, practicing good sleep habits, and exercising. Meditation is another healthy way to manage your stress levels. A medical professional or mental health specialist can help you determine which treatments are suitable.

How to manage a relationship when you have RSD

Successfully managing a relationship when you have RSD might be challenging. This doesn't mean that you can't be happy with your partner. It may just take some effort to overcome your rejection sensitivity and remain content in the relationship. Being open with your partner about your feelings might be helpful. If your partner can understand your condition, they may be able to help set your mind at ease during a difficult time.

Having a supportive partner can make a difference. If your romantic partner understands your situation, you may be able to navigate certain relationship pitfalls more successfully. Your partner might be able to reassure you when you're feeling shunned or rejected, for example. If you find that you need additional support outside of the relationship, therapy is another option. 

A trained therapist may be able to help you manage many of the symptoms associated with RSD. For example, they can work with you to help you learn how to handle your emotions during an outburst. A skilled therapist can help people with RSD learn how to channel emotions positively, making it easier to deal with RSD over time.

Therapists can also work with you and your partner together. You can learn the best communication techniques to strengthen your relationship, so that when problems do arise, you’ll have a solid foundation in place. They can also address any concerns you might have to keep your relationship progressing in a healthy way. 

Online therapy is available

If you want to begin therapy, but your RSD causes you to experience anxiety about attending sessions, online therapy may be a better alternative for you. Many individuals who attend sessions online report that the online therapeutic environment puts them at ease. Online counseling is also more convenient since it can be accessed at home, even outside of normal business hours.  

Online counseling has also been found to be just as effective as in-person therapy for individuals and couples alike. A comprehensive meta-analysis of studies conducted in the field found no significant differences in terms of outcomes experienced by those attending sessions online or in an office-based clinical setting. The study followed nearly 10,000 cases spanning various populations and mental health challenges. 

Takeaway

With online counseling from Regain, you can reach out to one of our compassionate, licensed therapists or relationship counselors, anytime day or night. It's a convenient and effective form of therapy, and you'll be matched with a compatible counselor who cares about your situation. Sign up today to start seeing improvements in RSD symptoms that may be affecting your life and relationships.