Areas to Explore; Rejection Sensitive Dysphoria
Hello again! My goal is to give you at least one personal piece a week, but I have to tell you it’s hard!! It is really difficult for me to just whip up something on a subject without really going there, consuming myself for at least 5 hours at a time. I have discovered that my process is to really let myself get fully immersed in the topic at hand and to write until it is complete. I did not create this platform to produce content for content's sake, but to make sure that I am writing about what feels genuine and what may offer information that I believe others can relate to.
Recently I have been on my own mental health journey. Learning more about myself; the way my brain processes specific stimuli or past events in my life, ways to balance my personal and professional goals, and how to truly be present. While I was never academically inclined in school, I ironically find myself wanting to understand the “why” behind everything. Diving into research and collecting information helps me to understand myself a little more and feel I have some sense of control over an otherwise uncontrollable world.
My Introduction to RSD
I started to learn more about adult ADHD; specifically ADHD in women and how it can present differently than what we may stereotypically think of. (More on this another time) Along the way I was introduced to the term; Rejection Sensitive Dysphoria. While this is not an official diagnosis that is listed in the DSM-5, (Diagnostic and Statistical Manual of Disorders), RSD causes an overwhelming, and extreme emotional response to feeling rejected (real or perceived).
It is completely “normal” and even a survival response of ours to want to be liked, belong and be accepted in society. We may find ourselves seeking approval from our peer groups, getting anxious or nervous in social settings, and caring what others think about us. However those who experience Rejection Sensitive Disorder may perceive these seemingly everyday social encounters quite differently. Those with RSD may have such a strong emotional reaction to judgments, exclusion, or criticism that it can become all consuming, completely change their mood and put them into an emotional and mental tailspin. To others their reaction may come across as a disproportionate response to the situation. Some reactions to feeling rejected may include emotional outbursts such as rage and defensiveness, over exaggeration of how people are against them, or it may present as people pleasing, staying in someone’s good graces and overcompensation.
It is important to note that those who experience Rejection Sensitive Disorder feel that their response is a valid representation of the situation at hand. They feel so deeply rejected that they may not know how to move past it at that moment and it may disrupt their entire day, mood and sense of self.
My Experience
With this little bit of information everything began to make sense and click for me. I have always been coined as “overly dramatic” and “too sensitive.” For me, I spent years people pleasing as a way to avoid rejection. Honestly, I have spent most of my life overwhelming people for their acceptance and reassurance. I also think my need for control comes from the idea that I can prevent the feeling of ever being disappointed or rejected. My fear of being alone or rejected was so intense that I would completely unravel if a friend didn’t respond, or a boss or manager asked to talk to me later, or people were hanging out without me. We all get worried about these situations of course, but for me it wasn’t something that COULD happen it was something that WAS happening. This became my reality, if only for a few hours. In those moments I felt like I had to get out of my own body. Sitting in the discomfort was impossible, so I would spin my thoughts searching for some sense of control or turn outward for reassurance.
Over the years I have had to learn that 1. Most of the time I am reacting to stories that I created based on circumstance and 2. My “pain” shouldn’t be resolved by outside responses (your friend responds, the boss just wants to talk scheduling, the friends hanging out AREN’T plotting to all leave you). I began to become aware of the way I think, and to process and find other ways to cope and regulate. Although if I am honest, I still get triggered and go back into my spiral from time to time and THAT’S OKAY.
Now, as I gathered this information I am not diagnosing myself, but rather feeling seen in a way that I never fully felt before. That’s what any of us want, is to just be SEEN for exactly who we are, to have one moment of “I’m not alone.” To know that years and years of feeling like “too much” or “NOT enough” is a feeling that maybe others feel as well, and maybe, just maybe, there is a reason behind it.
This being said, I am not looking at this as a reason to not try to find ways to regulate or restructure my responses, but as a way to find even more resources and coping strategies. But first I wanted to learn and share a little more information.
Rejection Sensitive Dysphoria and ADHD
Rejection Sensitive Dysphoria (RSD) can be linked to ADHD and it’s found that more than 99% of teens and adults with ADHD are more sensitive to rejection.
First it is important to understand what ADHD is. ADHD is not a behavior disorder, a mental illness or even a specific learning disability (although it does affect the way in which someone collects and processes information); it is a developmental impairment of the brain’s self management system.
Common ADHD symptoms:
- inattention
- lack of focus
- poor time management
- weak impulse control
- exaggerated emotions
- hyperfocus
- executive dysfunction
So what is the link between ADHD and RSD?
I want to note that adults and children with ADHD are more likely to be more criticized and corrected. Imagine constantly being redirected and instructed daily due to perceived differences in how you interact, study, complete tasks, or even simply play. Not only may this bring a huge amount of shame and guilt, but those with ADHD may have a harder time differentiating “minor rejections” (someone not immediately responding to your comment) to more significant forms of rejection (being teased or bullied on the playground). As a result anything that feels even slightly like rejection can be perceived as a threat.
Feeling rejected brings on feelings of shame and unacceptance. Adults and children with ADHD can experience negative emotions more intensely and often do not have the words to express HOW intense the sensation is. Therefore those who experience a sense of rejection may respond by yelling, hitting, throwing a tantrum or completely shutting down.
How Do We Recognize RSD and What Can We Do?
Symptoms of RSD in Children:
- Extreme anxiety brought on by small changes
- Trouble expressing themselves and reacting by yelling, name calling or physically lashing out
- Hyper-focusing on negative traits that they have been criticized for or have perceived criticism
- Avoiding social situations due to fear of disappointment, criticism or rejection
- people-pleasing
- Feeling so afraid to disappoint or fail that they can overwork themselves or shut down completely
Support Strategies/ Areas to Explore
There are a lot of similar strategies out there that involve acknowledging and reframing and then acting/moving forward. I decided to use the Conscious Discipline Model to model a sentence I would use with others as well as myself. This meets the hierarchical needs of our brain in a simple sentence structure.
Brain State Model;
3 Hierarchical Needs:
Safety
Connection
Problem Solving
Those with ADHD and RSD already experience a big influx of rejection just in the way that others see them, correct them or even TRY to help them manage. One of the biggest pieces we can offer others and ourselves is VALIDATION and CONNECTION. So I swapped these two needs for the way I structure a sentence.
Validation and Connection
Believe them, don’t immediately try to fix. Use phrases like “I see” or “I hear” and reminders that you are right there. If you are the one experiencing a moment of meltdown, mental spin out, or shutdown; let yourself acknowledge and validate the feeling. Don’t add the WHY just acknowledge and accept the feeling; I am feeling really sad, rejected and unaccepted. OR I am feeling scared right now. Work on accepting the feeling because it simply just IS.
When we start to spin, meltdown or feel attacked we go to the survival mode of our brain. We need to also feel safe, secure and know what comes next. It is important to note that for children and ourselves we still need to set boundaries around the way we react. Boundaries actually provide safety and structure and let our children or our own brains know what is expected of them/us. This may look like stating what they CAN expect or what they CAN’T.
Safety and Boundaries
You have given yourself or others validation in believing their experience. Now give the facts that offer safety and facts. “I am here”, “You are safe”. Or “I will not let you….”
Now combine those “I hear you are so upset they didn’t want to play, I am right here next to you.” or “I see you want to play with your friend and they said no, but I will not let you hit them, so I will stand right here.”
For myself I might use “I am afraid my friends will leave me, right now the fact is no one has responded to my texts, but I am safe and that’s all I really know.”
Problem Solving/Solutions and How to Move Forward
What now? After connection/validation, safety, now offer what is next or what we CAN control.
This looks like choices or next steps. Ex: I hear you are so upset they didn’t want to play, I am right here with you, I wonder if you would like me to play with you or if we can sit here for a little longer together.”
Ex for yourself/myself: “I am afraid my friends will leave me, right now no one has responded to me but that is all I know, I can set down my phone and go on a walk or I can go journal and write it.
Sentence structure
Connection: I see or hear, Safety: facts and boundaries, Problem Solving: choices and next steps.
More Areas to Explore:
Discover the WHY
All behavior is a form of communication, even our own behavior. Our triggers are our body's way of communicating that we have hit our window of tolerance and are usually a response to something we never learned to process or regulate. SO instead of just focusing on the behavior; “stop yelling, stop hitting, no cussing”. Let’s look at the WHY.
I know I said don’t ask or state why. SO how do we find out “the why”?? Look at how the person on the other end is being set up to feel. Ex: Your child is yelling at you telling you that they hate you. How do you feel? Sad, rejected, not seen. Chances are that is their WHY. So then we go back to making sure we are meeting the CONNECTION part of our brain.
Another example: You have hit your own window of tolerance. Your boss just said they need to talk to you later, that it is important. You start to spin what if’s, retreat, tell yourself you will get fired, you won’t make enough money to pay bills, you are no longer financially stable. How are you making YOU feel!? Scared, unsafe, at risk. So then we go back to the SAFETY part of the brain. “Right now I have a job, I am safe, I am here for myself and I am capable”.
Discover Tools
Grounding activities: When we spin we are not in the moment or in reality. Grounding activities that provide connection to ourselves or others are; going on a walk, reading a book, acknowledging our surroundings.
When I used to spin out I would become so disconnected with reality my vision would become blurry. I was living in an alternate reality so I would go on a walk or run and tell myself that I had to find the color purple. This would bring my back into my body, into the moment, and help me regulate.
Breathwork: Deep breathing. When your body is in survival mode your heart is racing, you are breathing faster and there is tension in our body. By deep breathing you are signaling to your nervous system that you are “okay” by slowing down your breath, reducing your heart rate and relaxing your muscles.
There are an endless amount of resources around breathing from meditation, breath techniques or even apps that help naturally calm our minds and bodies. I have used the Calm app for myself and my son at night to help slow our mind and body down, but there are so many other options.
These are just a few tools and daily changes that can help those we are experiencing symptoms or Rejection Sensitive Dysphoria or really anyone that is finding themselves approaching their window of tolerance, being triggered, or just need another way to reframe their mind and body.
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I have mentioned many times, and will probably mention it many times after, that writing has been a way to rediscover myself and is also my form of health care. I write to understand, to discover and to connect. Over the past few months my drive for the “why” took me on a journey to discover more about myself and habits and behaviors I have lived with my whole life. I began to discover that my reactions to rejection (perceived or otherwise) seemed to bring me back to the term Rejection Sensitive Dysphoria. I was also made aware of the link between RSD and ADHD and felt so seen in many ways. I wanted to share and spread awareness so others may begin to possibly see themselves or others in a different light, find coping strategies, or the validation they needed to seek out more help and information.
NOTE: I write this blog as someone who loves to explore their own experiences and wants to learn WHY. While I do have an educational and professional component that may give me unique experience and insight; This is not me speaking directly as a mental health professional. I do not diagnose or evaluate. If you have any questions or concerns about what you learn here please contact your physician or a mental health professional.
