Unpacking the Complex World of Rejection Sensitivity Dysphoria

Have you heard of one of the most popular acronyms going around in the Neurodiverse world — RSD? It stands for Rejection Sensitivity Dysphoria. The condition (and acronym) is gaining more recognition due to an overall growing awareness of neurodiversity, advancements in psychology, and a societal push towards mental health acceptance. RSD profoundly affects social interactions, relationships, and professional and educational settings. Understanding RSD not only enhances empathy but also enriches our discussions on mental health, making it an essential topic for everyone.

A First Day to Remember

Recently, I had a horrific experience on the first day of a new job. The protocol for welcoming a new staff member was to surround them in a circle at morning tea and each staff member was told to ask me one question each. The first question was “what is your biggest fear?”. Did I answer, “the intense emotional pain I feel because of a deep fear of being rejected”? No, I did not. I said sharks.

Understanding RSD: Insights from Science

To appreciate the depth of RSD’s impact, it’s crucial to understand its scientific background. According to the Cleveland Clinic, Rejection sensitive dysphoria is when you experience severe emotional pain because of a failure or feeling rejected, or fear of being rejected. This condition is linked to ADHD and experts suspect it happens due to differences in brain structure. Those differences mean your brain can’t regulate rejection-related emotions and behaviours, making them much more intense. Additionally, According to ADDitude, RSD is distinguished by its extreme, unbearable intensity, which sets it apart from normal emotional responses familiar to people who are neurotypical. This intense pain is often experienced as a physical “wound”; the individual feels as if they were stabbed or punched in the chest.

Personal Experiences of RSD

I can confirm — when I feel rejection sensitivity dysphoria, it feels like being winded, both emotionally and physically. Sometimes I get a cold and metallic feeling on the inside. Often, I can’t sleep because I get flashes of memory where something I said or did in the past was particularly awkward and I literally groan out loud with embarrassment. I have a few friends who I know also have RSD and I checked in with them on how they feel when rejected. One said, “it feels like a punch in the stomach and a heavy weight on my chest, and also a clawing feeling”. Another described it like “a shockwave” and it made her feel the impulse to reassess all of her existing relationships. My experience with RSD is not unique; clearly others share these intense feelings, highlighting the impact of the condition.

The Neurotypical Perspective

For a balanced approach, I sought insights from friends without RSD, revealing the contrast in how they process rejection. One friend said, “I feel the sting of rejection when it happens, but…I just take it in my stride as something I can move on from. Like, what will be will be, and there’s nothing I can do to change it and must find acceptance for what it is”. Another friend agrees they feel all of the emotions, but “over time all things tend to soften, and you get back on the horse and move on to bigger and better things”.

This description checks out with the research I found — while neurotypical individuals might feel upset or disappointed by rejection, these feelings typically dissipate over time. For someone with RSD, the emotional response can be longer-lasting and more difficult to manage or mitigate. People with RSD may have their self-esteem and self-worth significantly impacted by experiences of rejection. They might internalise these experiences more deeply, leading to a more profound effect on their overall perception of themselves compared to neurotypical individuals.

Common Coping Strategy: Avoidance

To shield themselves from the potential pain of rejections, people with RSD often develop avoidance behaviours. This might mean sidestepping social situations, not pursuing certain goals, or even developing a fear of success. While this strategy might offer short-term relief from the fear of rejection, it can lead to long-term consequences like feeling isolated, missed opportunities, and a sense of unfulfillment. Understanding these behaviours as protective, rather than antisocial or indifferent, can foster more compassionate support from those around them.

Strategies for Support and Management

Understanding RSD lays the foundation for support. Here are some ways to navigate these challenges, whether for yourself, or for others.

Supporting someone with RSD

Some of the key strategies to support someone with RSD is by:

1. Listen Actively and Validate Their Feelings

When they express feelings of hurt or rejection, listen without judgement. Validate their feelings by acknowledging that their emotions are real and significant to them, even if the situation might not seem as severe from an outside perspective.

2. Offer Reassurance

People with RSD might need more reassurance than others. Offer positive feedback and reassurance about your relationship with them, their abilities, and their worth. This can help counteract their internal narrative of rejection and failure.

3. Encourage Open Communication

Create a safe space for them to express their feelings and fears. Encourage them to share when they’re feeling vulnerable or when a situation might trigger their RSD, so you can understand and adjust your approach as needed.

4. Avoid Unnecessary Criticism

Be mindful of how you deliver feedback or criticism. Try to frame it constructively and emphasise their ability to grow and improve. When possible, highlight their strengths and the aspects of their work or behaviour you appreciate.

5. Choose your Words Carefully

Avoid telling someone they are being sensitive or overreacting. All people have the right to feel their feelings. If you’re able to help them process how they are feeling using the techniques above, that’s great. If you’re unable to or don’t want to, kindly give the person some space to process their feelings and come back to you.

Navigating your own RSD

As someone who experiences RSD, I also have some tips you might find useful in regulating your emotions and not acting impulsively.

1. Do nothing for 48 hours.

One of the hardest things to do in this situation is not react. Unless a response is required, then you do not have to give one straight away. The timeframe of 48 hours will stop you from avoiding the situation all together.

2. Bring yourself into the present

Using the technique below, you can bring yourself into the present moment quietly and ward off a panic attack:

1. List 5 things you can see.
2. 4 things you can touch.
3. 3 things you can hear.
4. 2 things you can smell.
5. 1 thing you can taste.

3. Regulate your Emotions.

To navigate the turbulent emotions that accompany RSD, I highly advocate for the ‘Dropping Anchor’ technique, a cornerstone of Russ Harris’s Commitment & Acceptance Model of therapy. This method not only aids in grounding yourself during moments of emotional upheaval but also serves as a first step towards regaining control over your responses. Additionally, the support of a buddy — a person who not only understands your unique perspective but can also shed new light on your situation — is invaluable. By combining these strategies, you’re able to achieve a state of self-regulation and gain a clearer understanding of the circumstances. With this newfound perspective, you’re in a better position to decide if and how you wish to respond, ensuring your reactions are thoughtful and deliberate.

Conclusion: A Call for Empathy and Action

To conclude, RSD is more than just a popular acronym or the “condition” on trend. It is a lived reality for many who carry the weight of unseen battles. It provides the potential for profound empathy and connection within relationships, communities, and workplaces. Understanding RSD is not just about recognising the signs or empathising with the emotional pain — it’s about embracing the full humanity of those around us, neurodiverse or not. It’s about fostering environments where everyone can feel valued, understood, and supported. This post is a call to action: to listen more deeply, to validate without reservation, and to communicate with kindness and intention. It’s a reminder that, while the sting of rejection may fade for some, for others it lingers, woven into the fabric of their daily lives.

I’d love to hear your experiences of RSD and how you’ve learned to cope or offer support to others. If you’re interested in learning some techniques, I have a free e-Guide you can download about managing stress as a neurodiverse person.