Rejection Sensitivity: ADHD or Trauma?

A term is popping up in various internet spaces: Rejection Sensitive Dysphoria (RSD).

The purpose of this blog is actually to help you explore if you experience RSD or not- especially if you’re questioning whether or not you have ADHD. As a baseline, everyone can have shame spirals. No one likes to feel rejected or really criticized. Rejection Sensitive Dysphoria is just something a little different.

There is a thing that’s happening that I’ve noticed: people want to be diagnosed with ADHD.

I can imagine more than a few people looking at me expectantly when they mention it after having watched more than a few TikToks or searching a subreddit. It’s kind of weird to want a mental health diagnosis of any kind right? Put that way, maybe. However, another way to look at it is that we all are searching for answers. ADHD can become a capital A Answer for some.

ADHD and neurodivergent folks as a community are experiencing a movement of acceptance and even celebrating differences in the way we all think. In that way, ADHD has positive traits whereas something like say depression or anxiety have fewer obvious positive aspects to it.

Most commonly ADHD can be an answer of: why do I feel different? Why don’t others understand me?

These are huge. Everyone deserves to be on the search for these answers, and live in ways that validate that way of being. However, ADHD is not the only answer here –I promise.

What is Rejection Sensitive Dysphoria really?

According to ADDitude, rejection sensitive dysphoria is a type of emotional dysregulation when one encounters “real or perceived rejection, criticism, or teasing.” This is not an official criteria for ADHD according to the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders- 5^th edition), but it is something that anecdotally a lot of folks are resonating with.

ADDitude’s author says that it’s not related to trauma, then goes on to talk about triggers. I find this confusing, and probably not true. This may be their way of distinguishing it from just a trauma response), but I would guess that it’s more of an overlap of ADHD and trauma. Hear me out.

How does this really show up with ADHD? Anyone who has talked to a loved one with ADHD knows that they can be interested in a wide scope of things. This makes them really fun to talk to because of their variety! However, a common experience is feeling like because they switch from project to project never quite finishing or becoming an expert in something they feel like a failure. (ugh, my heart).

If anyone makes a comment, quip, side-eye, etc. about them not sticking with their new hobby for example, close up shop. This comment will bypass any amount of wit, perseverance, sass, or spite and go straight to the ouch zone of their heart. That ouch may not register at the time, but it will show up in putting down that sequins tweezer for the last time. Or that tube of miniature paint. Or the instructions for the new streaming mic.

Then comes the darkness. Those inner demons that are convinced they are doomed to fail, that they should just give up, that no one likes them or believes in them come on full force.

To the outside observer, this change in mood can seem sudden if not random. What happened? However, if we were to take a look on the inside we would clearly see the wound.

What is the overlap of trauma?

This cascade of darkness I’m mentioning is too deep-rooted and impactful to not already have a significant thread in this person’s life. The difference between the ADHD experience of RSD and neurotypical experience of criticism is how we respond to the feelings of rejection.

The article on ADDitude mentions that the response to RSD is often to people please, overachieve, or stop trying altogether. However, it’s important to note that these responses are present in folks who do not have ADHD but do have trauma.

It’s hard to talk about ADHD without looking at least a little bit towards relational trauma. Kiddos with ADHD are more likely to be rejected and criticized throughout childhood for the way they do things. The exception to this is if they happened to grow up in a positive environment where ADHD is understood and accommodated for. It does happen- a parent living with ADHD understands the pain, and/or a school that’s particularly sensitive to neurodivergence.

Unfortunately, even though spaces like this are popping up more and more for kids, they just aren’t the norm. So rejection sensitive dysphoria is kind of the icky soup of nature and nurture overlapping and creating a hard to digest spoonful of harm.

So..which one is it?

I may have nerded out and created this visual aid to help explain my thoughts.

It flows from left to right considering the triggering stimuli (a person criticizes or rejects you covertly or overtly). The middle chevron shape is where things differ: someone with ADHD and trauma; someone with ADHD and a positive supportive environment; and someone with trauma and no ADHD. As you can see, all three types result in emotional dysregulation. Because rejection sucks.

However, how we respond to that rejection may be the key in deciphering is this a trauma response or more ADHD related.

The anxious/avoidant response is better covered by the wonderful folks at Therapist Uncensored who get into adult attachment types and the responses we have to those relational challenges.

You don’t have to have ADHD to hate rejection.

You don’t have to hate rejection if you have ADHD, but it’s likely the case.

What to do if you feel you have rejection sensitive dysphoria

Know you’re not alone in your experience. It can be scary how quickly these emotions take over, and with persistence can be ameliorated.

Please, please go to counseling! You can work on your relational history and the messages you’ve heard all your life that have woven a tapestry that just doesn’t suit you anymore. In therapy you could also find ways to regulate faster and with more love and care. Finally, you can tackle self-esteem in therapy. Phew those are Big topics and I wouldn’t want you to go it alone.

Additionally, there are support groups and threads out there on the internet with how to regulate after these ouch experiences. Always take what you read online with a grain of salt (including my article here)!