On Mental Health

Rejection Sensitive Dysphoria: 3 Words That Made Me Feel Less Crazy.

Yesterday I learned there’s something called “Rejection Sensitive Dysphoria” which describes exactly what I wrote about yesterday. When I first googled it after a friend on Twitter mentioned it to me, this line jumped out from this WebMD article: “People who have the condition sometimes work hard to make everyone like and admire them. Or they might stop trying and stay out of any situation where they might get hurt. This social withdrawal can look like social phobia…”


I did a lot of reading about it yesterday and this does seem relatively new as most of the articles I read were written in the last year. It seems like it’s something often connected to children (or adults, but most of the articles were about children) with ADHD. As a matter of fact, my friend who mentioned it first learned about it from a Facebook group for parents with neurodiverse children.

It is most certainly real as in it is a cluster of symptoms that exists and can cause great impairment and distress. It is not as of yet, however, an official disorder listed in the Diagnostic and Statistical Manual of Disorders (DSM-5). So it is not a condition with its own official code label, but instead is a constellation of symptoms that are often (though not always) associated with other conditions.

It is possible that RSD will be included as an official diagnosis in a future version of the DSM-5, but its absence in the meantime should not be taken as evidence that it is not legitimate, even if it lacks standalone status as an official DSM condition.

Psychology Today

Weirdly there was a lot that mentioned a genetic component to the diagnosis, which I want to read more about. The treatment was mostly, “Learn to deal with it with the help of a professional,” but I’m okay with that because just having a name for something seems to help when you are feeling overwhelmed by that thing. Also, if our medical budget ever stabilizes enough where I can feel justified going back to therapy, I can ask future therapists, “Have you ever worked with adults with RSD before?”

It’s funny because every article I read I was like: OH MY GOD. And also? How have I never heard of this because it describes me SO PERFECTLY. And weirdly? It mentioned something very specifically I’ve been thinking about lately but not been able to really get into words on this blog: The connection between pain and some of these emotional responses I have. That Psychology Today article has the following line in it: “Social rejection activates the same parts of the brain as does physical pain, and the experience of each can have many similarities on a brain scan.”


These intense reactions I get in these moments of “failure” or “disappointment” around shame often feel as terrible as if I had just busted my knee by falling on a trail run. It’s FAST, it’s INTENSE, and everything in me reacts like it’s PAINFUL even though it’s not…at least not in the physical sense.

And I’ve been thinking about that so much lately, trying to put words to it and then yesterday, with one introduction to the phrase “Rejection Sensitive Dysphoria,” I was able to find TONS of articles with people talking about that exact same thing.

The day I wrote about turning off Facebook after a shame spiral I was feeling such intense “pain” that I was thinking, “If I did not understand this cycle enough to know it will fade eventually, this pain would be enough to make me suicidal.” I mean, I wasn’t suicidal, because I know my brain and my responses but it’s like when people are injured and that pain is so severe that even though they know they are getting treatment or that pain medication is coming, their brain still thinks: I WOULD RATHER BE DEAD THAN EXPERIENCING THIS PAIN RIGHT NOW.

And it turns out? This is very on-the-nose for RSD!

And the part of me that feels like I can’t let go of the feelings of failure? Look at this from that same PT article: “People with RSD have such a strong emotional reaction to negative judgments, exclusion, or criticism from others that it sends them into a mental tailspin, leading to rumination and the pit-of-the-stomach malaise that won’t let them move forward with their day.”


I mean, basically I’ve written several posts in the last week or two about episodes of RSD and I didn’t even know that’s what I was writing about!

It’s just crazy to be constantly dealing with this thing in my head and being frustrated with it and constantly writing about it to try to make sense of it and BAM! Suddenly there’s a name for it and tons of articles on line making me feel normal because it is common enough that it has a name and smart people in the mental health industry are writing about it online.


There’s a lot of discussion as how RSD relates to Social Anxiety Disorder which I have been diagnosed with. Those two often overlap but there are different symptoms in RSD that relate to the after effects of social gatherings. So, basically the part of me that replays over and over mistakes that I made and beats myself up…that’s more RSD. And there’s a “normal” level of course that we all do it, but then there’s the level that disrupts your day and your ability to focus on anything other than that failure and that’s where the RSD line is.

While I check off almost all of the boxes whenever you see the “Do you have Rejection Sensitive Dysphoria” lists…the one that doesn’t seem to happen is that I have a very healthy marriage. It’s interesting reading the sections about relationship challenges for people with RSD, because I definitely see that in past relationships or in friendships but none of it relates to my marriage. I think that there’s such a strong foundation of unconditional love in our relationship that my RSD doesn’t get in the way of it. Now…there’s a lot that I could say about how/why that might be, but I’m just glad that I have it.

Anyway…I was just blown away by all of this yesterday and I wanted to share in case any of this is as new to you as it is to me.

8 thoughts on “Rejection Sensitive Dysphoria: 3 Words That Made Me Feel Less Crazy.”

  1. I’ve never heard of that before, and yes….I definitely have it too. I’m glad I can put a name to it now.

  2. Love learning about new stuff. Glad you found a name for what you’ve been going through!

  3. Maybe you have a form of neurodiversity as well as RSD. Women with ADHD often don’t present symptoms as strongly as men with ADHD and women tend to have more of the inattentive symptoms (losing car keys, problems focusing, taking on more responsibilities than they can manage) rather than the hyperactive symptoms that males with ADHD possess. Women frequently reach adulthood before receiving a diagnosis. Not saying you have ADHD but its something to consider, and if you do have it, it may offer some relief/release of guilt 🙂

  4. Bookmarking this to share. Yes, a name does help, even if it’s just to say I’m not alone… as much as it feels like it.

  5. Everything is working out for you!!! I am SO happy to share in your excitement about finding out about it.
    Julie A

  6. Anonymous, just brought up what I have wanted to bring up to you many times, but didnt. Why? I forgot and I was afraid you would be angry. I have ADHD and RSD. I was finely diagnosed with ADHD at age 60. I pretty much knew I had it, and thought I had it under control. After diagnosis, I saw things that I did that were a result of the ADHD. My daughter has ADHD and RSD- so hereditary? Yes, I can identify with that

  7. I am SO GLAD that just mentioning it is helping you understand yourself. It’s always a bit wonky for professionals when a diagnosis is considered “new” but I think the anecdotal evidence is strong. I am cheering you on.

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