What Is Rejection Sensitive Dysphoria?


Rejection is hard for anyone, but if it’s exceedingly painful and difficult to cope with, it could be Rejection Sensitive Dysphoria (RSD).

This is a relatively new diagnosis. In fact, experts are still debating whether it even exists as a distinct disorder.


Currently, the DSM-5, which is the standard manual professionals use to assess and diagnose mental disorders, doesn’t recognize RSD. As such, many medical professionals will not recognize or treat RSD either.

However, some psychiatrists and psychologists in the mental health space, particularly those focused on treating patients with ADHD, have started to examine the outsized impact that rejection has on some of their patients.

For those professionals who recognize RSD, they may diagnose it based on the symptoms a patient describes in therapy. Patients with RSD characterize rejection as intensely painful, using words like “awful,” “terrible,” and “catastrophic” to describe it.

They may determine that RSD is the sole culprit or disorder at play, or they may diagnose it as part of a related condition, particularly ADHD.

What does rejection sensitivity dysphoria feel like?

mom trying to console teen daughter who suffers from rejection sensitive dysphoria
Photo credit: Adobe Photo Stock

It’s important to note – RSD isn’t just feeling bummed. A person with RSD who’s rejected doesn’t just “take it hard”. It’s a significant, damaging, painful experience.

Worse, it can shape future behavior. Someone suffering from RSD will actively try to avoid future events that could trigger the same pain. This can make it even more challenging for someone with RSD to achieve stable, supportive relationships, creating a self-perpetuating cycle.

Dr. William Dodson is a leading professional in the RSD space. He writes,

“The pain is so primitive and overwhelming that people struggle to find any words to describe it. They can talk about its intensity . . . and cannot find words to convey the quality of the emotional pain.”

Can Rejection Sensitive Dysphoria be treated?

Treating RSD is challenging because so little research has been done in this area. The fact that it’s not even recognized as an official diagnosis also further complicates matters of research and treatment.

For example, you may be unable to include it in IEP goals for your child or to secure insurance coverage for treatment.

Currently, there doesn’t appear to be a “cure” for the condition, per se, but there are things patients can do to lessen its impact on their day-to-day lives.

First, to the extent possible, treat and manage any related conditions.

Particularly, ADHD seems to have a high co-occurrence, or overlap, with RSD. Effectively treating ADHD symptoms with therapy and/or medication, as needed, may help lessen the intensity of RSD symptoms.

Second, patients can do things to help lessen the intensity and pain of rejection and its related feelings (shame, isolation, etc.).

One way to do this is through Cognitive Behavioral Therapy, a recognized psychological practice used to treat a variety of disorders.

It focuses on the role that unhealthy thought patterns and behaviors play in a disorder’s symptoms and training a patient to recognize, cope, and potentially change their reactions to lessen those symptoms over time.

As greater research into this disorder continues, further treatment options are likely to emerge. If you think you or your child is experiencing rejection sensitive dysphoria, seek out the counsel of a trained professional.

You may also want to check out Dr. Dodson’s website, ADDittude, for additional information and resources.


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