What is Rejection Sensitivity Dysphoria?

Rejection Sensitivity Dysphoria or RSD is a label recently coined to identify people who are hypersensitive to rejection, criticism, judgment and/or sense of personal failure. This extreme sensitivity leads to emotional distress. 

People with RSD sense that they are being rejected much more than they actually are. The person with RSD perceives rejection on a regular basis. This feeling of rejection affects them in a big way. Even a little bit of criticism can significantly impact their entire day by making them feel shame, anger, or feelings of hopelessness. These feelings can even manifest into physical symptoms such as stomach aches, loss of appetite, and sleeplessness. Some people with RSD describe the pain of rejection as a physical pain, akin to being stabbed. 

What are the signs of RSD?

• Ruminating thoughts (repeatedly going over what occurred in your head)
• Magnification of what really occurred (seeing the rejection or criticism much bigger than it actually is)
• Extreme anger/Lashing out 
• Feelings of anxiety when you feel disliked or not accepted by others
• Need for approval and validation ADHD
• Frustration when you don’t feel accepted or receive validation
• Defensiveness and deflection
• Negative self-talk
• Low self-esteem (that’s based on how you think others view you)
• Self-harm
• Fear of rejection and criticism
• Social withdrawal
• Avoiding new opportunities 
• Easily embarrassed 
• Constantly feeling like the people in your life are mad at you or don’t like you
• Aiming for perfection 

Where does Rejection Sensitivity come from?

Like most mental health conditions, there is no one cause to point to. Rather, RSD seems to be a combination of several factors.

Possible causes of RSD include:

• Genes
• Insecure attachment with caregivers as a child 
• Trauma (such as abuse or neglect)
• Growing up with a standard of perfection
• Being made to feel bad about your normal behavior 

RSD and ADHD 

RSD appears to affect people diagnosed with ADHD significantly more than other populations. In fact, research suggests that as much as 70% of people with ADHD show symptoms of RSD. 99% of adults with ADHD are more sensitive than usual to criticism, according to WebMD. This could be because the  central nervous system is triggered in different ways in those with ADHD. 

Rejection Sensitivity Dysphoria In A Relationship?

It’s not surprise that RSD can create real issues while in a romantic relationship. Dating can be extremely difficult because the person with RSD sees interactions as negative, even when the other person is interested in them. They have a hard time opening up for fear of being judged. 

The partner with RSD is often upset by seemingly innocent things that their partner says or does. The person with RSD often jumps to conclusions and assumes that they’re being attacked or slighted in some way. The other person is forever having to comfort and support them, providing the reassurance they desperately need. This can be both frustrating and exhausting for the partner who’s on the receiving end.  

The following might be true for a partner with Rejection Sensitivity Dysphoria (RSD):

Constantly feeling like their partner is unhappy with them

They might mistake being tired for you being mad at them. 

Questioning little things their partner does 

A delayed text response could make theme worry you don’t care about them.

Needing for validation from partner  

A partner with RSD will need you to validate them with words and/or actions. Lack of affection (words or signs) could cause them to go into a tailspin of anxiety. 

Taking everything personal 

It might be hard to joke around with them. Innocent teasing based in love, could easily offend someone with RSD. 

Self-sabotaging 

A self-fulfilling prophecy is when people behave in ways that make their beliefs become reality. People with RSD may intentionally do things that elicit rejection and cause a breakup. 

Trouble committing 

A partner with rejection sensitivity could have commitment issues. They may be hesitant to take the relationship to the next step for fear of rejection. 

Putting on a show of perfection

People with RSD may go to extremes to avoid the negative feelings that come from criticism, so they’re constantly working to not give their partner anything to complain about. This can cause their own needs to be unmet. In addition, they’re hiding their authentic self from their partner. 

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Managing Rejection Sensitivity

RSD is the result of unhelpful thoughts taking over. You can reduce symptoms of RSD by taking charge of your thoughts. 

How to manage your RSD:

Consider only the facts.

Try to leave out the emotion, and quiet the thoughts in your head. When your partner asked you a question, was it really because they’re doubting you, or were they just looking for more information? When they fell asleep without kissing you, were they mad at you, or  were they just tired from their long day? 

Practice mindfulness.

You can avoid dwelling on the negative thoughts through mindfulness. Shift your attention to your breath. Focus on how your body feels. Negative thoughts will still come. Don’t dismiss them, but let them pass and return to your breath. 

Talk to your partner about it.

Educate your partner on what RSD is. Teach them about your symptoms and triggers. This will help your partner be more understanding when you have an emotional reaction. 

Find a productive distraction 

Rumination will have you playing back that situation again and again. Redirect your energy, and bury yourself in something else that requires your focus. Maybe that’s a hobby or good book, or a date with your partner. 

Take little risks 

You don’t have to climb the tallest mountain, but small challenges can help you build resiliency and confidence, two things that are lacking with RSD. 

Take a pause

Before reacting out of defense, take a moment to consider the situation. Process your emotions before acting out or lashing at your partner. Try to remember that most of the time, the rejection you are feeling is perceived and not based in fact. 

Practice self-care

Do things that bring you relaxation and joy. Stress management techniques can help you stay calm during difficult times. 

Seek professional help

If rejection sensitivity dysphoria is impacting your day to day life and causing stress in your relationship, therapy is recommended.  A therapist can help you grasp your emotions and deal with rejection in a more positive way.

How to deal with a partner who has RSD:

Take a softer approach

Instead of criticizing (“You always forget to pick up your dirty clothes”.), express how you feel (“It stresses me out when your clothes are on the ground”.) This little change will make it less of a dig at them. 

Ask them to share how they feel

When you see that they are upset, let them know you want to understand how they feel. Practice active listening. After they’ve explained their side, you can work on overturning their feelings of rejection.

Consider their triggers

If you know that big, group settings result in strong negative reactions, stop insisting you go to a party together. Try not to make them feel guilty for wanting to avoid situations that bring on symptoms of RSD. Be more intentional and propose activities that feel better for your partner. 

Attend therapy together

Couples counseling can be an effective way to increase your understanding of RSD and improve your connection.