ADHD and Rejection Sensitive Dysphoria

Have you ever been so enraged that you couldn't contain yourself?

Fury and anger hit a boiling point and your volcanic eruption really let someone know how betrayed and hurt you felt.

To someone with ADHD, this type of extreme reaction can occur in response to even the slightest criticism or rejection.

It's called Rejection Sensitive Dysphoria (RSD).

The pain [from RSD] is so primitive and overwhelming that people struggle to find any words to describe it. They can talk about its intensity ('awful, terrible, catastrophic') and cannot find words to convey the quality of the emotional pain.

— William W. Dodson, M.D.

Possible effects on someone suffering with RSD:

  • People-pleasing and over-achieving. Bending over backward for admiration, working to reduce any opportunity for negative feedback.
  • Social avoidance. Avoiding any potential for embarrassment, including rejecting new relationships entirely.
  • Withdrawal. Paralyzed by fear of failure, abandoning their goals and the things they enjoy.

What can be done:

  • Time separation. The extreme feelings often fade rapidly when space is created.
  • Reminder of past relationship. Past evidence usually shows that the inciting person doesn't actually desire to cause harm.
  • Reduce stress. Neglected mental/physical health will only accelerate strong, negative reactions.

The flip side is Recognition Responsive Euphoria (RRE).

Ed Hallowell, M.D. describes it as the enhanced ability to make constructive use of praise, affirmation, and encouragement.

People with ADHD often have a lifetime full of criticisms, so positive recognition makes an oversized impact.