What is Rejection Sensitive Dysphoria?

Ninety-nine percent of teens and adults with ADHD are more sensitive to rejection, and nearly 1 in 3 say it’s the hardest part of living with ADHD.

The RSD medical abbreviation stands for Rejection Sensitive Dysphoria. Although it is not an official diagnosis, it is the name for the phenomenon where people with ADHD are more sensitive to what other people think or say about them than most other people.

RSD causes you to not handle rejection well and can cause very negative and intense emotional reactions. A person with RSD may think someone has shunned or criticized them, even if that’s not the case.

Continue reading to learn more about RSD and what you can do if you suspect you might suffer from this condition.

What Is RSD?

RSD or Rejection Sensitive Dysphoria is a common condition seen in people with Attention Deficit Hyperactive Disorder (ADHD).

It can make adults with ADHD anticipate rejection and can make them vigilant about avoiding it. There is an emotional response to perceived or experienced rejection that can cause someone to suddenly shift moods and have an RSD episode. It is considered to be hard to describe, but those who experience RSD say that it is “intense, awful, terrible, overwhelming.”

RSD episodes are very intense, but typically very short-lived. People with RSD can have a number of symptoms, including the following:

  1. becoming easily embarrassed
  2. getting angry when they feel rejected or hurt
  3. setting high standards for themselves
  4. having low self-esteem
  5. feeling anxious in social situations
  6. withdrawing socially
  7. feelings of failure

RSD can easily be misidentified as another mental health disorder, so it’s important to get the right diagnosis.


Treatment Options

Although giving a name to the feeling of RSD alone can help many cope, there are treatments that can help relieve the symptoms of the condition. The primary treatment for RSD is medication.


There are two main types of medication that can ease the symptoms of RSD.

Medications such as Guanfacine (Intuniv) and clonidine (Kapvay) are drugs that lower blood pressure. However, they have also proven effective in helping with the symptoms of Rejection Sensitive Dysphoria.

Another type of mediation is monoamine oxidase inhibitors (MAOI). These medications have been the traditional choice for doctors treating RSD.

There are a few side effects, such as low blood pressure, agitation, sedation, and confusion. Additionally, these medications cannot be used in combination with first-line ADHD stimulant medications, all antidepressant medications, and a number of cold and cough remedies.

Although effective, MAOI type drugs can have significant disadvantages.

Therapy For RSD

Therapy has been shown to not be a particularly effective treatment method for the symptoms of RSD. This is mostly due to the episodic nature of RSD. However, a therapist may be able to help you learn how to deal with rejection in a more positive way.

Living Well With Rejection Sensitive Dysphoria

Rejection Sensitive Dysphoria is simply another part of ADHD that you must embrace and learn to manage. Almost all people with ADHD experience some level of rejection sensitivity.

Fortunately, there are medications that can reduce the symptoms and make RSD less difficult to live with. Check out our website for more on Adult ADHD and related conditions.