Weathering the Storm of Rejection Sensitive Dysphoria
- Emma Green
- 9 minutes ago
- 5 min read
“Drama Queen”
“Forever a victim”
“She’s doing the ‘woe is me’ act again”
“She’s having another hissy fit”
These were just some of the things I grew up hearing about myself – and continue to. In hindsight, remarks like these were thinly veiled commentary that people saw me as too sensitive, too emotional, too moody - and too easily hurt by the things they did or said.
It is little wonder then, that as a full-grown woman, I now find it hard to trust myself, because I have been led to believe that I am inherently the problem – that if I react, become defensive or try to stick up for myself against a perceived transgression, I am overreacting or taking things too personally.
For better or for worse, I have always cared far too much about what others have thought of me. Being scolded by authority figures felt excruciating. Seeing that I had one less friend on Facebook would induce heart-stopping, panic-attack-levels of anxiety. Being told that something nasty had been said about me once again would cause me to implode. Well-intentioned advice such as “Just ignore them” or “Don’t let them get to you” had little effect on me. No matter how much I pretended that something didn’t bother me, I would still end up ruminating on it for days, even weeks.
Was I just much more sensitive than others? Probably. Was it because I was exposed to much more interpersonal cruelty and trauma? Depends on who you ask.
Was I Born This Way?
As ADHD and Autism diagnoses continue to increase, particularly amongst women, non-diagnostic terms such as Rejection Sensitive Dysphoria (RSD) are increasingly drawing public attention. As a 34-year-old woman currently awaiting the results of my own Autism and ADHD assessment and who has spent years grappling with numerous mental health diagnoses that didn’t seem to quite ‘fit’ (e.g. depression, anxiety, bipolar II), RSD was certainly not a term that I had ever come across until a few years before – but it has completely transformed how I view both myself and my ‘touchy’ temperament.
Rejection Sensitive Dysphoria (RSD) is an intense emotional response to the perception (or anticipation) of rejection, criticism, failure, or teasing. The word ‘dysphoria’, which comes from the Greek for ‘unbearable’, is an apt term for describing the almost unbearable emotional pain that is triggered in someone when they are on the receiving end of judgment, disappointment or humiliation. Of course, no one particularly enjoys rejection or criticism, but for those with RSD, it can be particularly devastating.
The term was first coined by psychiatrist Dr William Dodson, who refers to it as a type of emotional dysregulation, primarily associated with ADHD. From this perspective, RSD is framed as a neurological disposition, with the brain’s emotional regulation systems, such as the amygdala and the frontal cortex, wired to produce not only heightened emotional responses but also difficulties in regulating those emotions. It is a trait thought to be present from early life, independent of experience, and linked to the same dopamine dysregulation that drives other ADHD symptoms. Through this lens, RSD is not about someone being ‘too sensitive’ but reflects a genuine neurological difference in how the neurodivergent brain processes emotional pain compared to neurotypical ones.
Was It Unresolved Trauma?
It is also proposed that those with ADHD may be more vulnerable to developing RSD, because they are much more likely to experience a history of negative feedback growing up. Numerous studies have found that children with ADHD are much more likely to be victims of bullying – more than double the rate experienced by their neurotypical peers. This is thought to be due to a variety of reasons: exhibiting differences not deemed socially desirable by their typically developing peers, their emotional reactivity being a desirable target for perpetrators, and being perceived as ‘intense’ or ‘weird’.
Rejection sensitivity can therefore develop because of exposure to repeated experiences of negative interpersonal trauma - bullying, criticism, social exclusion and invalidation. The nervous system learns that rejection signals danger, and it starts firing protective responses even to ambiguous cues. In these circumstances, rejection sensitivity is a learned adaptation, not just a wiring difference.
For somebody who desperately yearned for the approval and respect of their peers, I know being on the receiving end of bullying was completely soul-destroying. Any confidence or sociability I might have had as a child was completely eradicated by the time I got to secondary school. I spent most of my adolescence being on the receiving end of degrading treatment, for simply existing: I was shoved into doors and lockers, pinned down by my hair, slapped and punched in the face numerous times, had wood glue and Tipp-Ex thrown over me, my belongings stamped on and vandalised, pencils jabbed into my eye, and compasses slashed across my neck.
Everything about me seemed to be up for scrutiny and ridicule: my body, my weight, my hair, my teeth, my clothing, how I walked - even my surname. I had death threats made about my family and my pets. Outside of school, I still felt like I couldn’t escape – I would be hounded in the street, have stones thrown at me, and we even had our garden fence torn down and vandalised.
My survival strategy was to keep my head down and make myself as ‘invisible’ as possible, but it did little to protect me. Throw into the mix your other typical teenage experiences of crushes, heartbreaks and friendship fallouts (and probable undiagnosed AuDHD), and my teenage years became the perfect breeding ground for crippling mental illness, with the effects stretching far into adulthood.
The Chicken or The Egg?
So, is RSD caused by trauma or is it a neurological trait that trauma then amplifies?
Some researchers suggest that the relationship between neurodivergence, rejection sensitivity and trauma is likely to be reciprocal rather than a simple cause-and-effect. A neurological predisposition may make experiences of rejection feel more intense, while repeated experiences of bullying or social exclusion may further reinforce those responses over time.
I had hoped my sensitivity would have improved with age, but in many ways, I feel it has only gotten worse. Every new criticism or disparaging comment feels like it adds to a growing backlog of evidence accumulated over a lifetime that further proves that I’m unlikeable, a loser, not good enough, and frankly, pathetic. Life seems to have only made me more bitter and fragile, not stronger. I am covered in metaphorical scars that I will probably never truly recover from, no matter how much counselling I receive or ‘work’ I do on myself. I am still psychologically frozen in time as that broken 14-year-old child, emotionally stunted and living with the consequences of what went on two decades ago, whereas my peers have long moved on with their lives.
Discovering RSD and knowing there is a legitimate reason as to why other people’s words and actions deeply affect me has provided some much-needed validation and relief. Whether or not RSD will ever be fully embraced by the medical world remains to be seen, but it has offered people like me, the sensitive souls of the world, a lifeline and a much-needed opportunity to re-examine the relationship with ourselves, with others and with our pasts. Prior to this, I always saw my sensitivity as being a personality flaw that desperately needed to be eradicated - rather than something I was inherently born with and couldn’t help. This insight is at least one small step in being able to finally move forward with my life.
