- Have you been told you’re “a bit too sensitive” or “overreacting”?
- Do offhand comments make you spiral into a full-body shame meltdown?
- Does the phrase “Can we chat later?” send you into a mental dress rehearsal for being fired, dumped, or publicly exiled?
- Is a thumbs up emoji 👍 indisputable evidence that everyone hates you?
- Do you say “sorry” so often that you end up saying sorry for saying sorry?
Welcome to the world of Rejection Sensitive Dysphoria (or RSD), a lesser-known, yet deeply felt aspect of life with ADHD. It’s something that impacts most of my clients, my ADHD friends, my partner and… me!
Let’s unpack what’s happening (in your brain and your body), and how you can work with it. Not by “fixing” yourself, but by understanding yourself more deeply and responding with compassion.
What Is RSD (and Why Does It Feel So Awful)?
Rejection Sensitive Dysphoria is a term used to describe the intense, sometimes overwhelming emotional pain triggered by perceived rejection, criticism, or failure. Even if it’s imagined.
It’s a neurological response where:
- A neutral tone feels icy
- A delayed message feels like abandonment
- A raised eyebrow becomes a personal attack on your entire worth as a human being
Logically, you know it’s probably nothing. But your nervous system doesn’t care about logic right now.
What’s Actually Happening in the Brain?
Let’s talk science 🤓
When you perceive social rejection (real or not), your amygdala (the brain’s threat detection centre) kicks off an alarm. To your brain, rejection = danger. Back in cave-dweller days, being left out meant death by saber-toothed tiger. So your brain reacts fast and hard.
- Amygdala fires: “Danger! You’re being rejected! You’re about to die alone and unloved!”
- Hypothalamus joins in: releases stress hormones like cortisol.
- Prefrontal cortex (the rational part): takes a back seat. “I’m sure they were just tired” doesn’t get a say.
- Body response: rapid heart rate, shame spiral.
This all happens in seconds. No wonder you feel like crying in the work bathroom after someone says “we’ll circle back on that.”
RSD Shows Up in the Weirdest of Ways
RSD isn’t just another ADHD symptom, it’s a root cause.
So many ADHD struggles, especially emotional and social ones, can be traced back to the core fear of rejection and criticism. Recognising RSD as a root driver helps you stop blaming yourself and start working with the real mechanism at play.
😬 People-Pleasing
- Constantly trying to anticipate others’ needs or emotions
- Saying “yes” to avoid perceived disappointment
- Apologising reflexively, even when you’ve done nothing wrong
- “If they’re happy, I’m safe.”
🏃♀️ Avoidance (Especially of Feedback or Criticism)
- Procrastinating on tasks that might be evaluated
- Avoiding difficult conversations or conflict
- Ghosting people after perceived rejection
- “If I don’t try, I can’t fail (or be judged).”
🎭 Masking / Overcompensating
- Trying to appear “normal” or “together” at all times
- Hiding ADHD struggles out of fear of judgment
- Trying to be the “perfect” employee/friend/partner
- “If I show the real me, they’ll leave.”
📉 Low Self-Esteem
- Chronic internalised failure from years of misunderstood sensitivity
- Believing you’re inherently “too much” or “not enough”
- Struggling to accept compliments or trust positive feedback
- “If they’re nice, they’re just being polite.”
😡 Emotional Outbursts or Shutdowns
- Reacting with disproportionate rage or despair after perceived slights
- Sudden spirals over small interactions
- Meltdowns after “holding it together” too long
- “Why does it hurt this much?”
⌛ Procrastination & Perfectionism
- Fear of not being “good enough” leads to delays or endless revisions
- Projects stay unfinished because of fear of judgment
- Over-preparing to “earn” acceptance
- “It has to be flawless, or it’s a failure.”
😶🌫️ Social Withdrawal or Over-Isolation
- Avoiding social situations where rejection might happen
- Keeping people at arm’s length to protect against future hurt
- Struggling to make or maintain connections
- “If I don’t get close, I can’t be hurt.”
📱 Hypervigilance to Social Cues
- Overanalysing messages, tones, emoji usage, facial expressions
- Replaying conversations obsessively
- Constant need for reassurance
- “They paused before answering. They must be mad at me.”
😔 Rebound Shame After “Overreacting”
- Criticising yourself for being “too sensitive”
- Feeling humiliated after opening up or expressing emotion
- Vowing to “be more chill next time” (but it happens again)
- “Why am I like this?”
Why RSD & ADHD Go Hand in Hand
For many people with ADHD, RSD lies at the heart of their emotional experience. But why?
People with ADHD often experience:
- Faster amygdala activation
- Lower baseline dopamine, meaning the brain is more dependent on external validation for reward
- Weaker emotional brakes, especially under stress
Combine that with years of misunderstood struggles, social setbacks, and internalised shame, and it’s no wonder so many adults with ADHD live in a near-constant state of bracing for rejection. RSD becomes a pattern rooted in brain chemistry, lived experience, and deep sensitivity to connection.
That’s why a perceived rejection doesn’t just sting. It detonates.
In contrast, a neurotypical brain usually responds differently. When someone without ADHD perceives criticism or rejection, their amygdala still activates, but their emotional regulation systems typically engage more quickly and effectively. They can usually process the social cue, evaluate its accuracy, and move on without prolonged emotional overwhelm.
Sounds dreamy.
So What Can You Do About It?
Here’s the good news: RSD isn’t a character flaw. It’s a patterned brain-body response. And patterns can be changed.
Enter: Solution Focused Hypnotherapy.
Unlike old-school “let’s dig up your childhood trauma” approaches, Solution Focused Hypnotherapy (SFH) is a forward-looking, practical approach. It combines:
- Psychotherapy: helping you identify what is working, not what’s broken.
- Neuroscience: understanding how the brain functions under stress.
- Hypnosis (trance work): to calm the limbic system and access the subconscious mind for rewiring.
Here’s how SFH can help with RSD specifically:
⚖️ Regulates the Amygdala
Trance reduces stress levels and activates the parasympathetic nervous system (your “rest and digest” state). This teaches your brain and body: “You’re safe. You’re not being chased by a lion. It’s just an email.”
💪 Builds Emotional Resilience
By focusing on what you want (not what you fear), SFH helps rewire how you respond to perceived slights. You start to build distance between “they sighed during my presentation” and “I’m terrible at my job.”
📖 Shifts Your Inner Narrative
Through positive future visualisations and language, you gently train your subconscious to expect connection, not rejection.
😌 Creates Predictable Calm
Regular sessions create a dependable sense of calm, a baseline you can return to when emotions spike.
Everyday RSD First Aid
Whether you’re in hypnotherapy or not, here are some daily strategies that help:
- Name it to tame it: “This feels like RSD” is a powerful interruption.
- Pre-load your rational brain: Write down 3 reasons the situation might not be rejection. Read them like a prescription when spiralling.
- Nervous system care: Walk, breathe, hydrate, REST. (Seriously. Sleep is magic.)
- Don’t argue with the spiral: Acknowledge it, then gently redirect your focus.
Final Thoughts: You’re Not Broken, You’re Wired Differently
RSD hurts. But it’s not a life sentence. It’s your brain sounding a very old, very loud alarm. With the right tools, you can turn down the volume.
Through Solution Focused Hypnotherapy and self-awareness, you can learn to notice the wave before it crashes. And ride it with more grace, more calm, and maybe even a little humour.
Because honestly? Sometimes you just have to laugh at how dramatic your brain can be about a “thumbs up” emoji 👍
