Rejection Sensitive Dysphoria urgently needs to be 'medically' recognised as part of ADHD.
If you want to feel really vulnerable, try telling someone you have 'Rejection Sensitive Dysphoria' and wait for their eyes squint as they try to make sense of what you've just said and not burst out laughing.
I know that saying I have a sensitivity to rejection linked to my ADHD sounds like the most snowflakey-woke thing any neurotypical person has ever heard. However, they haven't impulsively quit jobs, ended relationships or felt suicidal at the slightest even imaginary rejection, even if self-imposed.
It's incredibly frustrating: you may still be able to rationalize, beating yourself up for being 'dramatic' whilst still feeling like you're trapped in hell. It can feel like having a toddler in control of my emotions.
As emotional symptoms aren't included in ADHD diagnostic criteria (hyperactivity, inattention & impulsivity), I didn't believe I had it, which made me question everything. I strongly believe this is why women and girls are so often misdiagnosed: because the diagnostic criteria is outdated and based on a tiny proportion of the population, especially as it wasn't even recognised in adults until 2008.
It was only hearing Dr Dodson talk about Rejection Sensitive Dysphoria being:
the one emotional condition only found with ADHD
resulting in such severe pain a person can become suicidal
lasting for very short periods of time
caused by a perceived or real 'rejection'
That I could accept my ADHD diagnosis and start to work with it, instead of against it. This genuinely saved my life.
I used to wake up to suicide notes I'd written, awkwardly no longer wanting to die and ripping them up into very small shreds so there was no risk of my housemate seeing and being as freaked out as I was. Having such rapid mood changes makes you gaslight yourself. I'd beat myself up for being so dramatic, selfish, and ridiculous, or googling what was wrong with me, before inevitably feeling that way again.
At the time, I was a full time fashion model. There is possibly no worse job to do for a person sensitive to rejection - I've been insulted to my face in every single way imaginable. I've been measured and shamed in front of entire offices for having hips 1cm too wide, sent home from a job where they spent 3 hours trying to get my eyebrows even, and another where they cut my photos off at the chin and refused to pay me.
Weirdly, rejection like this almost doesn't bother me. I found a way of coping by disassociating, which is what enables me to do lots of scary things, like setting up ADHD Retreats, courses, quitting my law job to become an ADHD Coach and publishing 3 books.
The rejection that does bother me hits after I do these things. It comes with the horrific waves of crushing insecurity, imposter syndrome, comparisons to other people, and scary feelings of overwhelm and panic. It comes with building myself up on a giant adrenaline wave of excitement and crashing down onto rocks, because I have inevitably made mistakes like misspelling 'ADHD' on my book, 'ADHD: an A to Z'.
Fortunately, learning about RSD enabled me to control it. I can spot warning signals or situations likely to trigger it and usually end up crying in bed instead of trying to figure out how to quit my entire life. However, it can still be very challenging to not want to tear down whatever it is that I've just created.
The amazing thing about being an ADHD Coach is knowing I am not alone, which is why I am oversharing this with you. This can be the worst part - feeling like nobody else could ever possibly understand what you're going through. The questioning of why it bothers you so much that your performance wasn't perfect, that you didn't get enough likes on a post, or the tiny mistake nobody else even noticed, to the point where it feels like your world is crashing down.
I've lost track of the number of people I know with ADHD who experience this. ADHD can cause a 30% neurodevelopmental delay in our executive functioning skills, which includes emotional regulation. When I feel it, it's like one of those old computer viruses that would make the entire screen flicker and shut down.
Here's some ways I've learned to manage it:
Reframing your thoughts - I cannot overstate how amazing Byron Katie has been for me in doing this. When I do this with coaching clients it's always a game changer: we get to choose what to believe.
Identify situations that cause you to feel RSD and what can help. For me, the best way of managing it is treating myself like a toddler and waiting for it to pass.
Hack your life to reduce the number of triggers and increase the accessibility of things that make you feel secure. Such as, MUTE ALL OF THOSE AMAZING PEOPLE YOU LOOK UP TO. Consume their content when you feel good about yourself and actually want to see it.
Set limits on your social media use: our brains love to seek it out when we're already feeling bad to try and numb our emotions. By having apps deleted from your homepage you can make it less of an automatic reason.
Keep reminders around you of how loved and happy and brilliant you are, exactly as you are. Such as having photographs of people who love you unconditionally up on your walls!
Set boundaries and check in with yourself regularly on your needs.
If you feel overwhelmed by RSD, remind yourself that it will pass. Try to label it and leave any triggering situations as soon as possible.
Think of the worst case scenario, and rationally plan out what you'd do next.
Remember that people generally feel about you how you feel about them. NO ONE HATES YOU AND YOU'RE NOT BEING FIRED / IN TROUBLE.
Remember to be objective and not to blame yourself. We can undermine ourselves by attributing bad treatment of us to RSD, but there is a big difference between being 'sensitive' and being treated unfairly. In many clients I work with, their reactions are completely natural to their situations!
Get a therapist and ADHD Coach (which the Government can fund if you're in the UK).
Here's some ways of supporting it for people who don't have ADHD but know someone with it:
Ask the person what kind of communication styles makes them feel the most comfortable.
Avoid 'surprises' such as unexpected calendar invites for meetings without explaining what these are for
Have set meeting agendas shared in advance and confirming key points afterwards
Reassurance: focus on the positives and 'sandwich' negative feedback between positives!
Set aside time to speak to the person if they need you, as most issues can be resolved very quickly and this avoids catastrophizing.
Written communication can be really helpful, such as on work or in relationships if you need to get your thoughts out.
Give people time and space to process potentially upsetting situations.
Set clear expectations, such as giving clear goals when explaining areas of potential development at work.
RSD hasn't been 'medically recognised', but that doesn't make it any less real.
Ironically, having RSD can make us extremely resilient - because nothing may be as bad as what we can mentally do to ourselves. I'm really good at handling rejection these days, because I have done so much work around RSD.
For the countless people who haven't, RSD can be an extremely dangerous and serious experience. I'm creating a course on this now, so drop me a message if you want preview access.
To join the ADHD course in , head here.