What is Rejection Sensitive Dysphoria?
My ADHD comes with a weird power. I like to think of it as the 'I have no dignity left anyway, so why not continue to embarrass myself' sort of power, that has resulted in incredible things, like people like yourself reading my writing.
For me, this is rooted in Rejection Sensitive Dysphoria: the crushing pain of feeling like the world has ended at objectively very 'small' issues, such as zoom freezing during a meeting. In comparison to this, putting a course out is easy, because my RSD underpins me with the belief that no one will do it anyway - except they do!
The challenge is managing this with a brain that loves to follow emotionally-charged rabbits holes. The latest was someone telling me that 'Rejection Sensitive Dysphoria hasn't been academically verified enough to be presented as fact' in my book, ADHD: an A to Z.
A few years ago, I might have tried to stop the entire book from being re-published, deleted my social media accounts, and booked a flight to Australia. However, now I've got a handle on my RSD, I ended up:
finding so many other testimonials that we had to create an entire testimonial page in the book
creating a 30 day course on Rejection Sensitive Dysphoria for ADHD Awareness month (October)
presenting on why more 'academic recognition' needs to be happen on emotional symptoms of ADHD to the World Health Organization.
Here's how I've managed to do this and you can too, if it's something you experience:
1) Understanding Rejection Sensitive Dysphoria (RSD)
Hearing this 'official' information from Dr William Dodson changed my life, because it mean I had a label for what I was experiencing. RSD is:
a triggered, wordless and intense emotional pain that occurs after real or perceived rejection.
said to be the one emotional condition found only with ADHD (as opposed to conditions such as Bipolar or Borderline Personality Disorder), as it lasts for a limited period of time and is triggered by something happening (i.e it may feel very rational, and is specific to a certain setting).
said to be neurological and genetic, with little medication options available, as it hits so quickly.
MRI scans have proven differences in the brain when a person experiences romantic rejection, including in the:
ventral tegmental area: controlling motivation, reward and dopamine
nucleus accumbens: which measures our losses and assesses risks
orbiofrontal / prefrontal cortex: associated with craving and addiction
the insular cortex and anterior cingulate: associated with physical pain and distress.
In my non-scientific-expert view, I'd compare RSD to your very worst experience of heartbreak. Except it's because you've forgotten to take your clothes out of the washing machine on for the 5th time in a row and your clothes now have a layer of mould and you know it's ridiculous to feel this level of pain over your clothes washing, but also WHY CAN'T YOU JUST DO IT???
ADHD is connected with a developmental delay in executive functioning skills of up to 30%, including emotional dysregulation. Severe emotional pain combined with impulsivity is extremely dangerous.
2) Recognising RSD
Understanding RSD is a 'real' thing literally saves lives (including my own), because we can spot what's happening and calm ourselves down, instead of ending up googling what's 'wrong' with us & believing we'll be sectioned if anybody ever finds out.
Although the intense bouts of RSD pain may not happen very often, it can impact our lives on a day to day basis with a determination to avoid it, making us live in a fight/flight/fawn/freeze mode. It can manifest in ways without us even realising, such as:
people pleasing
masking
decision paralysis
perfectionism & procrastination
a VERY horrible inner voice blasting how stupid we are throughout the day
a vulnerability to exploitation
very quick mood swing tornados.
Ultimately, RSD can batters our self-esteem and stop us from trying. Whether that's trying to socialise with people that care about us, produce 'good' work, or living our lives at all, it can result in depression and severe social anxiety on a day to day basis.
3) Managing RSD
Once we know what we're working with, we can apply the strategies that actually work for us. I've read possibly every single book on the above things, so now with the knowledge of what's actually causing them, I've been able to put these into context and pass the learnings on via the course.
Coaching people on managing RSD 1:1 has been some of my favourite work to do. Watching a person apply these interactive exercises, like being their own lawyer in their own RSD-court-case, or truly thinking through the reality of a situation, has been like seeing light bulbs spark on.
One person came to me with severe RSD due to a crippling fear of being rejected from law school, and after doing these exercises, realised they didn't even WANT TO GO. Their worst-case scenario was actually what they wanted to do, meaning they changed their entire career path as a result. These are the magical moments of coaching, and I am super excited to be making them as accessible as possible.
4) Supporting RSD
It's important to note that doing this work on RSD isn't because we are overly-sensitive snowflakes that need a fake-fur-lined office to work in with no room for well-intentioned feedback. Learning how to regulate our emotions means we can:
take responsibility for our actions
let ourselves feel appropriate emotions at the appropriate times (which are all very necessary and important!)
set boundaries, especially in areas we know may trigger RSD
ensure we are not taking advantage of by others by undermining ourselves as overly 'sensitive'
look after ourselves with a plan and toolbox of support when needed
Nobody teaches us how to regulate our emotions, but learning the difference between healthy pain and dysphoric, self-imposed suffering, is life-changing. We can't stop the waves from coming (and neither should we want to!) but we can learn how to surf (and disentangle the ankle cord from around our limbs).
5) Owning RSD
Just like ADHD, RSD is not a bad thing. It's a concept we have attached meaning to. I know that I may experience intense, soul-crushing pain at relatively 'small' things, but owning this means I get to decide how I feel about it (ironically).
It is actually an incredibly powerful rush of energy and emotion, that when channelled effectively, can result in incredible things, like this course itself! Without RSD, I wouldn't have written any of the books I've written. I wouldn't be able to emphasise with people about the pain they may experience, from insecurity to wanting to end their own life. In a world where silence and stigma are killing people - with a suicide every 40 seconds - having these conversations are more important than ever before.
Owning RSD means knowing how to look after myself, my emotions, and then being able to listen to the strong emotions I have and follow my gut.
If you experience RSD, I strongly recommend joining the course (probably first ever!) Rejection Sensitive Dysphoria course here.
If you can't afford it and want to do it, just let me know, and we'll make sure you can.
You can also get the ADHD book here.