ADHD and rejection sensitive dysphoria (RSD)

Few people go through life without being rejected at some point. And no one likes it when they’re not invited to a party, get turned down for a date, or don’t make the team.

But rejection can be especially hard for people with ADHD. They often experience its effects more intensely and take longer to recover from it. This type of severe reaction to rejection is often called rejection sensitive dysphoria, or RSD.

Learn more about RSD, and why people with ADHD may have trouble handling rejection.

What is rejection sensitive dysphoria?

RSD isn’t a formal condition or a medical diagnosis. It’s a term that refers to an extreme emotional reaction to rejection. People can feel intense pain when they feel rejected by someone important to them. It can also happen if they fall short of expectations — either their own or other people’s.

RSD also isn’t an official symptom of ADHD. But many people with ADHD experience it. They tend to feel emotions, both good and bad, more intensely than other people.

Why ADHD makes it hard to cope with rejection

Many people with ADHD struggle with managing emotions. Being rejected can bring up strong and long-lasting feelings, like disappointment, sadness, shame, and regret.

People who don’t have ADHD typically find ways to make themselves feel better more easily. For example, if a friend isn’t available to get together because of another commitment, people might think, “I guess my friend made that plan before I asked. We’ll get together next week instead.”

But people with ADHD struggle with a set of skills called executive function. Those skills include flexible thinking and self-control, which play a big part in handling rejection.

Executive skills allow people to come up with explanations for what happened and develop a plan to move on. This kind of thinking helps put things in perspective. But people with ADHD can struggle to shift their thinking. They may get hyperfocused on their feelings of rejection.

ADHD and the impact of low self-esteem

People with ADHD often already feel like they’re on the outside. They’re more likely to struggle in school or at work and may have a harder time with social skills. This can lead to poor self-esteem.

People with ADHD also tend to be more sensitive. They may be more likely to blame themselves when things don’t go as they’d hoped. If they don’t get invited to a party, their automatic thought might be, “What’s wrong with me?”

Rejection can trigger such painful feelings that people go to great lengths to avoid it. They might spend a lot of energy trying to please other people. Or withdraw from situations that might lead to rejection, whether it’s asking to join a committee at work or a game at recess.

This only makes them feel more alone. And it can contribute to mental health issues like anxiety and depression. These conditions often co-occur with ADHD.

Ways to cope with feelings of rejection

While rejection may hit people with ADHD harder than other people, there are strategies that can make it easier to cope. 

Consider different explanations. The first reaction when someone doesn’t respond to a text might be “That person doesn’t like me.” But stopping to think about other possible reasons can help. The person might just not have had the chance to answer yet.

Come up with a plan to move forward. Not chosen for the choir? Find another activity to focus on. A friend cancels plans? Reach out to someone else who might be free. Practicing coping strategies like these can help build resilience that will help when setbacks happen in the future.

Seek help. If strong negative feelings last for longer than seems reasonable, reach out to a doctor or a mental health professional. People with ADHD are at greater risk for mental health issues if they don’t get the help they need. So watch for signs of anxiety or depression. There are treatment options for kids and adults.

Want to know more? Explore:

• Other behaviors related to ADHD, like mood swings and trouble managing emotions
• How cognitive behavioral therapy (CBT) can help with managing emotions
• A mom’s description of what rejection sensitive dysphoria feels like