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A Complicated Relationship: Understanding Adhd & RSD

Updated: Nov 27, 2022


For many people with Attention Deficit Hyperactivity Disorder (ADHD), the world can feel like it's against them. They may feel like they're constantly misunderstood, and that no one really gets them.

It's not uncommon for people with ADHD to also suffer from comorbid conditions, such as anxiety or depression. One condition that is often comorbid with ADHD is called Rejection Sensitive Dysphoria (RSD).

RSD is a form of emotional sensitivity that can be triggered by real or perceived rejection. People with RSD often have a very high sensitivity to criticism, and they may interpret even the most well-intentioned constructive feedback as a personal attack.

As you can imagine, this can make it very difficult to maintain healthy relationships, both personal and professional. In this blog post, we’ll explore some key points of this complicated relationship, as well as how to best cope and manage these diseases.

What Causes RSD?

There is no one single cause of RSD. However, there are some risk factors that may make a person more likely to experience RSD. These risk factors include:

  • Having a parent or close family member with ADHD or another mental health condition

  • Experiencing trauma or abuse during childhood

  • Having difficulty making and keeping friends during childhood

  • Having difficulty in school due to ADHD or other learning disabilities

Rejection Sensitive Dysphoria can be comorbid with ADHD. The pain and anxiety associated with RSD can be so severe that it interferes with daily functioning.

For example, people with RSD may avoid social situations for fear of being rejected, or they may have difficulty maintaining relationships due to their hypersensitivity to criticism.

Because RSD can greatly impact social relationships, it is also important to seek out support from friends and family. For instance, loved ones can provide emotional support and help the individual to avoid situations that may trigger a reaction.

In addition, it may be helpful to find others who understand what it is like to live with RSD. Support groups can provide a safe space to share experiences and offer tips for coping with the


“Why’d you have to go and make things so complicated?” -Avril Lavigne

When you're living with ADHD, everyday tasks can feel like a struggle. But when you add Rejection Sensitive Dysphoria into the mix, life can feel downright impossible.

For people with ADHD, this often means that social interactions are fraught with anxiety and

fear. Rejection can mean anything from someone not wanting to talk to you at a party to being fired from your job.

While the two conditions share some symptoms, they also have unique features.

For example, people with ADHD may be more likely to take risks without considering the consequences, whereas those with RSD may become withdrawn and avoidant in social situations.

Additionally, people with ADHD may have difficulty completing tasks, while those with RSD may struggle with interpersonal relationships. While there is overlap between the two conditions, it is important to note that they are distinct entities that require different treatments.

What are the signs/symptoms?

It's an incredibly isolating feeling, and it's easy to see why so many people with ADHD struggle with it. Given the high comorbidity rate between ADHD and RSD, it is important for people with either condition to be aware of the signs and symptoms of RSD.

  1. Feeling sad or angry for no apparent reason

  2. Feeling easily offended or hurt by others

  3. Having a low self-esteem

  4. Feeling anxious or stressed

  5. Feeling hopeless or helpless

  6. Having difficulty concentrating

  7. Having suicidal thoughts

  8. Engaging in self-harming behaviors

  9. Experiencing changes in appetite or sleep patterns

  10. Withdrawing from social activities

Individuals with rejection sensitive dysphoria (RSD) may experience a range of physical symptoms when they perceive that they are being rejected or criticized. These can include racing heart, chest pain, shortness of breath, dizziness, fainting, and stomach pain.

RSD is thought to be related to an oversensitivity of the brain's reaction to dopamine. This may explain why individuals with RSD often report feeling "on edge" or "jumpy."

In addition to physical symptoms, individuals with RSD may also experience cognitive and emotional symptoms such as rumination, panic attacks, and suicidal ideation.

If you are experiencing any of these symptoms, it is important to seek professional help. A mental health professional can provide you with support and resources to help you cope with RSD.

How are ADHD & RSD Treated?

There is no one-size-fits-all approach to treating RSD. Some helpful coping strategies include building a support network, learning stress management techniques, and seeking professional help.

Subsequently, other common treatments include medication, therapy, and lifestyle changes.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a type of psychotherapy that can be effective in treating rejection sensitive dysphoria. CBT focuses on helping individuals to change their negative thinking patterns and behaviors. This can help to reduce the feelings of anxiety and depression that are often associated with rejection sensitive dysphoria.


Certain types of medication, such as antidepressants, can also be helpful in treating rejection sensitive dysphoria. These medications can help to reduce the feelings of sadness, anxiety, and irritability that are often associated with this condition.


In addition to therapy and medication, self-care is also important for those who suffer from

rejection sensitive dysphoria. Some self-care activities that may be helpful include exercise,

relaxation techniques, and journaling.

Additionally, it is important to make sure that you are getting enough sleep and eating a healthy diet.



RSD can impact any type of relationship, including familial, platonic, and romantic relationships.

It is important to remember that RSD is a real and valid condition that should not be ignored or dismissed.

Although RSD is still a relatively new diagnosis, it is becoming increasingly more recognized by the medical community. There are many ways to treat both ADHD and RSD, depending on the individual’s needs.

If you think you or your loved one may have RSD, please schedule an appointment with us so that we can help get you started on the path to healing. Thank you for reading this article and we hope it has been helpful.

Looking for some mental health motivation? Make sure to follow us on the gram for resources, encouragement, & education!

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