I have never been very good at handling feedback.  Even when feedback is well-delivered and is truly constructive, I still ultimately feel like I am disappointing someone and the emotion comes flooding in.  I have tried every trick in the book to reset my nervous system at that moment, but unfortunately, usually the only thing that helps is if I have a good cry and can release the nervous system build up.  It took me 2 years of therapy before I realized that this was rejection sensitivity dysphoria.  I would like to claim that this was the result of past traumatic experiences I had, but unfortunately, I think I have always been this way.  It has been very challenging to navigate my career in education, not to mention starting a business, being afraid of rejection.  This goes hand in hand with my imposter syndrome as well-my fear of rejection feeds my imposter syndrome of the narrative telling me I’m not good enough.  

Rejection Sensitivity Dysphoria (RSD) is very common among neurodivergent individuals, especially those with ADHD.  While on the outside it can look like you are just “too sensitive” and people might say that you need to “get a hold of yourself”, the pain that you are feeling is 100% real.  When it manifests at work, people may doubt your ability to be professional or lead others, which can significantly decrease your self-esteem.  In this blog, we’ll dive into what really is RSD and how to build your resilience so that pain slowly becomes less in every experience.

What Is Rejection Sensitivity Dysphoria?

Defining RSD in simple terms

Rejection Sensitive Dysphoria describes an extreme emotional response to real or perceived rejection, criticism, or failure. While not an official psychiatric diagnosis, it is widely recognized by clinicians as a debilitating core feature of ADHD, as well as autism and anxiety.  It has three main symptoms:

Overwhelming Emotions: A minor slight—like a delayed text, constructive feedback at work, or a misinterpreted tone of voice—can spark intense shame, sadness, or explosive anger.

Hyper-vigilance: To avoid this emotional pain, people with RSD may develop severe people-pleasing habits or become perfectionists. 

Social Withdrawal: Many isolate themselves and avoid taking risks or pursuing new relationships to protect themselves from potential rejection.

Why rejection feels so painful 

Rejection feels so painful due to the wiring of an ADHD brain and how it processes emotions and social experiences.  ADHD brains struggle to regulate emotions and “filter” social threats. The same circuits in the brain responsible for focus also regulate emotional responses.  Another reason ADHD brains are so sensitive to rejection is because of the negative feedback these individuals are often receiving, telling them that they aren’t doing something, doing it wrong, being “too much”, and so on.  It’s hard to take meaningful feedback well, when for most of your life, you have gotten two pieces of negative feedback for every one positive comment.  

Common experiences that people describe as RSD

Here are some common triggers:

• Applying for a job and not getting it
• Submitting a project or paper and receiving an abundance of constructive feedback in return  
• Performance reviews
• Making a request for literally anything and having it denied 
• Asking for help and having someone tell you no
• Making a mistake and having it pointed out (at home or at work)
• Having to tell your kids that you can’t do something because of work obligations

Signs You May Be Experiencing RSD

• Intense emotional reactions to criticism
• Fear of disappointing others
• Avoiding situations where rejection is possible
• People-pleasing and perfectionism
• Rumination after social interactions

Why RSD Is So Common in Neurodivergent Adults 

In addition to the reasons listed above, RSD is so common in neurodivergent adults because of masking, social pressure to appear neurotypical, and chronic self-monitoring.  You work so hard to appear “normal” and when someone points out where you may have slipped up, that can be devastating.  After years of work on myself, I realized that any time my husband pointed out where I forgot to do the laundry or any other minor task, it would result in me blowing up at him.  I was upset that I was carrying this huge emotional burden and he had “the audacity” to point out a minor thing I neglected.  This was worsened as I became more and more burned out by trying to appear normal at work (ie-not worrying about all things) and would feel completely exhausted and irritable by the time I got home.  

What Happens in the Nervous System During an RSD Episode?

Emotional threat versus physical threat

Again, this goes back to fight or flight response.  When you hear something negative, your nervous system perceives it as a threat and this is its way of protecting you.  Your body isn’t differentiating between an emotional or physical threat; according to your brain, it’s all a threat to your safety.

Why reactions can feel immediate and overwhelming

ADHD brains do not slow down to process the details of a feeling, thus anything that triggers your fight or flight response feels like an immediate and overwhelming threat to your safety.

The role of stress, overwhelm, and depleted capacity

Stress and overwhelm deplete your emotional capacity over time.  This lowers the bar for an emotional reaction, which makes it likely to experience tears or being unable to control speaking out of frustration or anger.

The Hidden Cost of Untreated RSD

• Relationship challenges
• Difficulty asking for help-this was a big one for me.  I would ask for help and be turned down, so then I felt that I needed to balance everything on my own.
• Career and workplace impacts
• Self-esteem and identity struggles
• Parenting while managing rejection sensitivity-I know I flew off the handle at my young children for saying something that was unkind, but they didn’t understand why it was unkind because they were so little (and also neurodivergent).  

What to Do in the Moment When RSD Hits

Grounding strategies for intense emotions

• I like 54321-5 things you see, 4 that you hear, 3 that you smell, 2 things you can touch and 1 emotion that you’re feeling.  I guarantee by the time you get to 2, you will start feeling better.
• Supposedly pressing your tongue against the roof of your mouth helps to stimulate the vagus nerve and can help calm you down.  It doesn’t work for me, but it has helped some of my clients.

Questions to ask yourself before reacting

First of all, stopping to ask any questions is a big step in the right direction.  Other significant questions you should ask yourself include:

• What am I feeling?
• What OBJECTIVE data supports this feeling? (usually there isn’t any, and it’s important to show your brain that).
• What past experiences support my feelings?

When to wait before responding to texts, emails, or conversations

This is also my kryptonite (see my previous post about being afraid to check my email).  I am proud to say that I have made the most improvement in this area.  Here are some boundaries and guidelines I use for email responses:

• If it’s work-related, I no longer feel obligated to respond after I get home.  
• If it’s a work-related email that is logistic in nature and is a short, informative response, I will probably answer that immediately.
• If it’s an email that evokes an emotional response from me OR will likely be a continued, back and forth conversation:
  • I will not answer it at night, I will wait until I arrive at work the next day.
  • If I find myself ruminating over it, I will type or handwrite a response IN A SEPARATE WORD DOCUMENT, not in the body of an email.  Sometimes it’s better to get those feelings out, even if you’re not going to send that exact email.
  • I may need to talk to people at work or students to get more information.  If that’s the case, I will respond explaining this and then give myself a little more time to process the situation.
  • Sometimes I get trusted co-workers to look over an email before I send it.  I am aware that I can sound very emotional, especially in email, so it helps to have an objective person check for that.

How to recover from an emotional spiral

These are very exhausting.  Some of my most effective tips include:

• Stepping into a room alone and allowing yourself to breathe, cry if you need to, but do so in private.
• Focus on deep breaths, in through your nose, and out through your mouth.
• Chewing mint gum also helps me calm down.
• Talking to a trusted friend/colleague.  You may not be looking for them to “fix” the problem, but just hear you out non-judgementally.
• Splashing water on your face and neck helps to disrupt the nervous system pattern.

Supporting a Child or Partner with RSD

What helps versus what makes symptoms worse

You can help by prompting your child or partner to answer the above questions to use a data-centered approach.  This gives “proof” that their negative thought is unfounded.  Consistent practice can help reframe their thought process. 

What doesn’t help is saying “that’s not a big deal” or “just get over it”.  Believe me, if I could “just get over it”, I would.  

Other helpful tactics include:

Communicating feedback more effectively

From personal experience, if you ask me to pick out something that isn’t great and needs to be reworked, that goes over a lot better than you telling me (I like control, I know).  Framing improvements as “brainstorming sessions” and reinforcing that the initial idea is good also goes a long way.  

Validating emotions without reinforcing distortions

Validating emotions in a non-judgemental way is definitely appreciated.  Make sure that when you do this, you don’t come across as patronizing.

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When It Might Be Time for Additional Support

Signs RSD is significantly affecting daily life

I knew I needed more support when I developed a fear of checking my email.  I was afraid that it was going to be someone angry with me.  I also began to struggle with having performance reviews without tearing up.  These were significantly affecting my ability to function and I knew that this required more support.

Therapy, coaching, and skill-building approaches

Therapy and counseling are instrumental in helping you learn how to reframe negative thoughts and build resilience to fight back against RSD.  These professionals are highly trained in strategies on how to help.

Addressing underlying burnout or chronic stress

As I mentioned before, burnout and chronic stress pour gasoline on the fire and keeps your fight or flight response activated.  Working with a board-certified health coach, like me, who specializes in helping you develop and implement systems that fit your brain and your lifestyle will help regulate your nervous system so it’s not as easily triggered.

Conclusion

RSD is a common and often misunderstood experience among neurodivergent adults.  You are not “too emotional” or “too much”; what you feel is very strong and it’s your nervous system going above and beyond to try to protect you.  The goal is not to eliminate sensitivity but to reduce the intensity and recovery time.  Small changes in awareness, nervous system regulation, and self-compassion can have a significant impact on these goals.  Remember that healing IS possible, even if rejection has felt overwhelming for years.  I am living proof!