Most people are aware of some of the more common ADHD symptoms, relating to challenges with attention, impulsivity, forgetfulness, organization, executive functioning and rapidly shifting emotions.
However, another symptom which many people with ADHD experience relates to having an intense fear of rejection, or even perceived rejection, criticism or failure. This symptom has only come to the attention of mental health specialists and researchers in recent years and is called: Rejection Sensitivity Dysphoria (RSD).
RSD is described by people with ADHD as an intense, hard to tolerate, and sometimes even as a physical pain, when they are confronted with social situations where they feel criticized or rejected in any way (not accepted, excluded, misunderstood, not wanted, ignored).
To manage this intense feeling, adults with ADHD may learn to cope with it by either:
- trying to please others (thus avoiding situations where others may be displeased with them); or
- avoiding people, social situations or relationships in general (again, for the purpose of avoiding the painful feeling of potential rejection).
These strategies may help adults with ADHD for some time, even many years, but eventually leads to disconnection from their own feelings and needs, isolation, loneliness and reduced life satisfaction and wellbeing.
One of my clients with ADHD described his painful experiences with the fear of rejection in this way:
“During the daily rat race, it feels so busy and overwhelming that I don’t really experience the need for having any more people in my life.
However, when life’s demands subside a bit and I have more time to think about what else is there I realize that I do want that human connection and communication. So I start doing something about it, send a text message to new acquaintance, check social groups on Meetup … and no reply. That hurts … a lot … and I return back to my shell to avoid the pain. Then Ego says: ‘No one likes you! No one wants to talk to you!’ and the vicious cycle continues. My next thought is ‘Let’s give up! Who needs these people? I am better off alone!”.
Moreover, when people with ADHD have a fear of failure, this fear may drive them to develop very high (many times unrealistic) standards of behaviour, expectations and work ethics for both themselves and others. Despite the positive consequences of such endeavors, this can also create problems for people with ADHD as described by another person with ADHD:
“Can’t sleep cause the thoughts are running wild. It’s like a TV show playing on repeat. Keep thinking about my colleagues and managers and situations at work … I feel so angry, asking myself ‘Why they are so incompetent?’, then feeling bad for my thoughts and feelings. It is so hard, because no one measures up to my perfect standards, and moderation of my expectation is so demanding and draining.”
Managing the Fear of Rejection (RSD)
It is obvious that Rejection Sensitivity Dysphoria is a very painful experience for people who have ADHD, and may have a significant effect on different areas of their life, particularly their relationships. Here are some ways to help people manage RSD more effectively:
Learn About RSD: Read and understand this symptom. Reflect over how it may be affecting you in your daily life, and your relationships in different life areas.
Use Mindfulness: Now that you know what it is you experience sometimes and have a label for it, learn to observe it, identify it when it happens, and talk to yourself in supportive ways after you notice your RSD kicking in. Remember that the experience of RSD may be overwhelming in the moment, so take time to get back to feeling balanced.
NB: If you catch yourself experiencing RSD that has made you feel or act in a certain way, just say “that was my RSD playing out right there”, as an explanation, not an excuse. Continue making conscious choices about how you want to act from that point onward.
Practice Self-Compassion: Remember that RSD is a symptom – you do not have a choice when it kicks in, but you do have a choice about what you do about it when it arises. Do not judge yourself, do not be harsh in your self-talk. Do not add unnecessary suffering. Admit, accept, manage (the best that you can), refocus and move on. If your RSD made you say or do something you regret, repair, re-do and forgive yourself.
Consider Medication: Talk to a psychiatrist who specializes in ADHD, about whether medication could help you with your ADHD symptoms and RSD. There has been recent research to suggest some medications may help alleviate symptoms of RSD (See article: Rejection Sensitive Dysphoria: Emotional Pain of Criticism).
Fear of rejection (RSD) is a challenging experience. Nevertheless, people with ADHD and other conditions can learn and practice to manage their worst symptoms, and live a meaningful and rewarding life based on their strengths and values.
Author: Ilana Gorovoy, B.Arts (Psych), B. Arts (Hons.)(Psychology), MPsych (Couns.)
With a Master’s in Counselling, Brisbane Psychologist Ilana Gorovoy draws on therapeutic approaches such as Cognitive Behavioural Therapy, Existential and Strengths-based approaches, Person-Centred and Positive Psychology, to assist her clients to become conscious of their strengths and difficulties, design and reach their goals, live a life of meaning and purpose, and reach their full potential.
To make an appointment with Brisbane Psychologist Ilana Gorovoy, try Online Booking – Wishart. Alternatively, you can call Vision Psychology (Wishart) on (07) 3088 5422.