This Little Known Disorder Makes It Nearly Impossible To Deal With Rejection
by Marissa Pomerance
No one likes rejection. None of us.
But most of us get better at accepting it as we get older—understanding that, while criticism or rejection can be painful, often, they’re also opportunities for growth.
But for people with Rejection Sensitive Dysphoria, criticism and rejection don’t feel like disappointing but helpful growth opportunities. They feel like deep, emotional, annihilating pain. A kind of pain that shatters their sense of self, calling into question their choices, their personality, their intelligence, their self-esteem, their worth.
This often misunderstood condition is just starting to gain more prominence in the world of psychology, though it has yet to be classified in the DSM.
Here’s everything we know about it right now.
1. RSD might be at the root of extreme emotional reactions.
Rejection can be painful for anyone. That’s a given. Just because you don’t like rejection, it doesn’t mean you have RSD. But for people with RSD, the feeling of rejection cuts deeper than the mild discomfort it evokes in most people.
That’s because any whiff of rejection is internalized; it doesn’t even have to be real rejection, but even perceived rejection, like if a friend forgets to respond to a text.
People with RSD feel the pain of rejection in the pit of their stomachs. It can deeply penetrate their psyche. It makes them feel shame—like they’re failing. Like they’ll never be good enough. Like they’re not meeting the expectations of others, or the extremely high expectations they’ve set for themselves. The negative self-talk that comes from rejection can become all consuming, and can last for days.
And the shame and sadness from rejection, criticism, or even social exclusion can enrage people with RSD, sending them into an emotional meltdown that’s seems out of proportion to the severity of the circumstances that caused it.
But the emotional outbursts of RSD can compound on themselves, becoming cyclical. Despair, hopelessness, a threatened identity— these can all lead to rage, which can lead to frustration— frustration over their lack of emotional control, frustration over not feeling heard, frustration that they can’t seem to move on from these feelings of rejection. And that frustration can just lead to more rage and uncontrollable outbursts.
2. RSD can lead to panic and anxiety.
But not everyone with RSD reacts with rage; some deal with rejection through avoidance and withdrawal. And these types of coping mechanisms add heaps of panic and anxiety to the already-full emotional plates of people with RSD.
Just the fear of rejection itself can be so strong, people with RSD might develop symptoms resembling social anxiety, like avoiding social situations, refraining from dating, or not speaking up in public. Since these situations can lead to pain and humiliation, people with RSD can start to circumvent them all together.
For women with RSD in particular, the anticipation of rejection might evoke such strong feelings of anxiety, they can withdraw into themselves, internalizing and dwelling on their experiences with rejection. They cut off contact with people who could help them, and suppress their emotions. They stop wanting to engage with others, or push themselves at work, or try something new— it feels safer to just do less.
In fact, rejection can lead to learned helplessness, causing someone to lose all motivation, and just give up and become passive because they don’t even want to try anymore.
3. It’s connected to ADHD and autism.
RSD isn’t always an isolated condition—often, it can stem from larger issues, like ADHD or autism.
People with ADHD might struggle to manage their emotions as emotions can feel more intense for them. Small events can trigger “flooding,” in which one strong emotion can become so all-consuming, it drowns out everything else.
RSD, and the highly emotional responses that come with it, can be an ADHD symptom itself, especially in adults. And sometimes, the other symptoms of ADHD can make the triggers of RSD worse. For example—if someone with ADHD tends to get distracted in social situations and ramble on, their friends and colleagues might react negatively and criticize them, triggering RSD, which can amplify feelings of social rejection, intense emotional pain, and anxiety.
For kids or adults with autism, having trouble understanding other people might encourage them to misinterpret criticism or teasing as intense rejection. And since hypersensitivity and emotional dysregulation are already a struggle for some people with autism, rejection and criticism can cause the intense flood of emotions of RSD.
4. RSD can be caused by a history of neglect.
This might not come as a huge surprise, but feelings of rejection in childhood can make you more sensitive to it later in life.
Being neglected, or forced to live up to impossible ideals of perfection, or being made to feel guilty and ashamed at a young age can all contribute to RSD. Having a highly critical parent or adult figure that squashed your self-esteem can make you ultra-sensitive to criticism. Or being abandoned by a loved one can create a lifelong fear of rejection. Being teased, bullied, or romantically rejected might also contribute to RSD.
Often, to cope with these long-standing feelings of rejection and social isolation, people with RSD form themselves into people pleasers, shapeshifting into the kind of person that could be liked and admired by all in an attempt to escape more criticism and rejection.
And histories of neglect, abuse, or abandonment might make someone with RSD more prone to questioning their relationships, as they might feel like any small social slight—not responding to a text, not getting invited to a party—is proof that people hate them, or that they’re getting rejected by a friend or partner. They overanalyze every conversation. They internalize every small incident as proof that they are not worthy or love or friendship.
5. RSD is highly connected to self-esteem.
Many people with RSD set high standards for themselves, which is why they can feel shattered when they’re rejected or criticized.
Because they often can’t separate this sense of rejection from their own self-esteem; the two are inextricably linked, and if they are not living up to their incredibly high expectations, then they are failing. They are a failure.
RSD is tricky to recognize. It’s not well-known, and it’s often tied up in other issues— like ADHD, or autism— making it, as a standalone disorder, difficult to parse. Diagnosis requires appointments with mental health professionals, specifically ones that specialize in RSD and ADHD, and treatment options are limited to therapy and maybe a few off-label medications.
But there are always pathways to better self-understanding, which opens pathways to techniques and strategies for management. And this self-work is what allows us to deepen our relationships, turn the lens inward, develop a healthier sense of esteem, and live a richer life full of even more choices.
Marissa Pomerance is the Managing Editor of The Candidly. She’s a Los Angeles native and lover of all things food, style, beauty, and wellness. You can find more of her articles here.
