There are myriad ways one comes about being a sensitive person. Developing empathy for example, is due to experiencing hardship, which is why the wonderful ADHD/ADD/VAST/DAVE brain is usually associated with the ability for empathy.
RSD’s Origins, like that of ADHD are Genetic and Neurological
Rejection Sensitive Dysphoria, strangely enough, isn’t necessarily due to life experience. Like many other aspects of ADHD, the source is genetic and neurological. Examples from my own life include sobbing after someone else’s grandpa died, someone whom I barely knew. To top it off, I was 8 when this happened. I was always identified as a sensitive kid, something encouraged by my loving parents, who could see the empathy I exhibited, but not the underlying condition that was there. It always showed up in the “people pleasing” way, identified below.
There are two basic presentations of RSD:
- Internalized: this can be easily confused with mood disorders due to the rapid nature in which it happens, and can come replete with suicidal ideation (in this light, it is often confused with Rapid Cycling Mood Disorder.
- Externalized: This shows up as seemingly out-of-the-blue fiery rage-fests toward people or situations which the ADHD brain identifies as being the culprit for the pain experienced.
RSD can Lead to Social Phobia
RSD can also cause ADHD brains to anticipate being rejected (which may or may not actually be the case), and can become social phobia. Social phobia, for clarity, is not just being afraid of social situations, but an intense experience in which the person expects to feel deep shame, embarrassment, and scrutiny from the whole of humanity found in close proximity.
The two main ways people cope with RSD
The two main ways people cope with RSD is is either becoming a people pleaser, or giving up entirely. The linked video from my Instagram @adhd_coach_jon shows the “giving up entirely,” what it doesn’t show, is the years of people pleasing leading to this moment.
Symptoms of RSD
Symptoms of rejection sensitive dysphoria are complex so it can be challenging to identify.
RSD can sometimes resemble certain mental health conditions which include:
- depression
- social phobia
- bipolar disorder
- borderline personality disorder
- post-traumatic stress disorder
Typical symptoms of RSD (that may also occur in some of the above conditions) include:
- low self-esteem
- avoidance of social settings
- fear of failure
- high expectations for self
- frequent emotional outbursts after being hurt or rejected
- feelings of hopelessness
- approval-seeking behavior
- anger and aggression in uncomfortable situations
- anxiety
Although symptoms of RSD can mimic other conditions, one distinguishing factor is that symptoms of RSD tend to be brief and triggered by emotional cycles, rather than an actual event.
For more information, visit Healthline.com
RSD Treatment
There are actual medications that can reduce or remove the experience of RSD. According to WebMD, the medications that provide the most relief are Guanfacine (Intuniv) and Clonodine (Kapvay). Unfortunately, the medical community, by and large is in the dark about RSD and certainly any ways it can be treated. Make sure you present your psychiatrist with a solid amount of evidence. You can find WebMD’s article describing the totality of knowledge thus far, and a list of symptoms, along with medications used to treat it here.
For More Information on RSD:
Dr. William Dodson is the originator of this idea. For more information, please look up Dr. Dodson, who’s practice is found here. He also does a virtual talk here, discussing RSD, ADHD, and everything in between.