Understanding ADHD neurodivergent traits Rejection sensitive dysphoria (RSD)

What is Rejection sensitive dysphoria (RSD)

Rejection-sensitive dysphoria is a symptom associated with ADHD that causes intense feelings related to the belief that you have let other people down, embarrassed yourself, failed at something, or made a serious, unfixable mistake. RSD is a new concept in the field of mental health, and it is gaining increasing recognition as a major symptom of attention-deficit/hyperactivity disorder (ADHD). The term was coined by William Dodson, MD, a psychiatrist who specialises in ADHD.

People with ADHD are particularly vulnerable to RSD due to their inherent difficulties in regulating emotions and social interactions. In this blog, we will explore the impact of RSD on people with ADHD, and we will also examine the latest research on this condition.



RSD does not an official diagnostic category in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), but it is recognised as a significant symptom of ADHD. RSD can be a debilitating condition for individuals with ADHD, and it can significantly impact their quality of life, relationships, and their careers. People with ADHD may experience RSD in various contexts, such as academic or professional rejection, social exclusion, or romantic rejection.

The prevalence of RSD in individuals with ADHD is not well-established, but some estimates suggest that it affects up to 90% of people with ADHD. The severity of RSD can also vary, with some individuals experiencing it more intensely and frequently than others. People with ADHD who also have comorbidities, such as anxiety or depression, may be more vulnerable to RSD.


Effects of RSD on People with ADHD

The effects of RSD on people with ADHD can be profound and long-lasting. RSD can trigger intense emotional reactions, such as anger, sadness, or despair, which can be difficult to manage or control. These emotions can also lead to impulsive or reckless behaviors, such as self-harm or substance abuse, and can have a negative impact on mental health. Additionally, RSD can impair social skills and lead to avoidance of social situations, which can exacerbate feelings of isolation and loneliness.

RSD can also impact academic and professional lives of people with ADHD. For example, a student with ADHD may avoid participating in class discussions or seeking feedback from teachers due to fear of rejection or criticism. Similarly, an employee with ADHD may be reluctant to share ideas or collaborate with colleagues, which can hinder workplace relationships productivity, and career progression.


Recent Research on RSD and ADHD in the UK

While RSD is still a relatively new concept in the field of mental health, there is increasing interest in researching its prevalence and effects on people with ADHD. Recent studies in the UK have shed light on this topic, and the findings have important implications for diagnosis and treatment.

Although RSD is not officially recognised as a separate condition in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Research suggests that it is a common and significant issue among individuals with ADHD. According to a study conducted by Dodson and colleagues in 2021, approximately 99% of individuals with ADHD experience RSD to some degree.

A 2021 study published in the Journal of Attention Disorders examined the relationship between RSD and emotional dysregulation in adults with ADHD. The study found that RSD was a significant predictor of emotional dysregulation, and it was associated with greater impairment in social functioning and quality of life. The researchers concluded that RSD should be routinely assessed in adults with ADHD to improve treatment outcomes.

Another 2021 study published in the Journal of Psychiatric Research investigated the impact of RSD on medication adherence in children and adolescents with ADHD. The study found that RSD was associated with poorer medication adherence and greater symptom severity. The researchers suggested that addressing RSD in ADHD treatment plans may improve medication adherence and overall outcomes.


Coping with RSD

Coping with RSD can be challenging, but there are strategies that individuals with ADHD can use to manage their symptoms.

Here are our five top tips for coping with RSD:

  1. Seek therapy: Talking to a mental health professional can help individuals with ADHD learn how to recognise their RSD triggers and develop coping strategies to manage their symptoms. Cognitive-behavioural therapy (CBT) is a common approach that can help individuals learn how to challenge negative thoughts and reframe their perceptions of rejection.
  2. Practice mindfulness: Mindfulness meditation and other mindfulness practices can help individuals with ADHD become more aware of their thoughts and emotions. This awareness can help them recognise when they are experiencing RSD and take steps to manage their symptoms before they become overwhelming.
  3. Build a support network: Having a supportive group of friends, family members, or peers who understand ADHD and RSD can be incredibly helpful. They can provide emotional support and practical assistance when needed and serve as a sounding board for coping strategies.
  4. Learn healthy coping mechanisms: Exercise, creative expression, and other healthy coping mechanisms can help individuals with ADHD manage their emotions and stress levels. These activities can provide an outlet for pent-up emotions and help individuals feel more in control of their lives.
  5. Educate yourself: Understanding ADHD and RSD can help individuals feel more in control of their symptoms. Reading books, watching videos, and attending support groups can all provide valuable information and resources for managing RSD.



RSD is a significant symptom of ADHD that can have profound effects on individuals' emotional, social, academic, and professional functioning. People with ADHD may benefit from assessment and treatment of RSD to improve their quality of life and treatment outcomes. Recent research in the UK has highlighted the importance of addressing RSD in ADHD diagnosis and treatment plans, and further research in this area is needed to fully understand the nature and impact of RSD on people.

Coping with RSD can be challenging, but seeking therapy, practicing mindfulness, building a support network, learning healthy coping mechanisms, and educating yourself about ADHD and RSD can all be helpful strategies. With the right support and resources, individuals with ADHD can learn to manage their RSD symptoms and lead fulfilling lives.



Dodson, W. (2021). Recognizing and Managing Rejection Sensitive Dysphoria. Attitude Magazine. Retrieved from

Jacobson, L. A., Murphy-Bowman, S. C., Pritchard, A. E., Tart-Zelvin, A., & Zabel, T. A. (2019). The Rejection Sensitivity Index: An evaluation in ADHD adults. Journal of Attention Disorders, 23(1), 55-65.

Mikami, A. Y., & Hinshaw, S. P. (2006). Resilient adolescent adjustment among girls: Buffers of childhood peer rejection and attention-deficit/hyperactivity disorder. Journal of Abnormal Child Psychology, 34(6), 823-837.



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