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Understanding Rejection Sensitivity Dysphoria (RSD)

What Is Rejection Sensitivity Dysphoria?

Rejection sensitivity dysphoria or RSD is an extreme emotional sensitivity to perceived rejection, criticism, or social failure.

What Causes RSD?

RSD is believed to be linked to neurodivergence and the management of dopamine. For those with RSD, social interactions that trigger perceived rejection or criticism can cause a drop in dopamine, leading to a strong emotional response. RSD is associated with ADHD, anxiety, depression, PTSD, and bipolar disorder.

Some common symptoms of RSD include:

  1. Emotional intensity. Your reactions to rejection, real or perceived, are extreme and long-lasting. Feelings of hurt, anger, and inadequacy consume you.

  2. Withdrawal. To avoid the possibility of rejection, you isolate yourself and pull away from social interaction. You have trouble opening up to others.

  3. Self-blame. You are overly self-critical and blame yourself for any rejection. Your self-worth depends entirely on what others think of you.

  4. Hypersensitivity. You perceive rejection and criticism where there is none. Neutral or ambiguous social interactions are interpreted as rejection. An innocuous comment sends you into a tailspin.

  5. Mood changes. Rejection causes intense emotional pain and mood swings, from sadness to irritability to rage. Your emotional state is unstable and unpredictable.

Causes and Risk Factors for Developing RSD

RSD can develop for several reasons, including:

  • Genetics. Some people may be born with a tendency toward emotional sensitivity and vulnerability to perceived rejection. RSD seems to run in families, so there may be a genetic component.

  • Early experiences. How you were treated as a child, especially by caregivers and authority figures, strongly influences your self-esteem and patterns of thinking about relationships. If you were frequently criticized, neglected, or made to feel like you weren’t good enough, it likely shaped your sensitivity to rejection.

  • Traumatic experiences. Going through an extremely painful rejection, betrayal, or loss can trigger the development of RSD or worsen existing symptoms. The trauma causes you to become hypervigilant about any signs of rejection to try and protect yourself.

  • Cognitive factors. The way you think about yourself, relationships, and the intentions of others has a big impact on RSD. If you tend to perceive ambiguity or mistakes as rejection, catastrophize the meaning of rejection, or blame yourself entirely, it fuels sensitivity to rejection.

  • Poor coping skills. Not having effective strategies for managing distressing emotions and negative thoughts contributes to the severity of RSD symptoms. Things like rumination, avoidance, and impulsivity intensify sensitivity to rejection rather than alleviating it.

For most people RSD develops due to a combination of these risk factors interacting over the course of their lifetime.

Tips for Managing Rejection Sensitivity

Be curious about your self-talk and thoughts

When facing rejection, it's common to have negative thoughts about yourself or the situation. Try to identify negative thoughts and be curious about where they are coming from.

Focus on self-care

Taking good care of yourself will boost your confidence and mood, making you better equipped to handle rejection. Connecting to a strong support system of people who appreciate you can help balance out feelings of rejection.

Start with small risks

Don't avoid rejection altogether. Start by taking small social risks in low-risk situations. For example, smile and make eye contact with a stranger (this is one of my personal favorites because people usually seem surprised by the kind gesture!), give a small compliment to someone, or start a conversation with someone new. Success with small rejections can help build your resilience over time.

Stay flexible in your thinking

Rather than perceiving rejection as a reflection of your self-worth, view it as an isolated incident. Rejection is often due more to the other person and/or circumstances rather than something wrong with you. Try not to take the rejection personally and instead focus on learning from the experience.

Seek professional help if needed

If rejection sensitivity is significantly impacting your life, consider seeing a therapist. A therapist can help you explore the underlying thoughts and behaviors that contribute to your rejection sensitivity. Therapy and support groups are also helpful for building self-esteem and learning coping strategies.


Bedrossian, L. (2021). Understand and address complexities of rejection sensitive dysphoria in students with ADHD. Disability Compliance for Higher Education, 26(10), 4-4.

Dodson, W. (2022). New Insights Into Rejection Sensitive Dysphoria.

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