When even small signs of disapproval feel like a storm in your chest, it can be hard to believe you’re not broken. This guide explores RSD with warmth and clarity — what it is, symptoms and causes, how it overlaps with ADHD, and gentle ways to deal with it day to day.
What is RSD?
Rejection Sensitive Dysphoria describes the intense pain that floods in when we sense rejection, criticism, or disapproval. It often comes on suddenly — a comment, a look, a silence — and the body reacts as though safety has been pulled away.
Imagine sending a message, seeing the “read” check mark, and no reply for hours. For some, that’s mildly annoying. For you, it may feel like your whole chest caves in. That’s RSD in action.
It isn’t weakness or drama. It’s a survival-shaped sensitivity, often rooted in emotional abuse, neglect, or unpredictable caregiving. Your body learned to scan for disconnection because connection wasn’t guaranteed.
Explore the RSD series
Symptoms (quick view)
- Sudden emotional wave after a tiny cue (silence, tone change, “Can we talk?”)
- Body cues: stomach drop, chest tightness, heat flush, shaky hands
- Mind loops: rumination, mind-reading, worst-case stories
- Behavior shifts: over-explaining/fawning or freezing/withdrawing
Full page: RSD Symptoms
Causes (quick view)
- Attachment wobbles: unstable care → scanning for disapproval
- Chronic criticism/perfectionism: mistakes feel like danger
- Sensitivity + conditioning: hypervigilance, fawn/freeze patterns
- ADHD (for some): emotion regulation differences can amplify spikes
Full page: Causes of RSD
RSD & ADHD
Many ADHDers report rejection that feels instant and overwhelming. Not everyone with ADHD has RSD, and many with CPTSD feel RSD without ADHD. The through-line is tenderness: a nervous system that protects connection at high volume.
Read next: RSD + ADHD Symptoms · RSD, ADHD & Women
RSD vs. healthy sensitivity
| Healthy sensitivity | RSD pattern |
|---|---|
| Feedback stings but settles with context. | Feedback lands like a worth verdict; body stays in alarm. |
| Silence is uncomfortable, manageable. | Silence equals rejection; urge to fix or disappear is strong. |
| You can check once and move on. | Checking feels impossible; rumination takes over. |
RSD in relationships
Closeness can feel both longed-for and scary. A safe partner’s silence might still trigger your body to brace for abandonment. Small structure helps: clear signals, short pauses, simple repair lines.
Full page: RSD in Relationships
How to deal with RSD
- In the moment: orient (3 colors), feel your feet, exhale longer (4-in/6-8 out), delay action 2 minutes.
- Language: one steady line beats over-explaining: “I got anxious and went quiet—back now.”
- Prevention: clear agreements, feedback preferences, gentle nervous-system hygiene.
Full page: How to Deal with RSD · Options map: Treatment
RSD self-test (reflective, not diagnostic)
Curious how these patterns show up for you today? Take a gentle self-assessment and get next steps matched to your result band.
Books & resources
Readers often find these supportive:
- Healing the Shame That Binds You — John Bradshaw
- Complex PTSD: From Surviving to Thriving — Pete Walker
- ADHD 2.0 — Edward Hallowell & John Ratey
Body-first practices deepen any reading: Grounding the Nervous System · Co-Regulation
RSD — FAQ
Is RSD an official diagnosis?
No. RSD is a descriptive term, not a formal diagnosis. Still, it names something very real that many people recognize in themselves.
How is RSD different from social anxiety?
Social anxiety is fear of judgment across social situations. RSD is a fast, intense wave tied to rejection or criticism cues. They can overlap but aren’t the same.
Does RSD only occur with ADHD?
No. Many with CPTSD experience RSD without ADHD; others feel it alongside ADHD. Support still centers body tools, skills, and—when relevant—ADHD-aware care.
What helps in the moment?
Orient, lengthen the exhale, delay action, and send one steady line. See How to Deal.
Is there a test for RSD?
There’s no diagnostic test, but you can reflect with our gentle self-assessment here: RSD Test.