Rejection Sensitive Dysphoria: Causes, Signs & Treatment

Making a relationship work out is usually at the core of both partner’s intentions when you are in a healthy relationship. The journey is even more delightful when couples know how to deal with issues around their partner’s rejecting or accepting behaviors. 

However, rejection-sensitive dysphoria (RSD) exists in many relationships and people may not know how to survive or thrive with this condition. 

So, what is RSD? What are its causes and symptoms, and how can you manage them in your relationship? Let’s answer these one by one in this guide.

What is rejection sensitive dysphoria?

Rejection sensitive dysphoria is generally viewed as an extreme emotional conflict that a person may experience in response to an actual or perceived rejection. It is the same for the rejection syndrome definition and is often triggered by the perception that an important person is rejecting one in one’s life. 

It is the fear an individual exhibits when faced with the possibility of disappointment, disagreement, or criticism, even when they’re constructive and genuine. 

In other words, an overwhelming condition propels the feeling of falling short of approval. 

Individuals with rejection sensitive dysphoria constantly anticipate being rejected by people. Hence, as a defense mechanism, they may reject people long before these people get the chance to reject them. 

What causes rejection sensitive dysphoria?

There are several causes of rejection sensitive dysphoria. Majorly, they include negative remarks, harsh treatment, constant disapproval, intense criticism, and lack of attention. Let us look at them one after another:

• Negative remarks

Usually, individuals with RSD disorder have previously gotten negative remarks in many instances of their lives. These remarks are often passed off as mere comments on how they dress or eat, their posture while standing or the way they do things, the degree of their laughter, or even how they look. 

From the perspective of their critics, it’s just a mere comment, but it doesn’t end as that for someone with RSD. They’d probably think about those comments countless times and see them as signs of potential rejection.

• Harsh treatment

Harsh treatments from important people like siblings, friends, family members, and colleagues are also significant causes of RSD. 

People with rejection sensitivity may have experienced being hit or slapped by a guardian or elder sibling, betrayal from friends, bullying from schoolmates, getting their stuff thrown out during an argument with their colleagues, spouses, or family members, and what-have-you.

These treatments instill a sense of low esteem and a feeling of not being important.

• Constant disapproval

People disapprove for numerous reasons. This might probably be by not getting a job done properly or failing to get an idea correctly among colleagues, not being able to do homework, or failing in class. 

People with RSD probably got different shades of these kinds of disapproval previously. And the severity of their current symptoms may depend on how often they got disapproved and the people from whom these disapprovals came.

• Intensive criticism

Like sensitive to criticism disorder or avoidant personality disorder, being criticized intensively could lead to rejection sensitive dysphoria, especially when this criticism comes from loved ones or those in places of authority. 

It triggers the feeling of not being good enough or not being able to please people, no matter how hard one tries. 

The human mind often gets self-satisfied when people seem pleased by their actions and conduct, which enhances their self-confidence. Sadly, the exact opposite could be the case for people who get criticized too often, hence the feeling of rejection.

• Lack of attention

Being social beings, no matter how introverted we are, an extreme lack of attention is enough to trigger feelings of rejection. As kids, many people may have been sent back into their rooms whenever they tried to have fun with friends and siblings. 

Some are not listened to when they try to say something. These things affect the kids’ feelings for longer periods than expected and eventually lead to rejection sensitive dysphoria in some cases.

Talking of these, the causes of RSD could be traced back to childhood, especially for children with attention deficit hyperactivity disorder (ADHD). This chronic condition includes attention difficulty, hyperactivity, and impulsiveness. 

Children with ADHD may struggle to regulate impulsive behaviors (i.e., acting without considering the consequences) or be extremely active. They may also have problems paying attention. 

Likewise, often starting in childhood, ADHD can last throughout adulthood. It could be a factor in low self-esteem, problematic relationships, and challenges at a job or school. Because of this, it can be common to see the occurrence of rejection sensitive dysphoria with ADHD.

Nevertheless, rejection sensitive dysphoria without ADHD is not uncommon. That is to say, although RSD is common in persons who have or have had ADHD, others with no history of ADHD can also have RSD. 

These messages could sound like this:

“You’re so lazy!”

“Why don’t you ever listen?”

“Why can’t you ever remember anything?”

“You lost something else again?”

“Sit down and keep quiet!”

“If you must say something, wait until others are done talking.”

“Pay attention!”

“You’ve always got excuses.”

Now, how does it feel listening to these remarks? Nevertheless, this is not to overlook children’s unethical behaviors at times. Of course, they should be corrected but less negatively and critically.

9 signs of rejection sensitive dysphoria

There are certain signs we could notice by observing people exhibiting RSD behaviors. 

However, figuring out if these signs are pointing toward rejection sensitive dysphoria could be complex, especially as the signs displayed may be signs of other mental health conditions like borderline personality disorder (BPD), post-traumatic stress disorder (PTSD), bipolar disorder, or obsessive-compulsive disorder (OCD). 

Nevertheless, here are 9 signs of rejection sensitive disorder to look out for:

1. Emotional outburst

Rejection sensitive dysphoria in relationships can manifest as emotional outburst.

Imagine feeling emotions so intensely that a small criticism feels like a massive wave crashing down on you. This is what emotional outbursts in RSD can look like. People might cry, shout, or have intense reactions because the emotional pain from even the thought of rejection is overwhelming.

2. Schizoid personality

The patient isolates themselves habitually from social settings and withdraws from other people for fear of being criticized. They’re not antisocial but protect themselves by avoiding situations where they feel vulnerable to judgment.

3. Defensiveness

They tend to appear defensive in small conversations because that’s how they can vindicate themselves from blame. Individuals with RSD might quickly jump to their defense over minor comments or questions because they’re preparing to ward off perceived criticism or rejection.

4. Impatience

They’re usually not patient enough to confirm their assumptions before they react to them. It’s a reaction to the internal stress of anticipating rejection, leading to swift, often premature responses to situations.

5. Imitation

They easily imitate people who probably seem liked by everyone. This is because they desire to be accepted like those people, hence the practice of acting like them. Individuals might mimic those they see as popular or liked, hoping to receive the same acceptance and avoid rejection.

6. Timidity

They are usually overly conservative and like to keep their opinions to themselves. This is because they assume no one would listen to them, so their opinions barely matter. Their silence is a protective measure against the pain of being rejected.

7. Laziness

They exhibit lazy attitudes because they have already get defeated by their assumptions of not being good enough. So they do not even try. It’s a defense mechanism against the anticipated pain of not being good enough.

8. Hasty dissension

They take light disagreement very personally because they hardly engage in arguments without feeling attacked. So any disagreement could mean a sign of rejection to them. They’re more sensitive to conflict, interpreting it as a direct rejection of who they are, which can make any form of disagreement intensely distressing.

9. Giving up easily

They lack a persistent spirit. They find it hard to hold on to friendships and relationships because of the illusion of being rejected. This illusion makes them give up quickly. 

The thought of being rejected is so daunting that it’s easier to withdraw early from relationships or goals rather than face potential failure or disapproval.

How do you treat rejection sensitive dysphoria: 7 useful options

The next aspect to consider is how to help a partner with RSD. Once you’ve completed doing a proper RSD test or rejection sensitive dysphoria diagnosis, yoiu need to seek a suitable rejection sensitive dysphoria treatment.

Here’s a tip, people with rejection sensitive dysphoria are more likely to cope with absolutely compassionate and understanding partners.

Apart from helping to regulate your partner’s behavior by your kind approach to symptoms they experience from rejection sensitive dysphoria, there are also other ways to treat RSD, especially if you are the patient. We’ll look at them below.

Although RSD psychology is not as of now diagnosed under the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which explains why it is difficult to deal with it medically, there are yet few medications for rejection sensitive dysphoria that help suppress the underlying symptoms which may be prescribed.

Here are seven useful options in simple and relatable terms:

1. Therapy

Just like talking to a friend can make a problem seem smaller, therapy provides a safe space to explore your feelings with a professional. 

Cognitive Behavioral Therapy (CBT), in particular, helps you challenge and change the negative thought patterns that contribute to RSD, teaching you how to react more positively to situations that might trigger an emotional response.

2. Medication

Sometimes, our brains need a little help to balance the chemicals that influence our mood and reactions. Medications, especially if you have ADHD as well, can help manage those intense emotions. 

It’s a bit like wearing glasses to see more clearly; medication can help your brain process reactions to rejection in a healthier way.

3. Education

Understanding RSD is like having a map in an unfamiliar city. The more you know about what causes your feelings and how common they are, especially in connection with ADHD, the less daunting they seem. This knowledge empowers you to navigate your emotions and reactions better.

4. Mindfulness and relaxation techniques

Imagine your mind is like a busy highway. Mindfulness helps slow down the traffic, allowing you to handle thoughts and emotions without getting overwhelmed. Techniques like deep breathing, meditation, or yoga can calm the storm of emotions associated with RSD.

5. Support groups

Joining a support group is like being part of a team where everyone understands what it’s like to play in your position. Sharing experiences and coping strategies with others who have RSD can provide comfort, reduce feelings of isolation, and offer practical advice on managing day-to-day challenges.

6. Lifestyle changes

Small tweaks in your daily routine can have a big impact on how you feel. Regular exercise, a healthy diet, and enough sleep can boost your mood and energy levels, making you better equipped to deal with stress and emotional discomfort. Think of it as fortifying your emotional armor.

7. Setting realistic goals

Sometimes, we set the bar so high that it’s almost impossible not to feel let down. By setting achievable, realistic goals, you’re less likely to encounter situations that trigger feelings of rejection or failure. It’s about knowing your limits and working within them to gradually build confidence and resilience.

In addition to above above-discussed points, Licensed Professional Counselor Jason Cerro shares 3 effective strategies to manage rejection sensitive dysphoria. Watch here:

FAQs 

Rejection Sensitive Dysphoria (RSD) is a complex emotional response that can be difficult to navigate. These FAQs aim to shed light on RSD in a straightforward and relatable manner, helping you better understand and manage its effects.

• What does rejection sensitive dysphoria look like?

Imagine feeling an everyday critique like a massive storm hitting you out of nowhere. For someone with RSD, a minor rejection or criticism can trigger overwhelming emotions such as intense sadness, anger, or anxiety, making small setbacks feel like huge defeats.

• How is rejection sensitive dysphoria linked with ADHD?

RSD and ADHD often travel together like unwelcome companions on a journey. ADHD can make it hard to regulate emotions, so when rejection comes knocking, the response is often bigger and more intense than usual, leading to the heightened emotional turmoil seen in RSD.

• Is rejection sensitive dysphoria a trauma response?

RSD can feel a lot like a reaction to trauma because it involves intense emotional pain. However, it’s not solely a trauma response. It’s more about how your brain is wired to perceive and overreact to rejection, whether or not trauma is present.

• How long does rejection dysphoria last?

The storm of RSD can pass as quickly as it arrives or linger like unwelcome rain clouds. The duration varies widely among individuals—some shake it off quickly, while for others, the feelings can last until a new situation or understanding helps ease the pain.

• How can you manage rejection sensitivity in romantic relationships?

Think of managing RSD in relationships as building a bridge of understanding. Communicate openly about your feelings, set healthy boundaries, and practice self-compassion. Remember, it’s okay to ask for reassurance and work together with your partner to navigate these emotional waves.

Getting rid of rejection withdrawal

Living with rejection sensitive dysphoria or being in a romantic relationship with a partner is not an issue to be overly worried about. 

Logically, a relationship with such a partner is even more likely to last longer, especially when you can help them through the various treatment stages as a partner to a patient. Or when you, as a patient, know how to manage it and communicate with your partner.

Trust is built in the process, and your partner’s ability to be more understanding and observant is strengthened. These are vital components of successful relationships. 

Therefore, seeing your counselor as a couple or individually and engaging in stress-relieving activities together are effective tips. And ultimately, be patient through the entire process, as this journey to nip rejection sensitive dysphoria in the bud will not come overnight.