Rejection Sensitivity in ADHD: More than Just Sensitivity

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ADHD and rejection sensitivity often go hand in hand. It's a topic that affects not only those with ADHD but also those around them. Discover here what rejection sensitivity is, why it often coexists with ADHD, and what we can do about it.

What is rejection sensitivity (RSD: Rejection Sensitivity Dysphoria)?

Most people don't like rejection. Whether it's in a romantic relationship, a friendship, or at work, it's common to experience negative, unpleasant feelings. This can range from confusion and sadness to anger. But usually, you can get your emotions under control fairly quickly. This isn't the case for someone who experiences rejection sensitivity.

An extreme (emotional) response to the perception of rejection

Rejection sensitivity refers to an individual's tendency to strongly react to signals or experiences indicating rejection, criticism, or lack of acceptance by others. It doesn't matter whether the rejection is ‘real' or imagined.

This leads to feelings of anxiety, insecurity, and pain when you feel you're not being accepted or valued by others. People sensitive to rejection may even interpret minor hints of rejection as evidence that they're not good enough or not appreciated.

RSD: Rejection Sensitivity Dysphoria

The official English term for rejection sensitivity is “rejection sensitivity dysphoria,” abbreviated as “RSD.” This concept is often used in psychology and psychiatry to describe and measure the level of sensitivity to rejection in individuals.

Is rejection sensitivity a diagnosis?

RSD doesn't have officially established symptoms and is not a formal medical diagnosis. However, doctors and therapists often use the term when they notice exaggerated reactions associated with an official behavioral disorder such as ADHD.

Causes of rejection sensitivity

The causes of rejection sensitivity are diverse and can be complex. People who have been repeatedly rejected or traumatized in their youth are at greater risk of developing increased sensitivity to rejection. Genetic predisposition, negative self-image, insecure attachment, and perfectionism can also contribute to feelings of rejection. Additionally, cultural and social influences play a role in how rejection is experienced and processed. It's essential to understand that rejection sensitivity is often the result of a combination of these factors, and individual experiences may vary.

Extra sensitive?

Difficult childhood experiences and early negative experiences can have a deeper impact on all of us. But especially if you're sensitive (for example, if you have ADHD or HSP), such an experience can have an even deeper impact. This is because we process things more deeply, have high self-awareness, and often take others very seriously. In general, people who don't have HSP or ADHD, for example, can more easily deal with negative experiences.

ADHD rejection sensitivity dysphoria

How does RSD feel?

Rejection sensitivity can evoke various feelings depending on the situation and individual characteristics. Here are some common feelings people may experience:

  • Anxiety: You may feel anxious in social situations, afraid of being rejected or criticized by others.
  • Uncertainty: There may be a constant underlying feeling of uncertainty about your own worth and acceptance by others.
  • Pain: Rejection can be painful, both emotionally and sometimes even physically, and can leave deep wounds that are difficult to heal.
  • Self-doubt: You may begin to doubt yourself and your ability to build relationships or be successful in social situations.
  • Sadness: The constant fear of rejection can lead to feelings of sadness or depression, especially if rejection is a recurring theme in your life.
  • Anger or frustration: Some people may feel anger or frustration towards others they see as the cause of their rejection, or towards themselves for experiencing these feelings.
  • Self-isolation: To avoid the pain of rejection, you may withdraw and isolate yourself from others, which can lead to loneliness and further negative feelings.

In short, rejection sensitivity can cause a wide range of emotional responses, ranging from anxiety and uncertainty to sadness and anger. These feelings can deeply impact your well-being and quality of life, and it's important to seek support if you're struggling with this.

RSD rejection sensitivity dysphoria

Examples of situations where rejection sensitivity comes into play

You may be unsure if you suffer from rejection sensitivity. Here are two examples of how rejection sensitivity can manifest in your life.

Example 1: Rejection sensitive in a job interview Imagine you have a job interview for your dream job. As you have the conversation, you notice yourself getting increasingly nervous as the questions become more intense. When the interviewer asks some critical questions about your work experience, you start doubting your own abilities and feel a knot in your stomach. You interpret the questions as signs of rejection and begin to imagine not getting the job. Even after the interview is over, you continue to dwell on what was said and feel insecure and anxious.

Example 2: Rejection sensitivity in friendship You receive an invitation from a friend to attend a party. Although you'd love to go and spend time with your friends, you feel a nagging sense of anxiety. You begin to wonder if you'll be welcome at the party and if your friends really like you. Even if you know you've been asked to come, you can't stop thinking about possible scenarios in which you'll be rejected or excluded. Eventually, you decide to stay home because you can't overcome the fear of rejection, even though you know it's irrational.

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As an ADHDer, you might have extra trouble with rejection sensitivity

As mentioned earlier, if you have ADHD, you might be more prone to rejection sensitivity. According to Psychology Magazine, HSPs also often suffer from rejection sensitivity. This has several reasons.

These are important reasons why someone with ADHD or highly sensitive persons can quickly suffer from rejection sensitivity:

  • Neurological differences: The neurological differences underlying ADHD can also affect how an individual processes social signals. People with ADHD, for example, may have difficulty filtering information and interpreting non-verbal signals. This makes us more sensitive to potential rejection.
  • Impulsivity and emotional regulation: People with ADHD may have difficulty regulating emotions and impulses. As a result, we may react more quickly and strongly to situations implying rejection. For example, we may impulsively react to criticism or rejection without first thinking about the situation. This can lead to increased feelings of rejection.
  • Repeated negative experiences: Many people with ADHD have had negative experiences in the past, such as rejection at school, work, or in social situations, because of symptoms like impulsivity, hyperactivity, or forgetfulness. These repeated experiences of rejection can lead to increased sensitivity to rejection in the future.
  • Self-image and self-confidence: People with ADHD may have lower self-esteem due to the challenges they face. Lower self-esteem can make us more sensitive to criticism and rejection because we already feel insecure about ourselves and our abilities.
  • Need for social approval: Like everyone else, people with ADHD have a need for social approval and acceptance. When we feel rejected, it can trigger a strong emotional response due to the important role social relationships play in our lives.

In short, the combination of neurological differences, impulsivity, repeated negative experiences, self-image, and the need for social approval can contribute to the higher prevalence of rejection sensitivity in people with ADHD. It's important to take these feelings seriously and provide appropriate support to help people with ADHD cope with rejection sensitivity.

Research on ADHD and Rejection Sensitivity (in the Brain)

Scientific evidence about who develops RSD and how it's linked to ADHD is still limited. That's because measuring rejection is difficult. However, Eugene Arnold, MD, a psychiatrist and behavioral health specialist at Ohio State University, believes that people with ADHD are more likely to exhibit symptoms of RSD due to differences in brain structure.

For individuals with ADHD, the frontal lobe of the brain, which controls attention, language, social skills, impulse control, judgment, and problem-solving, works somewhat differently. This may lead to missing certain social cues or details, or not cooperating well in a team. You might also interpret ambiguous conversations as a form of rejection, teasing, or criticism.

This can evoke overwhelming feelings of confusion, failure, betrayal, pain, and sadness. And you might find it challenging to regulate your emotions and get them under control as quickly as others without ADHD. Mental health conditions and mood disorders may also be linked to RSD. However, experts need to conduct more research on RSD to better understand it (Source: WebMD).

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Gabor Maté, author of ‘Scattered Minds' on Rejection Sensitivity

Dr. Gabor Maté is a renowned expert in the field of ADHD and trauma. This Canadian physician has shared insights about rejection sensitivity in ADHD. In his work, he emphasizes the relationship between ADHD and early experiences of rejection, stress, and trauma. Maté suggests that individuals with ADHD are often more sensitive to rejection due to their unique neurological and psychological makeup. He points out that early experiences of rejection or trauma can influence the development of ADHD symptoms, thereby reinforcing sensitivity to rejection later in life. This he discusses among others in his popular book: Scattered Minds.

Maté also underscores the importance of a holistic approach in treating ADHD. This approach should not only address the symptoms but also the underlying causes, including rejection sensitivity and trauma. He advocates for empathetic and supportive approaches that take into account the emotional needs of individuals with ADHD, including dealing with rejection sensitivity.

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The Consequences of Rejection Sensitivity in ADHD

Suffering from rejection sensitivity is not only very distressing, but it can also have serious consequences. Individuals with ADHD often experience a more intense sense of rejection than others. This can undermine our confidence and self-image. For example, we may feel excluded in social situations or believe that others don't appreciate us because of our symptoms, such as impulsivity or forgetfulness. These feelings can lead to anxiety, depression, and even social isolation.

Negative Consequences The primary negative consequences of rejection sensitivity in ADHD are:

  • Increased stress and anxiety: Rejection sensitivity can lead to ongoing stress and anxiety in individuals with ADHD. This is because we are constantly concerned about rejection and criticism from others.
  • Diminished self-confidence: Constant exposure to rejection can undermine the self-confidence of individuals with ADHD. This can lead us to undervalue ourselves and doubt our capabilities.
  • Social isolation: Individuals with ADHD may withdraw from social situations to avoid the pain of rejection. This can result in isolation and loneliness.
  • Depression: Rejection sensitivity can contribute to the onset of depression in individuals with ADHD. This is because we may feel powerless and hopeless about our ability to be accepted by others.
  • Interpersonal conflicts: The fear of rejection can lead to interpersonal conflicts and difficulties in forming and maintaining relationships. This is because our ADHD may make us defensive or withdrawn in response to perceived rejection.
  • Perfectionism: Some individuals with ADHD may develop perfectionistic tendencies as a way to avoid rejection. This can lead to excessive stress and frustration.
  • Limiting life opportunities: Rejection sensitivity can prevent individuals with ADHD from embracing new opportunities or taking risks. This may cause us to miss out on valuable opportunities in our personal and professional lives.

In summary, rejection sensitivity can have a wide range of negative consequences for individuals with ADHD, affecting our overall well-being and quality of life.

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How to Deal with Rejection Sensitivity in ADHD?

It is essential for individuals with ADHD and our loved ones to develop strategies for coping with rejection sensitivity. This may include learning to recognize and reframe negative thoughts and building self-compassion. Additionally, actively seeking supportive social networks can help.

Here are some valuable tips that can assist in coping with rejection sensitivity:

  • Awareness: It is important to become aware of your rejection sensitivity and the situations that trigger these feelings. By developing awareness, you can begin to understand why you have certain reactions and how to deal with them.
  • Self-compassion: Learn to be kind and understanding to yourself, especially when experiencing feelings of rejection. Self-compassion can help soften negative thoughts and feelings and accept yourself as you are.
  • Assertiveness training: Developing assertiveness can help you stand up for yourself in a healthy way and set boundaries in relationships. This can enable you to better handle situations where you feel rejected.
  • Seek support: Talk to friends, family members, or a therapist about your feelings of rejection. Sharing your experiences and emotions with others can provide a sense of connection and support. You can also do this in our community.
  • Change perspective: Try adopting a different perspective on rejection and criticism. Realize that rejection is not always personal and often says more about the other person than about you.
  • Practice self-care: Take time to care for yourself and engage in activities that bring you relaxation and joy. Self-care can help increase your resilience and better enable you to cope with rejection sensitivity.

By applying these tips and actively working to strengthen your emotional resilience, you can learn to better cope with rejection sensitivity and develop a healthier sense of self-worth.

Therapy, coaching and community

Professional guidance and therapy can also provide valuable tools for learning to cope with rejection sensitivity. Do you have ADHD and want to talk to a trainer/coach who specializes in ADHD? Find someone that you feel you can trust. What also helps, is being part of an online or offline community, where you can talk to other people who have similar struggles. Don't do it alone!

In Conclusion

Rejection sensitivity in ADHD is an important aspect of the condition that is often overlooked. By better understanding this phenomenon, we can create a more inclusive and supportive environment for individuals with ADHD. Recognizing the impact of rejection sensitivity on the daily lives of individuals with ADHD is a crucial step. This ensures better understanding and more effective support for those living with this condition.


  • WebMD
  • Barkley, Russell A. Taking Charge of ADHD: The Complete, Authoritative Guide for Parents. The Guilford Press, 2013.
  • Hallowell, Edward M., and John J. Ratey. Driven to Distraction (Revised): Recognizing and Coping with Attention Deficit Disorder. Anchor, 2011.
  • Nigg, Joel T. What Causes ADHD?: Understanding What Goes Wrong and Why. The Guilford Press, 2006.
  • Gabor Maté, Scattered Minds.
  • Maté, Gabor. In the Realm of Hungry Ghosts: Close Encounters with Addiction. Knopf Canada, 2008.

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