Rejection Sensitive Dysphoria: What is it and Could Your ADHD Child Have It?

Being a parent is a rewarding yet challenging journey. When your child is diagnosed with ADHD, it can add another layer of complexity to your role. With increasing awareness of ADHD, it is becoming well-recognised. However, there’s a lesser-known ADHD characteristic called Rejection Sensitive Dysphoria (RSD) that many children with ADHD experience.

Rejection Sensitive Dysphoria is the name given to one of the most common of all ADHD characteristics.

What is Rejection Sensitive Dysphoria (RSD)?

RSD is a relatively recent term that was first coined by American ADHD Expert, Dr William Dodson. According to Dr Dodson, RSD affects 95% of individuals with ADHD.

RSD, although not a diagnosable condition in itself, is a common characteristic of ADHD. It is the overwhelming and ‘unbearable’ feeling someone with ADHD feels when they receive a real or perceived form of rejection, criticism, judgement, or failure.

Think of it as a deep-seated, almost primal instinct to avoid criticism or failure at all costs due to the level of suffering it places on the person experiencing it. RSD turns someone’s world upside down, making them go to great lengths to protect themselves from criticism. It’s not just disliking criticism; it’s an extreme and painful response to it.

In Greek, “dysphoria” means “hard to bear”, and that’s precisely what people with RSD experience. They’ll go to great lengths to avoid criticism or perceived failure, even if it means putting themselves in unsafe situations.

Six Ways People with RSD Naturally Cope

1. PERFECTIONISM: Some people with ADHD will become perfectionists, having to be the best and win at everything to avoid failure.
2. OVERACHIEVEMENT: They may become overachievers, always striving for excellence.
3. PEOPLE-PLEASING: The need to please others as a way of avoiding criticism can be overpowering, making them vulnerable to exploitation. It’s vital to teach them the power of saying “no”.
4. AVOIDANCE: Some may choose not to try something at all, as they may feel that it’s better not to try than to risk trying and failing.
5. DISHONESTY: They might resort to lying to avoid criticism, even about minor things.
6. DEFENSIVENESS: Failing is so painful that they may find it difficult to own their mistakes, as that would mean accepting some kind of failure. This can often lead to defensiveness as a way of trying to push the blame for the failure away from them.

Reducing Rejection Sensitivity Dysphoria 

Unfortunately, there’s no magic cure for RSD, but there are strategies to help you and your child manage it, including:

1. BUILD SELF-ESTEEM: Focus on building your child’s self-esteem. Use growth mindset skills to encourage them to take small knocks in their stride. It’s best to avoid excessive criticism or overly strict parenting, as these approaches are proven to not work effectively for kids with RSD.
2. MEDICATION: Some experts believe that certain non-stimulant ADHD medications, like alpha agonists, may help alleviate RSD. Consult with a paediatrician or psychiatrist to explore this option.

Breaking the Negative Cycle

RSD often traps individuals in a negative cycle of failure and criticism. When a child is criticised, they feel like they have failed. This leads to the pain of Rejection Sensitivity, which will dysregulate them, leading to anger or other negative behaviours that will lead to more criticism and failure, and they will stay locked into this negative cycle often for their entire lives.

The key to breaking free is to focus on creating a positive cycle by helping your child achieve small successes. As much as people with ADHD are unable to bear criticism and failure, they absolutely thrive on success.

So focusing on their successes, even tiny successes, reduces their anxiety, keeps them regulated, and builds their self-esteem, increasing their capacity to achieve more successes.

Feeling good about themselves enables them, slowly over time, to take criticism more constructively and continue to grow positively, which becomes a more positive experience for each child.

While navigating ADHD and RSD can be challenging, remember that your support and understanding as a parent can make a world of difference.

Seek help, implement strategies, and provide a safe, nurturing environment for your child to thrive despite the challenges they face.

Remember, you’re not alone on this journey, and your time, patience, dedication, and love will help your child overcome these hurdles one small step at a time.

What to read next

• Parenting When You Have Adult ADHD – Useful Facts and Coping Strategies
• Expert Shares 8 Tips for Supporting a Child with ADHD
• Could Oppositional Defiant Disorder Be the Cause of Your Child’s Bad Behaviour?

About Rebecca Challoner

As well CEO & Founder of My Spirited Child and the National PEKE Centre, Rebecca Challoner is also a Writer, Presenter and Trainer on diverse needs, learning difficulties and behaviour.

Rebecca has presented at many conferences and events, including The VIC, QLD, WA and NSW ADHD Conferences, the National Education Summit, The Global Potty Talk Summit, Mummycon and countless other Seminars and Conferences both nationally and internationally.

Over the years, Rebecca has done a vast amount of work with neurodivergent children and their families and carers. Working with people around the globe to help improve the lives and futures of neurodivergent individuals.