Living with Rejection Sensitive Dysphoria

*Voicework done by Emmanuel

I have had experiences of Rejection Sensitive Dysphoria (RSD) from an incredibly early age. I believe it’s related to emotional dysregulation, and made worse by negative experiences– from continually not measuring up, from people rejecting the core of my being, and, in a lot of ways, from living as a neurodivergent person in a world not made for people like me.

I was always different growing up. As a child I just didn’t fit in, and found it hard to relate to other kids, and harder to make friends. I was the odd kid from the poor family everyone talked about. I was used to being alone, except for my brother and sister, from an early age.

One of my earliest childhood memories of rejection was a birthday party that I had been invited to by the mother of a classmate. We weren’t friends, and in fact, at the time I had no friends but was excited to be invited to something. My mother and I went to the town shop, and bought a small robot tank you could control and drive around. She helped me wrap the gift and walked me down to the child’s house.

When I got to the party, there was a cubby house out the back. After a somewhat lacklustre reception of my gift (many kids brought more expensive things), they were going to play some games in there.

I followed and was chastised by the child as I tried to enter. I was told I was “strange” and that they didn’t want me in there. This cut deeply, and I broke down and cried, and cried.

The child’s mother told her son off and tried to make me go into the cubby house with the others, but I could not. I can still feel the pain I felt at this, still summon up those feelings of a 5-year-old, rejected.

Flash forward many years later, and I’d been invited to a party by someone from high school, and a very similar thing happened. I’d plucked up the courage to attend the party, and had arrived early.

Later, some of the “cooler” kids had arrived. One of them had noticed me and said to the girl (whose party it was), “What are they doing here?” They were teasing the host about having invited me.

I still hadn’t shaken that strange kid label in high school.

Having overheard, I felt intense rejection again, made worse by hearing the girl say something to the effect of, “I felt sorry for them.” Debilitating hurt shot through me, and when the jock had moved on, I went to leave the party.

The girl and her mother noticed and asked me what was wrong. I felt shame at feeling the way I did, told them I was unwell, and left the party. I sat on the side of the road for a while, gathered myself together, and walked home, slowly.

Image is black with rainbow letters and reads, "what is rejection sensitive dysphoria?"

What is Rejection Sensitive Dysphoria?

Rejection Sensitive Dysphoria, or RSD for short, is a common issue experienced by Neurodivergent (ND) people. It is thought to be caused by increased difficulty in regulating our emotions, which leads to an incredibly heightened experience of rejection.

Put simply, it is an increased sensitivity to rejection (as the name implies), and the rejection does not have to be real. It can be imagined or feared.

RSD can be incredibly intense, and we can feel it to the core of our being as intense physical pain, discomfort, and sensory overwhelm. It can be almost impossible to reign in these sensations when an intense episode is triggered.

For me, it’s chest pain ache and discomfort, and tightness, and not being able to breathe, like a knife has been stuck into my chest. It can come on so rapidly, it can consume me before I can even consciously articulate it.

The snake begins to eat its own tail.

One thing you learn with being Neurodivergent and having RSD, is that often we can recall every intense moment of hurt and rejection like it was yesterday. This aspect can be insidious. If we could forget that hurt, maybe RSD would not be the debilitating issue that it is.

Image description: On a black background in the center of the slide is the rainbow lettered statement "RSD is common in neurodivergence." Centered below those words is a rainbow colored brain. Radiating out from the statement are phrases describing possible sources contributing to RSD:  "Acute memory of past rejection."   "Difficulty reading tone."   "Tired of being underestimated."    "Intense sensory and emotional reactions."   "PTSD"    "Being different means being frequently rejected."

All graphics were created by Kate Jones, autistic illustrator and graphic design artist at Kate Jones Illustration.

If wishes were horses.

Each rejection makes RSD more likely, and re-enforces it. It piles up like the bricks in a wall.

Image #5   Image description: On a black background in rainbow colored letters is the title "RSD is built up over time." Below the title are rows of sketched grey rectangles contain various statements: (light yellow) "What's wrong with you?!" (light pink) "Why are you here?!" (light green) "Toughen up." (light pink) "Are you crazy?!" (light blue) "What are you wearing?!" (light yellow) "Stop embarrassing yourself." (light green) "It's not that loud."  (light yellow) "Stop making noises!" (light pink) "Why are you crying?!" (light blue) "Sit up straight."  (light blue) " a baby."  (light yellow) "That's so childish."  (light green) "That's not even funny" (light blue and cut off by the edge of the page) "That's so... "

With ADHD, I was often chastised for misunderstanding simple instructions, forgetting things, not finishing what we start, doing things the wrong way, not caring enough, being too emotional, not being emotional enough.

I soon ended up carrying so much baggage relating to how I’d been rejected, that it felt like everything I did would result in rejection.

After a time, we often learn to become people pleasers to try counter the rejection– by being more helpful, seeking approval, and saying yes to everything because we are trying to counter balance that teeter-totter of rejection/approval.

Of course, with executive function issues, we are often unable to finish what we start, or adhere to and honor our commitments to others easily for a multitude of reasons.

This can, in turn, lead to more heightened experiences of rejection when those same people question our dedication and for over- promising and under-delivering, yet again.

I became trapped in an insidious feedback loop where I’d take on more tasks to compensate for the ones I’d dropped, and I’d fail to achieve those as well, begetting more experiences of rejection.

I call this the “terrible treadmill,” because it will go faster and faster and faster as you try to assuage your feelings by taking on more and more.

Image features a treadmill in the center with "The insidious treadmill of RSD" as the title. Around it is a cycle that begins with "person with experience of early relational trauma," then "becomes a people-pleaser to counter rejection," then "compressively helpful and always says yes," then "burnout," then "not able to honour commitments," then "more rejection." The cycle then repeats.

In the end, we can layer rejection upon rejection on top of one another, and potentially burnout as we overload ourselves.

RSD becomes a barrier to functioning when every interaction is a potential source of rejection.

We become so fearful of the debilitating physical and emotional toll of rejection that we become extremely risk averse. Everything needs to be analyzed, tone-interrogated (something I’ve always struggled with), and we actively look for rejection in situations, people, and their actions.

I would send an email, and if I didn’t get a prompt response, I’d start thinking that I had somehow upset the recipient. Maybe I would get a response to a question, but it would seem abrupt. An “OK” in response to my question in an email could trigger my RSD because it lacked sufficient context to prove it wasn’t rejection.

Also, often I’d become so concerned about not causing offense with an email, I might spend 2 hours writing it, redrafting it again and again, until I could not find any way to be offended by it.

Even then I might not send it because I feared I had missed something.

As a software developer, peer code reviews became a terrifying experience where I was just waiting to be told how incompetent I was. Daily standups, already an intense form of social anxiety, became something to avoid at all costs– just in case there was criticism. I found ways to avoid these things because of fear of rejection.

However, RSD thrives in an information vacuum, in us not knowing what others think about us, our work, and our place in the world.

Image reads: RSD thrives in an information vacuum. Under, it has three columns: what ifs-- what if I'm getting fired? What if my proposal is trash? Maybes-- maybe I should just quit. Maybe they are laughing at me. And possibilities-- could they be ignoring me? Do they think I'm not qualified?

The more we know about how we are perceived, the clearer things are, the less control it has.

By avoiding feedback, I was actually compounding the RSD, because the longer things went on without feedback, without knowing that I was doing a good (or bad) job, the more fearful of soliciting that feedback I became.

I denied myself the opportunity to course correct, to take on constructive feedback, and eventually, I had to deliver my changes, and due to inattentiveness, they were wrong.

This triggered recriminations from my co-workers, which in turn triggered a massive bout of RSD, and it hurt incredibly.

I may as well finish this story.

My issues with RSD, and not soliciting feedback, and making mistakes ended up with me being sent a meeting request with no context, with my manager, and a representative of HR for the following Monday morning at 9:00am.

This email was sent at 5pm Friday. I did not sleep, bar a few hours, during the time. For the whole weekend, I had a knot in my chest. I cleaned off my work laptop because I was convinced I was going to be fired.

In the meeting that Monday, I broke down sobbing hysterically for close to 30 mins. I broke down completely emotionally, and my boss and HR were shocked.

Yes, there were issues with my performance, and yes, they wanted me to go onto a Performance Improvement Plan (PIP). But they didn’t want to fire me. I told them I hadn’t slept because of the meeting invite with no context sent on the Friday night. My boss was shocked, and said, “We did that to minimize your worry.”

I did not understand I was neurodivergent at the time, but understood my issues around not having enough information. I cried and said, “It was the worst possible thing you could have done.”

In an odd way, it can feel like the RSD is trying to protect us, and therein is a lie. By causing us to disengage, and avoid sources of rejection, RSD forces us to other ourselves without a real reason, which makes us feel more isolated, then more rejected in-turn. Othering ourselves to avoid possible rejection still builds up that same wall of negative experience and shame.

Living with RSD

Important things first.

Please don’t let anyone tell you that experiencing RSD is wrong is wrong or invalid. It’s real, what you are feeling in terms of the physical and emotion experience is real, and it is valid. We shouldn’t feel shame for the way we experience emotions, or the way that our brains are wired.

RSD can trigger our fight-or-flight responses, often making us feel like we need immediate distance from the source of the feelings. During an RSD event, it’s the worst possible time to take definitive actions about something. You may want to leave a group, quit your job, or sever ties with the person in question.

Our brains and nervous system scream at us to do something, anything to end the feeling, or reduce the risk of it. The best thing we can do in the short term is to find a temporary retreat, somewhere calm, and wait for the intense feelings to pass. Decisions made in the heat of the moment can cause regret and further feelings of isolation.

Someone said to me in a conversation about OCD (a topic for another day), that not all thoughts are true, and we need to understand that.

The same is absolutely true of RSD. To me, when I’m caught up in it, it can feel very much like rumination, constantly turning over a negative thought in my head, over and over, reinforcing it with every loop. It can pull in other thoughts, and soon it feels like a spiral of negative thought.

Image has text that spirals and reads, "Why aren't they calling me back? Was it something I said? Do they take this long to respond to everyone? Why was I not named in that list? Why didn't they tag me in that post? Do they not want to be associated with me? Have they worked out that I'm a fraud? OMG, has everyone?!

I’ve found, as I mentioned before, that my RSD thrives in the absence of information to contradict it. That information void, or abyss is where it dwells, in the what-ifs, the maybes, the possibilities, the bigger we make that space in our lives the more it can thrive.

If we have some way to express the why of what we are feeling, it can be good to get it out and articulate it. This might be talking to a friend, or journaling or some other process. Get the thought and the why outside your mind somehow. Bring it out so that you can see it in daylight, instead of just feeling it.

Socially-Triggered RSD

If you fear you’ve upset someone, sometimes the only thing we can do is to ask them. Because worst case scenario, you have upset them (where you feel you are now), and best case scenario is that it was imagined, or a misunderstanding.

This can be hard, because we still need to handle the possibility that we are right, but at least we know, and it becomes a fact. It may offer an opportunity to clear the air and stop the what-if feelings that plague us.

If someone else has done something to trigger your rejection sensitivity, it can be difficult to decide whether or not to approach them over it so that you can clear the air between you.

If that person doesn’t understand Rejection Sensitivity, they will likely not understand how we could be so upset over what they might consider a seemingly innocuous action.

Sometimes I can feel very left out and rejected when people name others around me in my peer group, but don’t name me. The feelings of being “other” surface and the RSD swells in my chest.

Socially-related RSD can be very hard to deal with because we seemingly have the choice of staying quiet about it or engaging with the other parties involved to try and resolve it.

Trying to resolve the issue with another party always feels risky to me because I might open myself up to further rejection. Staying quiet may also mean we disengage with that person for fear of another event proving the RSD correct.

Work environment (self)

It’s hard, but after my own experiences, I recommend to solicit feedback regularly. It’s a lot better to find out something needs to change earlier. Checking in can help to avoid a large rejection trigger later.

If you are worried about the tone of a communication, maybe run either actual communication or the broad gist of it past another person (this can be hard in some workplaces or when working in isolation).

I’m aware there’s a balance here between under communication and over communication.

Work environment (leadership)

To any bosses out there,

As my boss, you can help me by keeping a steady channel of feedback open to me. Not just the negative feedback or when things aren’t correct, but positive feedback as well. We need to unlearn the idea that soliciting feedback is an entirely negative experience.

It’s absolutely critical to me that I hear if you are happy with my work, and if you are not, give me opportunities to course correct.

Never make meeting invites ambiguous. Never send an invite saying “catch up,” with no context. This, as discussed above, was a massive RSD trigger for me. Even if I’m doing well and performing my job, I’m probably thinking you are going to fire me — I don’t have evidence to the contrary.


We need to interrogate our thoughts and realize that not all thoughts are true. We need not to live in the maybes, because uncertainty is where RSD lives.

We need to accept that we are going to experience RSD, and it’s not wrong to feel what we feel. Our brains are wired differently, that’s all. We should not be ashamed of that.

Of course, there are times when people truly reject us, and those are the hardest times of all.

I’m feeling an incredible amount of RSD about how this article may be received.

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86 Responses

  1. This was really good to read. I was only recently diagnosed with ADHD (combined type) by a neuropsychologist. I have been self diagnosed for a year with RSD and treating it with Clonidine that I easily obtained through teledoc (life changing). This is the most detailed account of RSD I have ever seen. Thank you for publishing this well written account. I think this helps people by validation.

  2. I have to say I experience RSD differently. I am super sensitive to the tone of communication and for me being told there were issues with my performance would be a HUGE trigger in and of itself. I need people to always tell me what they want instead of what they don’t want and allow me the options so I feel in control. As an autistic person I strictly control my environment which helps me control my emotions. For example: my if my bf said “don’t text me before 9am. U need to stop.” That would make me want to cry my eyes out. But when he said, “hey sweetie,… can u message after 9 please because I’m sleeping till then and I want to be able to not still be half asleep when I’m talking with you, princess , okay?” That’s no problem. Not triggering to me at all.

  3. I really appreciated your insights – I thought the tie in the criticism received as a child was spot on, I feel like that’s the reasoning behind my rejection sensitivity dysphoria

  4. My daughter has rsd, and she’s super sensitive to anything she sees as rejection… if you don’t answer her immediately, or phrase you response wrong (I have no tact unfortunately), she gets super upset and takes it not just as a rejection, but that you hate her… I’m absolutely sending this to her to read!

  5. TFMW you read a version of your childhood with only a few details changed and realize that the term you’d been half-jokingly using is actually 100% correct.

    Thank you.

  6. An acquaintance posted your article on Facebook.
    I didn’t know anything about this.
    Thank you for sharing your life in a clear and understandable way.
    This absolutely fits someone I know that has trauma/ADD. Now they can talk about this with their counselor.

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