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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54 Responses

  1. As a blind person, can I please just say that this is a very interesting article. Also, can I just say that this website is incredibly unique. Fully described alt text for images, and the fact the comment box actually uses the words “talk to us”, natural English language, rather than the language of the internet, is actually really refreshing. I’ll be sticking around to learn more about autism and those who are neurodivergent. Now, forgive my ignorance, but is autism neurodivergent, or is that another thing besides the autism? Would being blind be considered neurodivergent? I’m genuinely curious.

    1. Autism is neurodivergent, neurodivergent is not always autism. Neurodivergent is a whole spectrum of conditions, like autism, ADHD and dyspraxia. Someone can be autistic, or dyspraxic, or ADHD, or any combination of those (or other conditions under the neurodivergence umbrella) and be neurodivergent. I hope this helps.

  2. I think I might have RSD and your article was very helpful in helping me feel not so alone..When I was a child there were times I was almost constantly mocked and made fun of and later in junior high even physically attacked. The adults told me I should “just ignore it” and that would “make them go away”. Until I was around 12 I did not have the maturity to “ignore it”. And once I did I went to the opposite extreme in “controlling myself” and put feelings like being hurt behind a wall. I am 63 now and even now thinking about that period is painful.
    Nit sure if what I have is RSD but I do hace a deep fear of rejection..And it helps to read in your article that how we feel is real and valid.

  3. I’d like you to know how helpful this blog was/is in validating my neuro diversity because of CPTSD and like someone else said, ‘putting a name to it’…RSD. It was so serendipitous as well… A coworker sent this to me in regards to a young person we work with. I literally just got an email from my very recent ex…there was no chance of us working out.. I was devestated and rejected all over again. Even though a part of me knows he loves me deeply and holds me in high regard I just can’t help feeling utterly rejected. The physical pain is real. I had been hurting and crying over it when she sent me this link. I saw the title and was confused for a moment, thinking .. how did she know that that just happened?…
    And just yesterday my coworkers were saying how wrong I was in my thinking that I wasn’t good enough etc etc and how much they appreciated me and how much an intregal part of the team I was. I said wow, i must be really hard on myself..
    It is so frustrating to deal with this.. I mean i have come a long way..and reading this article is so validating and supports me to know that it is ok…this is how my brain got wired.
    I was a victim of incest by father from when i was a baby until I was 9 when he completely rejected me. My family was very religious and I was always different in style along with everything else so I got all of it above (from the article, sit up straight, what are you wearing?, stop fiddling, stop crying…etc etc etc)
    I have come such a long way…but it still hurts so much. Really really does. I am looking forward to utilizing my new found validation in how I respond and how my brain works and not feeling like I have to hide it or just get on. My coworkers are amazing and understanding and love me…but somehow I just really want to be validated for my neurodiversity! <3
    Onwords and upwords everyone.
    ANd thank you again <3

  4. Hello! Just barely discovered this concept (yours is the second source I’ve read on the topic), and am feeling a mixture of “Wow, this is totally me and this explains so much” and “OMG, this is totally me and I’m absolutely appalled that this explains so much and now what do I do?” Have also been struggling for about a month with the sudden realization/possibility/fear that I am perhaps also somewhere on the autism spectrum but having absolutely zero confirmation other than positive results on a bunch of internet self-tests (AQ, Aspie, etc). Not sure where to go from here but thinking that this RSD thing is maybe yet another indicator that I am in fact neurodivergent after all… Thank you for writing this!! Changing my view of the world drastically… but learning is a good thing.

  5. Thank you for this. This was deeply, deeply validating and moving. It helped me hold self compassion reading through it for things that are going on right now, triggering my RSD, and I’m beating myself up for.

  6. This is an EXCEPTIONAL piece and perfect timing for me. Thank you so much. I’m going to have re-read it many times. I’m very stuck in RSD recently. I don’t know the right way out.

  7. I would recommend looking for trauma-trained therapists. EMDR can help with this. I’d also say that, even though not all people with RSD are “codependent,” literature on that can be helpful for setting boundaries, stopping the people-pleasing, and learning to love yourself. I’m a work in progress, but those are the therapies I’m currently using.

    1. I feel incredibly inspired by your story and the knowledge you’ve shared here. This article/post helped me, tremendously. Thank you.

  8. April – Thank you so much for sharing this. I have never felt so seen, so understood in my entire life.

    I only learned about RSD recently…and it left me feeling so many things. Shame, anger, sadness. Relief. And a deep abiding doubt that I could ever do anything to change this…thing…that has so fundamentally shaped my being.

    Your writing gives me hope.

  9. Ahhhh internet anonymity, you are my friend here.

    This is quite possibly one of the most helpful things I have ever read. You somehow have described me and my life in a parallel universe where you have already understood yourself, and you are an “April” which I am not.

    I am ADHD (not formally so perhaps disingenuous for me to say so; if so, I am deeply sorry. I tick every box, always have but could not possibly afford the diagnosis) and I deal with exactly what you describe. I have never slept well. I cyclically traverse every negative interaction or rejection every night and it causes the same physical issues with heart rate ,chest tightness and just an all round falling into a black hole. When something “bigger” happens I am all consumed and just so sad. I am up all night, angry and depressed all day.

    I am also a software engineer. I get so hurt in so many ways in the role and constantly sit with imposter syndrome, about to be discovered. This is despite knowing that no one else here can do what I can do. I permanently feel like an outcast in the role. In any given week I will go from feeling like a genius to a moron 10 times over. I have put myself in an incredibly volatile position now as a contractor. the money is crazy really, but I can be fired with zero notice, considered dispensable and my god do I know it. I need the money for the family at the minute but it is difficult living in the situation. I feel like a spoilt brat complaining about their presents; sorry. To add context, I have been on my own since 16, I have worked every hour to get to my position and just trying to get to a point to provide to my family. I do appreciate the insane chances the world has created for me .

    Life is so difficult with it and reading this really gave me some feelings of empowerment or at the least, a connection to something or someone which is lovely.

    I can pinpoint all the different trauma (all of which I bear huge amounts of shame for, some people should have been in prison for… all a big secret forever) that got me here but still not sure how I can get where I want to be. I am very good at projecting myself as something different, it is hard to live in someone else’s shell. Don’t get me wrong, there are so many ways in which I am incredibly happy. I have the most wonderful wife and children and together, when ignoring the rest of the world, we have everything we could ever need with each other.

    I am lucky in my current position I have a couple of work peers who I analyse all the problem interactions. It is not always helpful as sometimes they agree with my rejection analysis but it helps to almost solidify things. They also ground me to prevent my fight response from taking over (although the fight response thus far in my life, has been 90% all talk, and only really to myself).
    One of the things I find hardest is I can step back and think that a feeling is silly, invalid, is not… “normal”, my personal feelings could be considered wildly disproportionate but alas, they are there, the little goblin in my head throwing more coal in the “you’re a piece of **” furnace whilst laughing. I have always told myself that it is anxiety. It is a big secret though as it comes with so many preconceptions for people… which starts the feeling of rejection from the get-go.
    Dealing with rejection is a tough cookie when you are rejecting yourself first.

  10. I really appreciate you taking the time and effort to share this. I’m in the midst of one of those feedback loops today and my wife just happened across your post and shared it with me. We both have ADHD and everybody in our household of seven is ND somehow.

    Reading this piece felt very validating to experiences throughout my life. I’d read about RSD before, but hearing the personal experience of it resonated so much more.

    One thing that I’ve come across over the years that can be helpful is working on self-compassion. The researchers, Dr. Kristin Neff has done a lot of work on the concept and why it’s helpful, but one of the core pieces to it is the experience of “common humanity” , which pushes back on that “other” or set apart feeling that comes with RSD. But the other benefit of self-compassion work is that it centers on SELF compassion and validation that can lessen the people pleasing, potentially codependent behaviors and the reliance on others for feedback to anchor one’s self-concept.

  11. As a therapist, this article was a wonderful first-person explanation of something I believe many of my clients experience. This is a great description of something I have not seen clearly defined elsewhere, the symptoms of which often end up leading to less-than-helpful diagnoses like Borderline Personality or generalized social anxiety. Your clear examples and helpful focus on solutions was wonderful. I sent this on to several clients who felt very “seen” by it. Thank you!

  12. Great article!! I felt so identified! Thank you so much for give us a new understanding for our fears.

  13. Thank you for shining a light and giving a name to something that has haunted me for most of my life

  14. Was having an episode of RSD today, thank you for your post. As I gain more understanding around my Autism I am finding these things I have been dealing with for over 38 years.

  15. I needed this. Thank you so much for taking the risk to share this detailed explanation for all of us that have suffered with no knowledge of the issue. We are healing through your experience.

  16. I am in the middle of an RSD loop and feeling deep pain today. Thank you for helping me not feel so alone.

  17. Good that you wrote this! <3 I'm currently on a mission to find out what is to be done about this, it's the most debilitating aspect of my adhd. I usually muster the courage to go check my assumptions, but it can take far, far too long, especially if I'm a bit low.

    And when I didn't get enough sleep for a long period it got so bad that my relationship died before i got around to face the risk of rejection and conflict associated with bringing up the problems. I just trudged on, getting the kids to school every morning even though i dont become human until about 10 am normally, thereby giving my partner a chance to get into a full time employment … And i became a zombie without noticing it properly. And she stopped loving me. 🙁

    After the separation i soon came back to normal when I got to sleep. But too late. Her love for me was dead. She was as heartbroken as I was. And said that she had loved me so much that she knew how it should feel, and it didn't any more.

    … I'm curious to know if you have tried Intuniv/guanfacin, and if it did something for the RSD symptoms?

  18. This article has articulated to me in a very clear and well written way what I have been experiencing for the last week, I thought it was.. not a thing I suppose, idk, thank you for this

  19. I have never felt more seen. RSD rules my life. Thank you for helping me understand what this thing is. Maybe I can find a way to address it now.

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